Surf City Privilege License Form

Print Form TOWN OF SURF CITY PRIVILEGE LICENSE APPLICATION Please call the tax department 910-328-4131 for assistance in computing your privilege license tax. DBA Doing Business As Name Federal Tax ID / Mailing Address Location Address Do not use P. O. Box Business Location Phone Secondary Phone Contractor Yes City State Zip Code Fax Type of Business Ownership Corporation Sole Proprietor Partnership Other Website address No License Number Contact Person Name Phone Number Email Address Date business began in Surf City or will begin in Surf City INDIVIDUALS NOT COMPANIES OR CORPORATIONS COMPLETE THE FOLLOWING Applicant Name Phone PLEASE COMPLETE REVERSE SIDE OF FORM FOR PRIVILEGE LICENSE COMPUTATION. I affirm under penalties prescribed by law that I have examined this application and statement and that to the best of my knowledge and belief it is true complete and made in good faith for the taxable period stated pursuant to the Town of Surf City Privilege License Tax Ordinance. A licensee shall be responsible for notifying the Town of Surf City of any changes in location and/or Signature of person making application Date Print name of person making application PLEASE REMIT COMPLETED APPLICATION TO PO BOX 2475 SURF CITY NC 28445 910 328-4131 DO NOT COMPLETE BELOW THIS LINE ON THIS PAGE FOR OFFICE USE ONLY Cost of License NEW RENEWAL EXP The undersigned has examined the Zoning Laws of the Town of Surf City North Carolina and the above business complies with requirements thereof* Approved by Town Planner Nature of Business Describe fully the Type of Sales and/or Services provided Please answer the following questions that APPLY to your Business Hotel Motels Etc Restaurant Cafeteria Lunch Stand seating capacity 0-4/ 25. 00 5 or more/ 42. 50 a* Total Number of Chairs Stools and Benches b. Take-out only Amount of Gross Receipts Number of Rooms 1. 00 per room/ 25. 00 minimum c* Catering 50. 00 flat fee d. Sales of other items such as T-shirts and hats Amount of Gross Receipts e. Delivery 50. 00 flat fee f* Bar 100. 00 Live Entertainment 25. 00 g. On Premises Beer 15. 00 Wine 15. 00 A copy of Beer Wine License must be attached before issuing a license Barber/Beautician/Manicurist/Pedicurist Number of operators 2. 50 per operator a* Products Amount of Gross Receipts b. Massage Therapist - no charge but a copy of Pender or Onslow County Health Permit and Proof of insurance must be attached before operating. Chain Store Do you operate as a Chain Store 50. 00 Flat Fee Convenience Store a* Gasoline Sales Flat Fee 50. 00 b. Retail Sales of Cigarettes and/or Soft Drinks No Flat Fee 4. 00 c* Off Premises Beer 10. 00 d. All other Retail Sales excluding items listed above Other See enclosed Fee Schedule for OTHER applicable fees Retail/Wholesale Fees Based on Gross Receipts sum together before calculating amount Amount reported as gross receipts on a business state income tax return* The law provides that satisfactory evidence shall be furnished showing the facts on which retail and wholesale license s are based* A request may be made to present an operating statement or other records reflecting gross sales before the license can be listed* This information is held in the strictest confidence.