APPLICATION FOR THE REGISTRATION TO CONDUCT
TOWN OF NIAGARA
7105 LOCKPORT ROAD
NIAGARA FALLS, NY 14305
Telephone (716) 297-2150 ext. 126 Fax: (716) 297-9262
BUSINESS REGISTRATION APPLICATION
Business Name:
Address:
City/State: Zip Code:
Phone #: Fax #:
Number of Employees: Business Hours:______________
Days of Operation: (Circle appropriate days) MON TUES WED THURS FRI SAT SUN
Manager/Owner: Home Address (if other than a corporation)
Emergency Contact (During Non-Business Hours)
_______________________________________________________________Phone #:
Billing Information:
Purpose and Description of Business
__________________________________________________________________________________________
If partnership, names and addresses of all partners:
1. ________________________________________________________________________________________________________
2. ________________________________________________________________________________________________________
3. ________________________________________________________________________________________________________
4. ________________________________________________________________________________________________________
If Corporation, the names and addresses of all Officers
1. _______________________________________________________________________________________________________
2. _______________________________________________________________________________________________________
3. _______________________________________________________________________________________________________
4. _______________________________________________________________________________________________________
Alarm System:
Alarm Company: Phone #
I Hereby Swear to the Truth of the Above Information:
X
Applicant’s Signature Date:
$50.00 Registration Fee: (make check/money order payable to Town of Niagara)
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