Fillable TOWN OF BEDFORD DEPARTMENT OF PLANNING & COMMUNITY (Town of Bedford)

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TOWN OF BEDFORD DEPARTMENT OF PLANNING & COMMUNITY (Town of Bedford)

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Country of origin: US
File type: PDF

U.S.A. forms for Town of Bedford

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TOWN OF BEDFORD
DEPARTMENT OF PLANNING & COMMUNITY DEVELOPMENT
215 EAST MAIN STREET, BEDFORD VA 24523
Phone 540-587-6021; Fax 540-587-6143; E-Mail cjohnson@bedfordva.gov
2021 BUSINESS LICENSE APPLICATION FEE $30.00
BUSINESS NAME:
DBA:
FEDERAL IDENTIFICATION # (or Social Security #):
TYPE OF BUSINESS DESCRIPTION OF BUSINESS
Individual
Occupation:
Corporation
Occupation:
LLC
Occupation:
Partnership
Occupation:
Registered
A B C
(Circle One Type)
Non-Profit
Occupation:
PHYSICAL ADDRESS OF BUSINESS MAILING ADDRESS (If different from physical address)
Bldg.#
Bldg.#
Street
Street
Suite #
Suite #
City
City
State
State
Zip Code
Zip Code
Phone
Fax
PO Box
E-Mail
City
Website
State
Zip Code
BUSINESS OWNER’S PERSONAL INFORMATION
Name
Home Address
Phone #
Mobile Phone #
E-Mail
TOWN STAFF USE – THE ABOVE INFORMATION IS VERIFIED BY STAFF BELOW:
Zoning Permit Issued? Issued Date: _______________ Not Required
STAFF SIGNATURE TITLE DATE
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TOWN OF BEDFORD DEPARTMENT OF PLANNING & COMMUNITY (Town of Bedford)

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Completed 13 November 2021

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