Business License | City of Broken Bow

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City of Broken Bow

Business License

Business License Application

Business Type:(Required)

Business Start Date (at this location):(Required)

Primary Function of Business:(Required)

Is this a new business?(Required)

Yes

Is this a new location for an existing business?(Required)

Yes

D.B.A. (Name of Business):(Required)

Business Location:(Required)

City State ZIP Code

Mailing Address (if Different from Business Location):

Street Address City State ZIP Code

Owner/Principal/Corp. Officer:

Name(Required)

Email(Required)

Title(Required)

Address(Required)

Street Address City State ZIP Code

Phone(Required)

Fax No.

Business Ownership Status:(Required)

Sole Proprietor

Partnership

Corporation

LLC

Non-Profit

Other:

Emergency Contact Information: (Required for fire and police protection)

Name:(Required)

Telephone No.(Required)

Applicant Contact Information:

Business Phone No.(Required)

Federal Employer's ID #:(Required)

Business Phone No.(Required)

Is this an out-of-town contractor?(Required)

Yes

In what city is the business located?(Required)

Is your business Door-to-door solicitation?(Required)

Yes

Is this a home occupation?(Required)

Yes

Temporary location (in a tent, stand, or structure):(Required)

Yes

Mechanical, Electrical, or Plumbing Contractor?(Required)

Yes

Registration of State Licenses Required for Contractor and Journeymen, with annual renewal on birthday of each year

Itinerant Vendor License must be issued.

Does your business involve the sale, transport, or manufacture of food or beverage?(Required)

Yes

Has State Health Dept approval been granted? (580-286-6628).

Sign Contractor? (Insurance Filing Required)(Required)

Yes

Does your business involve the sale of beer, on or off premises?(Required)

Yes

Approved Beer Licenses No. (copy attached)

File

Drop files here or

Max. file size: 32 MB.

Does your business involve the sale of liquor, on or off premises?(Required)

Yes

Approved Liquor License No. (copy attached)

File

Drop files here or

Max. file size: 32 MB.

Does your business include vending machines, video games, pool tables, and other coin-operated amusement devices on premises?(Required)

Yes

A Family Amusement License may also be required.

Does your business involve the sale or rental of tangible personal property (merchandise, goods or products) or the furnishing of specified services (transportation, meals, lodging, parking, etc.)?(Required)

Yes

Oklahoma State Sales Tax Permit is Required. (405-521-3160) State Sales Tax Permit Number:

File

Max. file size: 32 MB.

I declare under penalty of perjury that the above application is true and correct to the best of my knowledge. I certify that I will operate my business in accordance with all applicable Federal, State and City laws and regulations. I further understand that any false statements made above are grounds for denial, cancellation, suspension, or revocation of the business license and/or certificate of occupancy.

Please have the following items when applying for your business license.

Completed business license application

Copy of the businesses Oklahoma Sales Tax permit, when applicable

Copy of liquor license, when applicable

Payment for business license in the amount of $75.00 or your quoted prorated amount.

McCurtain County Health Department certificate, when providing a food service.

Signature of Owner or Authorized Agent

Date

MM slash DD slash YYYY

210 N. Broadway Street • Broken Bow, OK 74728

Phone: (580) 584-3407 • (580) 584-2282 • (580) 584-2885 • Fax: (580) 584-6898

TDD 800-722-0353 • TTY 800-522-8506/voice or 711 • Web: www.cityofbrokenbow.com

The City of Broken Bow is an Equal Opportunity Provider and Employer.

In accordance with Federal law and the U. S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability. (Not all prohibited bases apply to all programs.) To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S. W. Washington, D. C. 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD)

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