SECTION C: BILLING ADDRESS
(Address where DCRA should mail Renewal Notices)
7. Business Name (if different than line1)…………………………………………………………………………………………………………………….….……………………
7a. Attention (Contact Name)………………………………………………………………………………………………………………….….……………………
7b. Street Address (if different than in Section C) ………………………………………………………………………………………….….…………………….
7c. City ………………………………..………………………………………
State ………………………………………..
Zip …….……………………
SECTION D: REGISTERED / RESIDENT AGENT
Corporations, Partnerships and LLCs must provide Registered Agent information. Sole Proprietors who are not District residents must name a Resident Agent.
8.
Contact Name ….…………………………………………………………………………………………………
Title …………..…………..……………..
8a. Business Name …………………………………………….……………………………………………………………………………...………………………..
8b. Street Address ………..……………………………………………………………………………………..…
Suite …………...….……………………
8c. City………………………………………..……………….
State ……………………………………………..
Zip ………………….…………………..
8d. Phone (
) ………………..………...…….
Business Email …………………………………………………………………..……….
SECTION E: LICENSE ENDORSEMENTS: Business Activities (Vendors: skip this Section)
List all your business activities and their NAICS Codes. Choose from the Table of Endorsement Business Activities in the Instructions
BUSINESS ACTIVITY – LICENSE ENDORSEMENT
Related NAICS Code for Activity
1
2
3
4
5
6
7
8
9
10
SECTION F: BUSINESS EQUIPMENT, MACHINERY, & FACILITIES INFORMATION (Vendors: skip this Section)
Give information about your business about your Basic Business License in Tables I, II and III below. If you need more space, write it on more paper and add it to the application.
Table I. AUTOMOTIVE & OTHER EQUIPMENT
Give the required information for each vehicle you will use in your business.
Equipment Type
Vehicle Make
Year
Identification No.
License Plate
State
Tare Weight
Capacity
Ambulance
Carriages
Driving School
Horses
Solid Waste Truck
Tow Truck
Tow Unit
Truck or Van
Other _____________
Table II. EATING ESTABLISHMENTS & HOUSING (Permanent & Transient)
Give the number of units in each establishment type in your business.
Type
Rooms / Units
Restaurant Seats
Resident Manager Name
Manager’s Phone
Apartments
Boarding / Rooming House
Carriages
Hotel / Motel
Restaurant
Other
1-1-07
1
2
3
4
