County
of Greenville
Business Registration Application
301 University Ridge, Suite 1000
Greenville, SC 29601
Phone (864) 467-7300
Application Year __________
Registration # ____________
Business Name ____________________________________
Physical Business Location ___________________________
City/State/Zip ______________________________________
Telephone __________________ Fax __________________
Check All Applicable Blocks
Registration New ( ) Renewal ( )
Ownership Change ( ) Location Change ( )
Out of Business ( ) Closing Date _________________
Real Estate Tax Map Number
_________________________________________________
Real Estate Owner _________________________________
Mailing Address ____________________________________
City/State/Zip ______________________________________
Telephone Number _________________________________
SCDOR REF# __________________________________
Federal ID Number/ SSN # ___________________________
Business Owner ___________________________________
C/O _____________________________________________
Mailing Address ___________________________________
City/State/Zip _____________________________________
Telephone _______________________________________
Number of Employees ________ Ownership: (check One)
Corp ( ) Indiv ( ) Partn ( ) LLC ( ) LLP ( )
Type of Business Activity
Agricultural, Forestry,
Fishing, Hunting (11)
Professional Scientific &
Technical Services (54)
Management of Companies &
Enterprises (55)
Administrative and Support,
Waste Mgmt & Remediation
(56)
Health Care & Social
Assistance (62)
Arts, Entertainment &
Recreation (71)
Accommodation & Food
Services (72)
Transportation and
Warehouse (48-49)
Real Estate, Rental & Leasing
(53)
Bars, Taverns, Pubs,
Nightclubs (72241)
Person Completing Application (Print Name) _________________________________________________________________
Title of Applicant _______________________________________________________________________________________
Mailing Address ___________________________________________ City/State/Zip _________________________________
E-mail _______________________________________________
Day Phone ____________________________________
I attest, under penalty of perjury, I am in compliance with the Immigration Reform and Control Act of 1986 (Department of
Homeland Security Form I-9, Employment Eligibility Verification)
Signature __________________________________________________
Date ___________________________________
New Businesses Must Register with the County Prior to Beginning Operation.
RENEWAL BUSINESS REGISTRATIONS MUST BE FILED PRIOR TO DECEMBER 31 EACH YEAR.
COU
NTY OF GREENVILLE
BUSINESS REGISTRATION APPLICATION
301 University Ridge, Suite 1000
Greenville, SC 29601