CITY OF SPRINGFIELD, MISSOURI
TEMPORARY BUSINESS/OCCUPATIONAL LICENSE APPLICATION
This application is for new, temporary businesses only.
You may submit the application online or mail it to:
City of Springfield, License Division, PO Box 8368, Springfield MO 65801-8368
Contact us: 417-864-1617
A. BUSINESS INFORMATION
Business Name: __________________________________________________________ Business Phone: ___________________________
Mailing Address: ____________________________________________________________________________________________________
Where will your business activity occur in Springfield? ______________________________________________________________________
Where will you be staying while in Springfield?
________________________________________________________________
What period of time will you be operating in Springfield? ____________________________________________________________________
What type of business activity will you be engaging in while in Springfield? List types of good or services to be offered.
B. OWNERSHIP TYPE
(Check the appropriate box): 1.Sole Proprietor 2.Partnership 3.Limited Partnership 4.Limited Liability Company
5.Corporation: _________________________________________________ ____________________________________________ _______________
Corporation/LLC Name Corporation/LLC Address Corporation/LLC Phone
C. OWNERSHIP INFORMATION: If ownership is sole proprietor, complete line 1 including home adders and home phone. If a partnership or a limited partnership, list all
partners, their home addresses and home phones. If a corporation or limited liability company, list principal officers or members, their home addresses, home phones, and driver’s
license numbers. Attach an additional page if needed.
1._____________________________________________________ _______________________________________________ _______________________
Name & Title Home Phone Home Address
2._____________________________________________________ _______________________________________________ _______________________
Name & Title Home Phone Home Address
3._____________________________________________________ _______________________________________________ _______________________
Name & Title Home Phone Home Address
D. MISSOURI RETAIL SALES TAX NUMBER: You must provide a copy of your Missouri Retail Sales Tax License Coded for Springfield or
a copy of an exemption letter stating that a sales tax license is not required. You should contact the Missouri Department of Revenue at
(573) 751-3505 concerning obtaining a sales tax license or exemption letter. If you currently have a Missouri retail sales tax license, please
enter the number in the space provided. ________________________________________________
E. WORKERS COMPENSATION INSURANCE: Proof of workers compensation insurance is required before a license can be issued if your
business activity will involve building, demolishing, altering or repairing property in Springfield.
Enter name here: _________________________________________________________________ Date: ___________________________
ATTENTION:
By entering my name on the line below, I certify that the information contained in this application is correct. I understand that a license
category will be assigned to be after the application is reviewed. I also understand that I will be contacted regarding the license fee and may be asked to
provide additional information related to the nature of the business or the calculation of the license fee.
_______________________________________________________ Date: _________________________ Fee Paid: ______________
OFFICE USE ONLY BELOW THIS LINE:
Licensing Personnel: Please include fee calculations in the space provided.
Licensing Personnel
