City of

GRAYMOOR-DEVONDALE

Application for Business License

For July 1, 2016 - June 30, 2017

Each person or corporation who engages in business, as well as rental agents or persons renting property to others, which operate within the boundaries of the City of Graymoor-Devondale must apply for a business license each year as authorized by City Ordinance Chapter 110.

Said license will be sent upon payment of a fee based upon the gross sales/receipts for the preceding calendar year as stated in the applicant’s most recent Federal Income Tax form, or other verifiable form showing gross sales for the Graymoor-Devondale location and a copy of said form must accompany the application for verification. Any applications received which are not accompanied by IRS Form 1040 Schedule C, IRS Form 1065, or IRS Form 1120, or other verifiable form will be returned and the business may be subject to a penalty and interest, if payment is not received by June 30, 2016. Businesses filing after that date are subject to a 10% penalty and interest of 1.5% per month. All new businesses should apply for Business License before opening, and shall pay a fee of $25 for the startup year. The City reserves the right to inspect during business hours any business or rental agent operating within its boundaries to determine that a valid business license for the current year is held.

Name of Business located in Graymoor-Devondale:

______

Address______Phone______

Name of Owner/Manager______Operating Hours______

Name and Address of Parent Company if different from above:

______Phone______


Please list the Insurance Carrier for your Business, to enable verification of Municipal Insurance Premium Tax remittance

______

Annual Gross Sales/Receipts for Last Tax Period (2015) ______

Multiply the first $250,000 times .1% (.001) ______

Multiply all over $250,000 times .05% (.0005) ______

New Business – Startup $25.00 (one time payment) ______

TOTAL DUE BY JUNE 30, 2016: ______

*Make checks payable to: City of Graymoor-Devondale. 1500 Lynn Way – Louisville, KY 40222

**Attach copies of the appropriate schedule/form submitted in the Applicant’s Federal Income Tax Return for calendar year 2015 for verification of Gross Sales/Receipts.

I hereby certify that the statements made herein and in any supporting schedules are true, correct, and complete to the best of my knowledge.

______

Signature & Title of Applicant Date