Dear Osage Beach Business
Owner:
An
application
for your City of Osage Beach
Business/Merchant
License is
attached.
Please
complete
the
following
steps
when applying
for a
'new'
license or
'renewing'
your
current license.
Complete
or edit your
application,
making
any necessary
changes.
Make sure your alternate contact information
is
complete, (name and phone). In case of
an
emergency
the
police
department may need to
contact this
individual.
If this is a NEW license, please include
a copy of your State of Missouri Retail Sales Tax
License
(Only required if
you
collect retail
sales
tax.) This
document should
also reflect that
your business
is
registered within
the city limits of Osage Beach. (RENEWAL licenses are not
required
to
provide
this
information.)
Include
a 'No Tax Due
Certificate'
from the
Missouri Department
of Revenue. You may
contact the
department
by
calling 573-751-9268.
(
Only required
if
you
collect retail
sales
tax)
Include
your $50.00
payment.
Checks may be made
payable
to the City of Osage Beach.
Mail your
completed application,
retail sales tax license, no tax due
certificate,
and
payment to:
City of Osage
Beach
Attn:
City
Clerk
1000 City
Parkway
Osage Beach, MO
65065
Incomplete applications
will be
returned
so please answer all questions. If a
question
is not
applicable,
please
indicate 'n/a'.
If
you
need assistance in
completing
the application
,
please call the City Clerk's
office at
573/302-2000,
ext. 1020 and we will be
happy
to
assist
you.
Sincerely,
Tara Berreth,
City
Clerk
En
c.
Business License #
Sewer Dept.
Building Dept.
Planning/Zoning
CIT
Y OF OSAGE BEACH
BUSINESS/MERCHANT LICENSE APPLICATION
Business Name Business Phone #
Pl
ease Indicate Ownership Status: [ ] Individual [ ] Partnership [ ] Corporation [ ]LLC
Business Street Address/Location
Business Mailing Address City State Zip
E-Mail: Website:
Owner Name Owner Phone #
Owner Mailing Address City State Zip
Name of Manager/Emergency Contact Person Emergency Phone #
Ty
pe of Business: [ ] Entertainment [ ] Healthcare [ ] Retail
[ ] Financial Services [ ] Massage [ ] Service
[ ] Food Sales / Service [ ] Real Estate [ ] Solicitor
[ ] Gas / Convenience
Please Describe Business in Detail
May the City of Osage Beach make available to the public any/all information provided on this application? [ ] Yes
[ ] No
Missouri Retail Sales Tax Identification # Federal Tax Identification #
Applicant Signature Date
**** Al
l Business Licenses Expire on April 30 ****
There is a fee of $50.00 for this license. Any license that remains unpaid thirty days after it becomes due and
payable shall be subject to a penalty of 5% of the amount due on the license with an additional 5% for each
additional month or fraction thereof, not to exceed 25% in the aggregate.
*T
he issuance of a ‘License’ shall not be construed as a waiver of any further requirements under the Ordinances of the
City of Osage Beach. *
Ci
ty of Osage Beach
Attn: City Clerk’s Office
1000 City Parkway
Osage Beach, MO 65065
Phone: 573/302-2000 / Fax: 573/302-2039
www.osagebeach-mo.gov
POLICE/FIRE DEPARTMENT CONTACT
INFORMATION
BUSINESS
NAME:
ADDRESS:
PHONE
NUMBER:
OWNE
R
NAME
:
OWNE
R
HOME PHONE
NUMBER:
CELL:
MANAGER
NAME
:
MANAGE
R
HOME PHONE
NUMBER:
CELL:
OTHER
KEYHOLDER
NAME:
OTHE
R
KEYHOLDER
HOME PHONE
NUMBER:
CELL:
ALAR
M
COMPANY NAME
:
ALAR
M
COMPANY PHONE
NUMBER:
TYPE
OF
ALARM:
(
CIRCLE
ALL
THAT
APPLY
)
__
BURGLARY
FIRE
________
PANIC
___
ANY OTHER
INFORMATION
THAT DEPARTMENTS MAY NEED: IE:
Hazardous
Materials stored on
site, am
munitions, etc.
PLEASE
CONTACT
COMMUNICATIONS
OFFICE AT THE POLICE
DEPARTMENT
AND ADVISE OF
ANY CHANGE IN
INFORMATION. 573-302-2010.
THANK
YOU.
RETURN
TO:
911 CENTER
1000
CITY
PARKWAY
OSAGE BEACH, MO
65065