BUSINESS LICENSE REGISTRATION APPLICATION

[Pages:1]CITY OF BALTIMORE DEPARTMENT OF FINANCE BUREAU OF REVENUE COLLECTIONS

Catherine E. Pugh Mayor

Miscellaneous Tax/License Unit 200 Holliday Street, 1st Floor, Rm 3 410-361-9690COBBusinessLicense@

Henry Raymond Director of Finance

BUSINESS LICENSE REGISTRATION APPLICATION

LICENSE YEAR__________________________

AMOUNT ENCLOSED_____________________

Please complete this form to register or renew your Business License Remit your payment, a self addressed stamped envelope and a copy of your current State Traders License.

PLEASE PRINT OR TYPE INFORMATION

SDAT BUSINESS NAME AND ACCOUNT NUMBER

PHONE #

OWNER'S NAME

BUSINESS ADDRESS MAILING ADDRESS TYPE OF LICENSE

ZIP CODE ZIP CODE

LICENSE TITLE ANTIQUE DEALER CONSIGNMENT GOODS EMPLOYMENT AGENCY JUNK DEALER/SCRAP METAL DEALER MUSEUM MASTERS SECONDHAND DEALER MASTER CONSIGNMENT GOODS RETAIL MOTOR FUEL TICKET AGENCY GOING OUT OF BUSINESS

FEE $50.00 $50.00 $250.00 $475.00 $165.00 $50.00 $50.00 $150.00 $250.00 $100.00

LICENSE TITLE BOWLING ALLEY (per lane, $100 min) DANCE ACADEMY HALL OR SPORTS CENTER MOTION PICTURE THEATER FOR PROFIT THEATER MASTERS ANTIQUE DEALER POLES SECOND HAND DEALER TOWING SERVICE (per vehicle)

FEE $40.00 $50.00 $165.00 $165.00 $165.00 $50.00 $50.00 $50.00 $100.00

If you have more than one location that requires a license you may add that information on the reverse side.

WE ARE NOT RESPONSIBLE FOR INCOMPLETE REGISTRATION FORMS FAILURE TO PROPERLY COMPLETE YOUR REGISTRATION FORM WILL DELAY THE PROCESSING OF YOUR LICENSE AND COULD

RESULT IN YOUR BUSINESS BEING PLACED IN VIOLATION.

If you have any question or need assistance please contact the Miscellaneous Tax/License Unit at 410-361-9690.

THE SECTION BELOW IS FOR OFFICE USE ONLY

Date Received ________________

Date Processed___________________

Total Fee Paid ________________

Initials of Processor _______________

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