City of Greenacres
Business Information
Business Name
Address City ST Zip
Mailing City ST Zip
Name of Plaza
Business Phone Alternate Phone
Web-Site E-Mail Address
If Applicable State License Number
Applicant or Owner Information
Owner Name Phone
Corporation Phone
Address City ST Zip
Pursuant to F.S. 205.0535 (5) No Business Tax shall be issued unless the FEIN number or SSN number is obtained from the person to be
taxed. If a FEIN is not available, the applicant must complete the attached form with the SSN for the person being taxed pursuant to F.F.
119.071 (5).
FEIN or Social Security number to be completed on attached
Describe Nature of Business
Proposed Hours of Operation Days Open
Number of Employees Number of Vehicles Used
Mark below if your business requires the following or if you are claiming any of the following
Remodeling / Renovations
Utilize Outside Storage
Handle Hazardous Material
Sell Alcoholic Beverages
Widows Exemption
Veterans Exemption
Disability Exemption
Non-Profit Exemption
Age Exempt
State the quantity below as it applies to your business:
Merchandise Retail, Wholesalers, Industrial, and Entertainment/Amusement Businesses:
Gross square feet of floor area as reflected in your lease/floor plan
Assisted Living Facilities, Apartments, Dwelling Rentals, Hotels, Motels, Boardinghouse:
Number of units/rooms
Restaurant-Including Fast Food, Drive Through, Specialty Dessert, Deli, Dinner Theater:
Number of chairs/seats for food service and Lounge Areas
Amusement, Vending
Number of coin operated machines
In addition to the regulations of the City of Greenacres, there may be additional approvals and/or restrictions imposed
by other agencies including Homeowners Associations. I further understand that I cannot operate my business prior to
receiving a Business Tax Receipt from the City of Greenacres.
I hereby declare this application has been examined by me as of this date and to the best of my knowledge and belief is
true and accurate:
Applicant’s Signature Title
Print Applicant’s Name Date
Business Tax ID # PCN Number
Zoning Approved Denied by Date:
Approved Use
Inspection Date Inspection Fee$ Total Amount Due $
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