New Business License Form

NEW BUSINESS LICENSE FORM

CITY OF DANVILLE,
OFFICE OF COMMISSIONER OF THE REVENUE

Jack V. Thomson III
Commissioner of the Revenue
311 Memorial Dr.
P.O. Box 480
Danville, VA 24543
434.799.5145

TRADE NAME*
NATURE OF BUSINESS *
FED TAX ID OR SS #*
ESTIMATED GROSS UNTIL YR END*
MAILING ADDRESS *
LOCAL BUSINESS ADDRESS *
LOCAL BUSINESS PHONE *
Format: (000) 000-0000.
BUSINESS EMAIL
CONTACT PERSON *
CONTACT TITLE *
CONTACT PHONE *
Format: (000) 000-0000.
CONTACT EMAIL
INDIVIDUALPARTNERSHIPCORP OR LLC
YesNo
ENTITY ID #
NAME*
If Corporation, enter corporation or LLC name; otherwise enter individual or partner name
PARTNER NAME
ADDRESS
If different from mailing address shown above
PARTNER ADDRESS
PHONE
If different from business phone number shown aboveFormat: (000) 000-0000.
PARTNER PHONE
Format: (000) 000-0000.
THIS SECTION - CONTRACTORS ONLY
CLASS ACLASS BCLASS CN/A
STATE LICENSE #
TYPE OF CONTRACTOR
ATTACH ALL SUPPORTING DOCUMENTATION. CLICK HERE FOR INFORMATION ON REQUIREMENTS.
Cancelof
START DATE *

MonthDayYear
Date business started in Danville
SIGNATURE*

Clear
PARTNER SIGNATURE

Clear
DATE*

MonthDayYear
YesNo
Should be Empty: