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|[pic] |Office of Joe G. Tedder, Tax Collector for Polk County, Florida | |

| |PO Box 2016 | Bartow, FL 33831-2016 | Tel. 863-534-4700 | Fax: 863-534-4735 | Email: BT@ | |

| | | |

| |COUNTY LOCAL BUSINESS TAX ACCOUNT APPLICATION FORM | |

| |To be submitted October through June | |

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|Section|Application Instructions: Please print. Enter all required information. Once completed, follow payment instructions at the bottom of page 2. |

| |Note: Tangible Personal Property information and the telephone number and email address provided in this application are recorded on behalf of the Property |

| |Appraiser as part of the applicant’s tangible personal property tax return (required under F.S. 193) and are not subject to a regular public records request. |

| |Applicants can have their telephone number and email address made available to the public by checking the applicable box provided. Social Security (SSN) or |

| |Federal Employment Identification (FEIN) Number is required under F.S. 205.0535 (5). SSN and FEIN are not subject to regular public record requests. |

| | | |

|1. |Name of Applicant (Owner or Principal): Enter the legal name of the owner or principal of the business making application. |

| |First | |

|2. |Business Entity Type & Name: Check one Business Entity Type and enter the Legal Name of the Business where applicable. |

| |( Corporation |Enter Corporation’s Legal Name ( | |

| |( General Partnership |Enter General Partnership’s Legal Name ( | |

| |( Limited Partnership |Enter Limited Partnership’s Legal Name ( | |

| |( Limited Liability Company |Enter Limited Liability Company’s Legal Name ( | |

| |( Sole Proprietor (Individual) |No Entry For Sole Proprietor ( Legal Name Of Sole Proprietor Should Be Printed In Section1 |

| | | |

|3. |Fictitious Name: A Fictitious Name or “Doing Business As” Name is used by a Corporation, General Partnership, Limited Partnership, Limited Liability Company |

| |or Sole Proprietor that is different from their legal name. If applicable, enter the Fictitious Name and Number provided by the Florida Department of State, |

| |Division of Corporations. (Note: Fictitious Name Numbers are obtained online at .) |

| |Enter Fictitious Name: | |Enter Fictitious Name Number: | |

| |Note: If Fictitious Name is provided above without a Fictitious Name Number, the applicant is required to explain why they do not need to comply with the |

| |Fictitious Name Registration Act: |

| | | |

| | | |

|4. |Business Location: Enter physical location of business. |

| |Address | |

|5. | Location Boundary: Indicate the boundary status of the physical location of the business. |

| | |

| |Check only one |

| |A. |( Outside of Polk County. |

| |B. |( In Polk County and inside the city limits entered in Section 4. |

| |C. |( In Polk County only (not inside city limits). |

| | | |

|6. |Mailing Address: Enter mailing address if different from business/physical location entered in Item 4 |

| |Address | |

|7. |Required Confidential Telephone & Email Address: Enter telephone number and email address. |

| |Telephone: |( ) |

|8. |Tangible Personal Property: The business must provide information regarding their tangible personal property, which is used for commercial purposes and may |

| |include office furniture, computers, tools, supplies, machines, and leasehold improvements (not real estate). |

| | |

| |Check only one |

| |A. |( Tangible property exceeds $25,000 in value or leases any tangible property. |

| | | If Item A is checked, the applicant is required to file a Tangible Personal Property Tax Return with the Polk County Property Appraiser’s Office by |

| | |April 1st. |

| |B. |( No tangible property. |

| |C. |( Tangible property does not exceed $25,000 in value. |

| | |If Item C is checked, the applicant is required to enter the business’ tangible personal property in the following table |

| | |Description of Tangible Property | Age of Item| Year Acquired | Original Cost |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | | | | | |

| | Note: If a business acquires Tangible Personal Property in excess of $25,000 in value, they must file a Tangible Personal Property Tax Return with the Polk |

| |County Property Appraiser’s Office. |

| | | |

|02/10/2020 | |Page 1 of 2 |

|[pic] |Office of Joe G. Tedder, Tax Collector for Polk County, Florida | |

| | | |

| |COUNTY LOCAL BUSINESS TAX ACCOUNT APPLICATION FORM | To be submitted October through June | |

| | | |

|9. |Social Security or Federal Employer Identification Number: | | |

| |Note: A Sole Proprietor enters their Social Security Number. All others enter their Federal Employer Identification Number. |

| | | |

|10. |Request for Fee Exemption: Applicant qualifies for the following exemption - | |

| | (This section applies to individuals requesting an exemption from a business tax and fee and requires written documentation in support of the request. |

| |Please refer to the attached Exemption Instructions for more information. |

| | |

| |(Exemptions generally do not apply to those who sell intoxicating liquors, or malt and vinous beverages, or those who operate gaming devices. |

| | | |

|11. |Select Activities; Amount Due: Review instructions and enter code number |

| |Review the List of Activities provided with this application and select all that apply to your business (up to eight) by entering the corresponding code |

| |number of the activity desired in the spaces provided below. Note the Class designation for each item. Also note “+” indicates that a copy of the |

| |corresponding state license, registration or certification is required to be attached to this application. |

| | |

| |1. _________________________ 2. _________________________ 3. _________________________ 4. _________________________ |

| | |

| | |

| |5. _________________________ 6. _________________________ 7. _________________________ 8. _________________________ |

| | |

| |Tax Amount Due Information: |

| | |

| |( If only “A” items were listed above, the applicant is a Class “A” Business and the annual tax due is 31.50 |

| |( If at least one item listed above is a “B” and no item is a “C”, the applicant is a Class “B” Business and the annual tax due is $57.75 |

| |( If at least one item listed above is a “C”, the applicant is a Class “C” Business and the annual tax due is $315.00 |

| |Note: New business applications submitted July 1st through September 30th are paying one-quarter the amount due for the remaining tax year plus the following|

| |year’s tax payment. |

| | |

| |Also Note: Applicants who qualify for an exemption (see Exemption Instructions) are only eligible for a Class A or Class B local business tax receipt at no |

| |charge. |

| | | |

|12. |Previously Issued Business Tax Receipts Statement: Please review the following. |

| |This application is for a new business tax receipt and does not waive or relieve the business making this application from any previous or other local |

| |business taxes due, including penalties and collection costs, etc. |

| | | |

|13. |Business Tax Receipt Account Status: Indicate status. |

| | |

| |Check only one |

| |A. |( The business is submitting a Polk County Local Business Tax Account application for the first time. |

| |B. |( The business already has a Polk County Local Business Tax Account and is adding a new location. |

| |C. |( The business had a Polk County Local Business Tax Account, ceased doing business, and is now resuming business activities. |

| | | |

|14. |Sworn Statement: Carefully review and sign the following Sworn Statement. |

| |(1) I, the undersigned, under penalty of perjury, swear or affirm this application (including addendum, attachments, and any documentation provided in |

| |support of a fee exemption) is true and correct. |

| | |

| |(2) I acknowledge and understand that a local county business tax receipt (previously referred to as an occupational license) is issued pursuant to this |

| |application and is for the privilege of doing business in Polk County and does not waive Florida’s licensing, registration, and/or certification |

| |requirements, nor does it waive any other such requirements of any city, county, state or federal authority that must be met prior to engaging in or entering|

| |into the activity, business, profession or occupation for which this application is being made. |

| | |

| |(3) I specifically acknowledge that a business tax receipt issued pursuant to this application does not indicate that the parcel of land upon which the |

| |business intends to operate is properly zoned for the activities in question and that it is the responsibility of the business to verify same with the |

| |appropriate zoning authority prior to commencing its activities or operations. |

| | |

| |(4) I specifically swear or affirm under penalty of perjury that if I have requested a fee exemption I meet the requirements of Florida Statute 205.055 which|

| |entitle me to the exemption. |

| | |

| |(5) I also affirm that I, the business owner/principle of record indicated hereon, is in compliance or will comply with all federal, state and legal |

| |requirements. |

| | | |Date: | |

| |Signature of Applicant: | | | |

| | | |

|PAYMENT INSTRUCTIONS |

|Please submit this completed application with payment due. |

| |

|If submitting a completed application by mail, do not send cash and |

|include a check made payable to Joe G. Tedder, Tax Collector. |

| |

|Use the address provided top of Page 1 when mailing in your completed application with payment. |

| |

|Checks must be in U.S. funds and drawn on U.S. banks. |

|02/10/2020 | |Page 2 of 2 |

Polk County Tax Collector’s Office: List of Activities and Exemptions

|EXPLANATION OF DESIGNATIONS |

|A |= |Non Regulated Class A Activity |

|B |= |State Regulated Class B Activity |

|C |= |Declared Class C Activity |

|+ |= | |

| | |Applicant must also provide copy of |

| | |state license, certification, |

| | |registration, etc. |

| | | |

|Note: Numeric County Business Tax Code precedes |

|listing. |

|AGRICULTURE |

|A |11000| LTD AGRICULTURE |

| |0 | |

|B |11000| ANIMAL INDUSTRY |

| |5 | |

|B |11001| AGRICULTURAL PRODUCTS DEALER |

| |0 | |

|B+|11002| FARM LABOR CONTRACTOR |

| |0 | |

|B |11003| FERTILIZER COMPANY |

| |0 | |

|B |11004| FRESHWATER COMMERCIAL FISHING |

| |0 | |

|MINING |

|A |21000| LTD MINE RELATED ACTIVITY |

| |0 | |

|B |21001| MINING |

| |0 | |

|UTILITY |

|A |22000| LTD UTILITY RELATED ACTIVITY |

| |0 | |

|B |22001| DRINKING WATER TREATMENT PLANT |

| |0 | |

|B |22002| ELECTRIC COMPANY |

| |0 | |

|B |22003| GAS COMPANY |

| |0 | |

|B |22004| INDUSTRIAL WASTE WATER |

| |0 | |

|B |22005| WASTEWATER TREATMENT PLANT |

| |0 | |

|B |22006| WASTEWATER UTILITY |

| |0 | |

|B |22007| WATER UTILITY |

| |0 | |

|CONSTRUCTION |

|A |23000| LTD NON-LICENSED CONSTRUCTION ONLY |

| |0 | |

|B+|23001| ASBESTOS CONSULTANT |

| |0 | |

|B+|23002| CONTRACTOR AIR CONDITIONING A |

| |0 | |

|B+|23003| CONTRACTOR AIR CONDITIONING B |

| |0 | |

|B+|23004| CONTRACTOR ALARM RESIDENTIAL |

| |0 | |

|B+|23005| CONTRACTOR ALARM SYSTEM I |

| |0 | |

|B+|23006| CONTRACTOR ALARM SYSTEM II |

| |0 | |

|B+|23007| CONTRACTOR ASBESTOS |

| |0 | |

|B+|23008| CONTRACTOR BUILDING |

| |0 | |

|B+|23009| CONTRACTOR ELECTRICAL LIGHTMAINT |

| |0 | |

|B+|23010| CONTRACTOR ELECTRICAL LOW VOLT |

| |0 | |

|B+|23011| CONTRACTOR ELECTRICAL RESIDENTIAL |

| |0 | |

|B+|23012| CONTRACTOR ELECTRICAL SIGN |

| |0 | |

|B+|23013| CONTRACTOR ELECTRICAL UNLIMITED |

| |0 | |

|B+|23014| CONTRACTOR ELECTRICAL UTILITY LINE |

| |0 | |

|B+|23015| CONTRACTOR GENERAL |

| |0 | |

|B+|23016| CONTRACTOR LP GAS |

| |0 | |

|B+|23017| CONTRACTOR MECHANICAL |

| |0 | |

|B+|23018| CONTRACTOR MOBILE HOME SETUP |

| |0 | |

|B+|23019| CONTRACTOR PLUMBING |

| |0 | |

|B+|23020| CONTRACTOR POLLUTANT STORAGE |

| |0 | |

|B+|23021| CONTRACTOR POOLSPA COMMERCIAL |

| |0 | |

|B+|23022| CONTRACTOR POOLSPA RESIDENTIAL |

| |0 | |

|B+|23023| CONTRACTOR POOLSPA SERVICE REPAIR |

| |0 | |

|B+|23024| CONTRACTOR RESIDENTIAL |

| |0 | |

|B+|23025| CONTRACTOR ROOFING |

| |0 | |

|B+|23026| CONTRACTOR SHEET METAL |

| |0 | |

|B+|23027| CONTRACTOR SOLAR |

| |0 | |

|B+|23028| CONTRACTOR SPECIALTY STRUCTURE |

| |0 | |

|B+|23029| CONTRACTOR UNDERGROUND UTILEXC |

| |0 | |

|B+|23030| ELEVATORS |

| |0 | |

|MANUFACTURING CONSUMER |

|A |31000| LTD MANUFACTURING CONSUMER |

| |0 | |

|B |31001| BAKERY |

| |0 | |

|B |31002| FOOD MANUFACTURING PLANT |

| |0 | |

|B |31003| FOOD PROCESSOR |

| |0 | |

|MANUFACTURING PROCESSING |

|A |32000| LTD MANUFACTURING PROCESSING |

| |0 | |

|B |32001| FERTILIZER PLANT |

| |0 | |

|B |32002| PRINTING FACILITY |

| |0 | |

|MANUFACTURING OTHER |

|A |33000| LTD MANUFACTURING OTHER |

| |0 | |

|B |33000| MANUFACTURING |

| |5 | |

|B |33001| PROCESSING |

| |0 | |

|WHOLESALE |

|A |42000| LTD WHOLESALE DISTRIBUTOR |

| |0 | |

|RETAIL TRADE |

|A |44000| LTD RETAIL TRADE |

| |0 | |

|B |44001| CONVENIENCE STORE |

| |0 | |

|B |44002| FRUIT VEGETABLE STAND |

| |0 | |

|B |44003| LP GAS APPLIANCE EQUIP DEALER |

| |0 | |

|B |44004| LP GAS APPLIANCE EQUIP INSTALLER |

| |0 | |

|B |44005| LP GAS DEALER |

| |0 | |

|B |44006| MEAT MARKET |

| |0 | |

|B |44006| MERCHANDISE DEALER W FOOD |

| |5 | |

|B |44006| MERCHANDISE VENDING W FOOD |

| |7 | |

|B+|44007| MOBILE HOME DEALER |

| |0 | |

|B |44008| MOBILE VENDOR W PREPACKAGED FOOD |

| |0 | |

|B+|44009| MOTOR VEHICLE DEALER |

| |0 | |

|B |44010| PETROLEUM PRODUCTS DEALER |

| |0 | |

|B |44011| RECREATIONAL VEHICLE DEALER |

| |0 | |

|B+|44012| RESIDENTIAL SOLICITATION |

| |0 | |

|B |44012| RETAIL STORE W FOOD SALES |

| |5 | |

|B |44013| SEAFOOD MARKET |

| |0 | |

|B |44014| STALL MARKET W AG PRODUCTS |

| |0 | |

|B |44015| SUPERMARKET GROCERY STORE |

| |0 | |

|B |44016| VESSEL DEALER |

| |0 | |

|C |44017| FLEA MARKET |

| |0 | |

|TRANSPORTATION |

|A |48000| LTD TRANSPORTATION |

| |0 | |

|B |48001| COMMERCIAL DRIVER |

| |0 | |

|B |48002| INTRASTATE MOVER |

| |0 | |

|B |48003| MOBILE HOME MOVER |

| |0 | |

|B |48005| MOTOR VEHICLE RECOVERY AGENT |

| |0 | |

|B |48006| TAXI |

| |0 | |

|B |48007| VEHICLE ESCORT DRIVER |

| |0 | |

|B |48008| WRECKER OPERATOR |

| |0 | |

|WAREHOUSING |

|A |49000| LTD WAREHOUSING |

| |0 | |

|B |49001| FOOD WAREHOUSE |

| |0 | |

|B |49002| STORAGE TANK FACILITY |

| |0 | |

|B |49003| JUNK SCRAP YARD |

| |0 | |

|INFORMATION |

|A |51000| LTD INFORMATION |

| |0 | |

|B |51001| CABLE TELEVISION |

| |0 | |

|B |51002| HIGHWAY OUTDOOR ADVERTISING |

| |0 | |

|B |51003| TELECOMMUNICATIONS |

| |0 | |

|B+|51004| TELEMARKETER |

| |0 | |

|FINANCE, INSURANCE |

|A |52000| LTD FINANCE INSURANCE |

| |0 | |

|B |52001| BAIL BOND AGENT |

| |0 | |

|B |52002| BANK |

| |0 | |

|B |52002| COLLECTION AGENCY |

| |9 | |

|B |52003| COMMERCIAL COLLECTION AGENCY |

| |0 | |

|B |52004| CONSUMER COLLECTION AGENCY |

| |0 | |

|B |52005| HOME IMPROVEMENT FINANCE |

| |0 | |

|B |52006| INSURANCE ADJUSTER |

| |0 | |

|B |52007| INSURANCE AGENCY |

| |0 | |

|B |52008| INSURANCE AGENT |

| |0 | |

|B |52009| INSURANCE COMPANY |

| |0 | |

|B |52010| INVESTMENT ADVISOR |

| |0 | |

|B |52011| MONUMENT ESTABLISHMENT |

| |0 | |

|B |52012| MORTGAGE BROKER |

| |0 | |

|B |52013| MORTGAGE LENDER |

| |0 | |

|B |52014| MOTOR VEHICLE RETAIL INSTALLMENTS |

| |0 | |

|B |52015| PRE NEED FUNERAL BURIAL SALES |

| |0 | |

|B |52016| RETAIL INSTALLMENT SALES |

| |0 | |

|B |52017| SALES FINANCE COMPANY |

| |0 | |

|B |52018| SAVINGS AND LOAN |

| |0 | |

|B |52019| SECURITIES BROKER |

| |0 | |

|B |52020| SECURITIES DEALER |

| |0 | |

|C |52021| CHECK CASHERS |

| |0 | |

|C |52022| PAWNSHOP |

| |0 | |

|PROPERTY SALES, LEASING |

|A |53000|LTD PROP SALES LEASING EQUIP RENTAL |

| |0 | |

|B+|53001|CONDO LEASE SALES |

| |0 | |

|B |53002|MOBILE HOME PARK |

| |0 | |

|B+|53003|MOBILE HOME PARK SPACE LEASING |

| |0 | |

|B+|53004|REAL ESTATE APPRAISER GENERAL |

| |0 | |

|B+|53005|REAL ESTATE APPRAISER INSTRUCT |

| |0 | |

|B+|53006|REAL ESTATE APPRAISER RESIDENTAL |

| |0 | |

|B+|53007|REAL ESTATE BRANCH OFFICE |

| |0 | |

|B+|53008|REAL ESTATE BROKER |

| |0 | |

|B+|53009|REAL ESTATE INSTRUCTOR |

| |0 | |

|B+|53010|REAL ESTATE SCHOOL |

| |0 | |

|B |53011|RENTAL SERVICE |

| |5 | |

|B |53012|SENIOR 55 HOUSING COMMUNITY |

| |0 | |

|B+|53013|TIMESHARE LEASE SALES |

| |0 | |

|B |53014|TITLE AGENT PROPERTY |

| |0 | |

|B |53014|VEHICLE AND OR EQUIP LEASING |

| |5 | |

|B |53015|VEHICLE RENTAL LEASING |

| |0 | |

|PROFESSIONAL, TECHNICAL |

|A |54000|LTD PROFESSIONAL TECHNICAL |

| |0 | |

|B+|54001|ARCHITECT |

| |0 | |

|B+|54002|ATTORNEY |

| |0 | |

|B+|54003|AUCTION BUSINESS |

| |0 | |

|B+|54004|AUCTIONEER |

| |0 | |

|B+|54004|BARBER |

| |1 | |

|B+|54005|BUSINESS AGENTS |

| |0 | |

|B+|54006|CERTIFIED PUBLIC ACCOUNTANT |

| |0 | |

|B+|54007|COSMETOLOGIST |

| |0 | |

|B+|54008|COSMETOLOGY SALON |

| |0 | |

|B+|54009|EMBALMER |

| |0 | |

|B+|54010|FACIALS |

| |0 | |

|B+|54011|FUNERAL DIRECTOR |

| |0 | |

|B+|54012|FUNERAL DIRECTOR AND EMBALMER |

| |0 | |

|B+|54013|FUNERAL ESTABLISHMENT |

| |0 | |

|B |54014|LABORATORY |

| |0 | |

|B+|54015|LANDSCAPE ARCHITECT |

| |0 | |

|B+|54016|MANICURING |

| |0 | |

|B+|54017|PRIVATE INVESTIGATION AGENCY |

| |0 | |

|B+|54018|PRIVATE INVESTIGATOR |

| |0 | |

|B+|54019|PROFESSIONAL ENGINEER |

| |0 | |

|B |54021|PROFESSIONAL FUNDRAISER |

| |0 | |

|B+|54022|PROFESSIONAL GEOLOGIST |

| |0 | |

|B+|54023|SECURITY AGENCY |

| |0 | |

|B+|54024|SECURITY OFFICERS |

| |0 | |

|B+|54025|SURVEYOR MAPPER |

| |0 | |

|B |54026|UTILIZATION REVIEW AGENT |

| |0 | |

|B+|54027|VETERINARIAN |

| |0 | |

|ENTERPRISE MANAGEMENT |

|A |55000| LTD ENTERPRISE MANAGEMENT |

| |0 | |

|B+|55001| COMMUNITY ASSOCIATION MANAGER |

| |0 | |

|B+|55002| EMPLOYEE LEASING COMPANY |

| |0 | |

|SUPPORT SERVICE |

|A |56000| LTD SUPPORT SERVICE |

| |0 | |

- continued on back -

|SCHOOL |

|A |61000| LTD SCHOOL |

| |0 | |

|HEALTHCARE |

|A |62000| LTD HEALTHCARE RELATED ACTIVITY |

| |0 | |

|B+|62001| ACUPUNCTURE |

| |0 | |

|B+|62002| ADULT DAY CARE CENTER |

| |0 | |

|B+|62003| ADULT FAMILY CARE HOME |

| |0 | |

|B+|62004| ADV REG NURSE PRACTITIONER |

| |0 | |

|B |62005| AMBULATORY SURGICAL CENTER |

| |0 | |

|B+|62006| ASSISTED LIVING FACILITY |

| |0 | |

|B |62007| ASSISITED LIVING UNIT |

| |0 | |

|B |62008| BIRTH CENTER |

| |0 | |

|B+|62009| CHILD CARE FACILITY |

| |0 | |

|B+|62010| CLINIC ABORTION |

| |0 | |

|B+|62011| CLINIC HEALTH CARE |

| |0 | |

|B |62012| CLINICAL LABORATORY |

| |0 | |

|B |62013| CLINICAL SOCIAL WORKER |

| |0 | |

|B |62014| DENTAL HYGENIST |

| |0 | |

|B+|62015| DENTAL LABORATORY |

| |0 | |

|B+|62016| DENTIST |

| |0 | |

|B |62017| DIETICIAN NUTRITIONIST |

| |0 | |

|B+|62018| ELECTROLISIST |

| |0 | |

|B+|62019| ELECTROLYSIS FACILITY |

| |0 | |

|B+|62020| FAMILY DAY CARE HOME |

| |0 | |

|B+|62021| HEARING AID SPECIALIST |

| |0 | |

|B |62022| HOME HEALTH CARE AGENCY |

| |0 | |

|B |62023| HOME MEDICAL EQUIP PROVIDER |

| |0 | |

|B |62024| HOSPITAL |

| |0 | |

|B |62025| LARGE FAMILY DAY CARE |

| |0 | |

|B+|62026| LICENSED PRACTICAL NURSE |

| |0 | |

|B+|62027| MARRIAGE AND FAMILY THERAPIST |

| |0 | |

|B+|62028| MASSAGE THERAPY ESTABLISHMENT |

| |0 | |

|B+|62029| MASSAGE THERAPIST |

| |0 | |

|B+|62029| MEDICAL HEALTH PHYSICIST |

| |5 | |

|B+|62029| MEDICAL MARIJUANA CENTER |

| |8 | |

|B+|62030| MENTAL HEALTH COUNSELOR |

| |0 | |

|B+|62031| MIDWIFE |

| |0 | |

|B+|62032| NURSING HOME |

| |0 | |

|B+|62033| OCCUPATIONAL THERAPIST |

| |0 | |

|B |62034| OPTICAL ESTABLISHMENT |

| |0 | |

|B |62035| OPTICIAN |

| |0 | |

|B |62036| OPTOMETRY BRANCH |

| |0 | |

|B+|62037| OPTOMETRIST |

| |0 | |

|B |62038| ORTHODIC FITTER |

| |0 | |

|B+|62039| ORTHODONTIST |

| |0 | |

|B+|62040| PEDORTHIST |

| |0 | |

|B+|62041| PHARMACIST |

| |0 | |

|B+|62042| PHARMACY |

| |0 | |

|B+|62043| PHYSICAL THERAPIST |

| |0 | |

|B+|62043| PHYSICAL THERAPIST ASSISTANT |

| |1 | |

|B+|62044| PHYSICIAN |

| |0 | |

|B+|62045| PHYSICIAN CHIROPRACTIC |

| |0 | |

|B+|62046| PHYSICIAN NATUROPATHIC |

| |0 | |

|B+|62047| PHYSICIAN OSTEOPATHIC |

| |0 | |

|B+|62048| PHYSICIAN PODIATRIC |

| |0 | |

|B+|62049| PODIATRIC PHYSICIAN LTD |

| |0 | |

|B+|62050| PROSTHETIST |

| |0 | |

|B+|62051| PSYCHOLOGIST |

| |0 | |

|B+|62052| PSYCHOLOGIST LTD LICENSE |

| |0 | |

|B+|62053| REGISTERED NURSE |

| |0 | |

|B+|62054| RESPIRATORY THERAPIST |

| |0 | |

|B |62055| SPEECH LANG AUDIOLOGIST |

| |0 | |

|B |62056| SPEECH LANG PATHOLOGIST |

| |0 | |

|ART, ENTERTAINMENT, RECREATION |

|A |71000| LTD ART ENTERTAINMENT RECREATION |

| |0 | |

|B |71001| AMUSEMENT ATTRACTION RIDES |

| |0 | |

|B+|71003| ATHLETE AGENT |

| |0 | |

|B |71004| ATHLETIC TRAINER |

| |0 | |

|B+|71005| BALLROOM DANCE STUDIO |

| |0 | |

|B+|71006| BODY PIERCING |

| |0 | |

|B+|71007| HEALTH STUDIO |

| |0 | |

|B |71008| LOUNGES |

| |0 | |

|B+|71009| TALENT AGENCY |

| |0 | |

|B+|71010| TATTOO |

| |0 | |

|B |71010| THEATER W FOOD SALES |

| |5 | |

|C |71011| CIRCUS |

| |0 | |

|C |71012| EXTREME ENTERTAINMENT |

| |0 | |

|C |71013| FAIR |

| |0 | |

|C |71014| GRAPHIC ENTERTAINMENT |

| |0 | |

|C |71015| SPECIAL EVENT |

| |0 | |

|C |71016| VARIETY PROGRAM |

| |0 | |

|ACCOMODATIONS, FOOD SERVICE |

|A |72000| LTD ACCOMODATION OR FOOD SERVICE |

| |0 | |

|B |72001| BAR |

| |0 | |

|B+|72002| FOOD CATERING |

| |0 | |

|B+|72003| FOOD DELICATESSEN |

| |0 | |

|B+|72004| FOOD EVENT VENDOR |

| |0 | |

|B |72005| FOOD MEAT MARKET |

| |0 | |

|B |72006| FOOD MOBILE VENDOR PRE PACKAGED |

| |0 | |

|B+|72007| FOOD MOBILE VENDOR PREPARED FOOD |

| |0 | |

|B+|72008| FOOD SERVICE |

| |0 | |

|B+|72009| LODGING BED BREAKFAST |

| |0 | |

|B+|72010| LODGING HOTEL |

| |0 | |

|B+|72011| LODGING MOTEL |

| |0 | |

|B+|72012| LODGING STR APARTMENT |

| |0 | |

|B+|72013| LODGING STR RESORT CONDO |

| |0 | |

|B+|72014| LODGING STR RESORT DWELLING |

| |0 | |

|B |72015| LODGING STR RESORT DWELLING MGR |

| |0 | |

|B+|72016| LODGING STR ROOMING HOUSE |

| |0 | |

|B |72017| RECREATIONAL CAMP |

| |0 | |

|B |72018| RECREATIONAL VEHICLE PARK |

| |0 | |

|B+|72019| RESTAURANT |

| |0 | |

|B+|72020| TRAVEL BUREAU |

| |0 | |

|OTHER SERVICES |

|A |81000| LTD OTHER SERVICES |

| |0 | |

|B |81000| DRY CLEANER LAUNDRY SERVICE |

| |5 | |

|B |81003| LAUNDRY FACILITY |

| |0 | |

|B+|81004| MOTOR VEHICLE REPAIR AUTO PAINT |

| |0 | |

|B+|81005| MOTOR VEHICLE REPAIR GARAGE |

| |0 | |

|B+|81006| PEST CONTROL SERVICE |

| |0 | |

|B |81007| SEPTIC TANK SERVICE |

| |0 | |

|B |81008| VEHICLE WASHING FACILITY |

| |0 | |

|C |81000| FIREWORKS |

| |8 | |

|C |81001| FORTUNE TELLER |

| |0 | |

|PUBLIC SERVICE |

|A |92000| LTD PUBLIC SERVICE |

| |0 | |

|LOOKING FOR OTHER ACTIVITIES? |

| |

| |

|Applicants seeking a Class B Local County |

|Business Tax Receipt for activities licensed, |

|certified, registered and/or regulated by the |

|state which are not found on this list may do the|

|following: |

|Present a Florida license, certification, |

|registration, etc. |

|Refer to a comprehensive listing of Class B |

|activities on file with the Tax Collector’s |

|Office at: |

|businesstaxes/code_detail.asp |

|EXEMPTION Instructions |

| |

|To obtain an exemption, provide a signed written |

|request for the specific exemption you are |

|seeking. If documentation is required to be |

|submitted for the exemption, please attach the |

|required documentation with your written request.|

|See available exemptions in the next column. |

| |

|* Consult Chapter 205 of the Florida Statutes and|

|Polk County Ordinance Number 09-070 for more |

|details. |

| |

|Available exemptions |

| |

|Senior Citizen (Receipt Issued - No Charge) - This |

|exemption is available to sole proprietors |

|(individuals) upon providing personal identification|

|indicating the applicant is sixty-five (65) years of|

|age or older.* |

| |

|Disabled Person (Receipt Issued - No Charge) - This |

|exemption is available to those living in sole |

|proprietors (individuals) upon providing personal |

|identification indicating they live in Polk County |

|and one or more of the following items: A disabled |

|person parking placard; vehicle registration renewal|

|notice indicating disable person tag; disable person|

|property tax exemption; disabled person hunting |

|license; disabled person fishing license; and/or |

|certification from a reputable physician stating |

|that the applicant is disabled.* |

| |

|Widow(er) With Minor Dependent(s) (Receipt Issued - |

|No Charge) - This exemption is available to sole |

|proprietors (individuals) upon providing personal |

|identification, proof of a deceased spouse, and at |

|least one minor dependent (child under the age of |

|eighteen). * |

| |

|Widow(er) Deceased Disabled Veteran (Receipt Issued |

|- No Charge) - This exemption is available to sole |

|proprietors (individuals) who can demonstrate they |

|are the unremarried spouse of a deceased disabled |

|veteran of any war in which the U.S. Armed forces |

|participated.* |

| |

|HONORABLY DISCHARGED VETERANS (Receipt Issued - No |

|Charge) - This exemption is available to a veteran |

|of the United States Armed Forces who was honorably |

|discharged upon separation from service, or the |

|spouse or unremarried surviving spouse of such a |

|veteran upon providing Honorable Discharge |

|Certificate or DD214 form.* |

| |

|ACTIVE DUTY MILITARY SPOUSE (Receipt Issued - No |

|Charge) This exemption is available to the spouse of|

|an active duty military service member who has |

|relocated to Polk County pursuant to a permanent |

|change of station order upon providing a copy of the|

|Change of Station order.* |

| |

|INCOME ASSISTANCE BASED (Receipt Issued - No Charge)|

|- This exemption is available to low-income |

|individuals who are receiving public assistance, as |

|defined under F.S. 409.2554 as money assistance paid|

|on the basis of Title IV-E(adoption assistance) and|

|Title XIX of the Social Security Act (Medicaid), |

|temporary cash assistance, or food assistance |

|benefits upon providing a copy of the award letter. |

| |

|INCOME BASED (Receipt Issued - No Charge) |

|This exemption is available to individuals or a |

|person whose household income is less than 130 |

|percent of the federal poverty level based on the |

|current year’s federal poverty guidelines upon |

|signing the sworn statement as to income status.* |

| |

|Note: For 2018 130% of the federal poverty guideline|

|for a one person household is $15,782. Add $5,616 |

|for each additional person in the household for |

|total household income. |

| |

|Exempt Individuals with MAJORITY Business Interest |

|(Receipt Issued - No Charge) - This exemption is |

|available to honorable discharged veterans, active |

|duty military spouses, and low income individuals |

|who own a majority interest in a business with fewer|

|than 100 employees upon providing documentation in |

|support of the exemption category and number of |

|employees.* |

| |

|Note: Also the local county business tax receipt |

|issued with an exemption will indicate exempt status|

|and are not transferable. |

|LOCAL BUSINESS TAX RECEIPTS ARE NOT NEEDED FOR THE |

|FOLLOWING ACTIVITIES |

| |

|BONA FIDE EMPLOYEE (Receipt Not Required) - An |

|individual who is only an employee of a business |

|operating in Polk County is not required to obtain |

|their own local business tax receipt. Note: State |

|licensed real estate broker associate or sales |

|associate are considered to be an employee. * |

| |

|Agricultural (Receipt Not Required) - All farm, |

|grove, horticultural, floricultural, tropical, |

|piscicultural and tropical fish farm products |

|manufactured therefrom shall be exempt from all |

|local county business taxes when the same is being |

|offered for sale or sold by the farmer or grower |

|producing said products.* |

| |

|Religious (Receipt Not Required) - Generally no |

|local county business tax receipt is required for |

|practicing the religious tenants of any church.* |

| |

|Charitable (Receipt Not Required) - Generally no |

|local county business tax receipt is required of any|

|charitable, religious, fraternal, youth, civic, |

|service, or other such organization non-profit or |

|not-for-profit activities.* |

| |

|Youth (Receipt Not Required) - All persons eighteen |

|(18) years of age or younger or those persons less |

|than twenty (20) years of age who are enrolled |

|full-time in a daytime high school program in Polk |

|County and who are acting as a sole proprietorship |

|with no persons in their employment shall be exempt |

|from the provisions of this Ordinance.* |

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