"Business Application Form"

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Business Application Form
Section A
Please indicate why you are filling this form:
1. Original application for new business
Yes
No
2. Change of location of the business
Yes
No
3. Amend application on existing business
Yes
No
B. Name ______________________________________________
For: If a company or office gives entity name, if not give owners or partnership
C. Trade Name____________________________________________
D. Business location (Do not use P.O. Box for location)
Street
_________________________________
City
_________________________________
Telephone _________________________________
Zip code _________________________________
E. Mailing Name Address
Name
________________________________ Street ______________________________
City
_________________________ Zip code _________________________
F. Nature of Business ______________________________________________________
Indicate business to be undertaken
G. Acts/Laws governing the business__________________________________________
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Business Application Form
Section A
Please indicate why you are filling this form:
1. Original application for new business
Yes
No
2. Change of location of the business
Yes
No
3. Amend application on existing business
Yes
No
B. Name ______________________________________________
For: If a company or office gives entity name, if not give owners or partnership
C. Trade Name____________________________________________
D. Business location (Do not use P.O. Box for location)
Street
_________________________________
City
_________________________________
Telephone _________________________________
Zip code _________________________________
E. Mailing Name Address
Name
________________________________ Street ______________________________
City
_________________________ Zip code _________________________
F. Nature of Business ______________________________________________________
Indicate business to be undertaken
G. Acts/Laws governing the business__________________________________________
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By-laws should also be include
I. Type of ownership:
(a) Sole proprietor
(b) Partnership
(c) Company
J. Beginning date for Business
__________________
Day
Month
Year
K. Ownership: (I).If an entity fill the Incorporation date ________________
Day
Month
Year
(II)If individually owned or partnership:
Name
Personal Identification No (PIN)
Location
_________________________ _________________________ ___________________________
_________________________ _________________________ ___________________________
_________________________ _________________________ ___________________________
I declare that the above information is correctly filled and that I shall abide by all the rules of
registration.
Person ______________________________
Title___________________________
Signature____________________________
Date_________________
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