Business Privilege License Application

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For City Use Only

__________________
Account Number

__________________
Clerk Date

 

City of Reading Citizens’ Service Center
815 Washington Street
Reading Pennsylvania 19601-3690
1(877) 727 3234 Fax (610) 655-6242
www.readingpa.gov
License Fee - $55.00

 

BUSINESS PRIVILEGE LICENSE APPLICATION

 

The following information is necessary for our records and will be held in strict confidence.

All applicable questions (1-26) must be fully answered and clearly printed.

 

 

1. Business Name:__________________________________2. EIN/FIN:____________________

  1. Business Location:_______________________________

  2. ( _____Own Building)

    (_____Rent Building) – Landlord’s Name:_________________________________________

    Landlord’s Address:________________________________________________

  3. Business Mailing Address Where All Forms Are To Be Sent:_________________________
    ____________________________________________________________________________________

  4. Business Phone: ___________________________________7. Fax:_______________________

8. Business Web-site:_____________________________ 9. E-Mail:_______________________

  1. DATE OPENED IN THE CITY OF READING:_______________________________________

  2. DESCRIBE BUSINESS ACTIVITY:_______________________________________________

  3. Will you be working in the City of Reading 15 or more days?:_______________________

 

13. Organization & Type of Business

       

Proprietorship

_____

Regular

_____

Wholesale**

_____%

Partnership*

_____

Seasonal

_____

Retail

_____%

LLP

_____

Temporary

_____

Service

_____%

LLC

_____

Job-Site

_____

Commission

_____%

S-Corp

_____

Itinerant Vendor

_____

Rental

_____%

C-Corp

_____

   

Non-Profit

_____%

Association

_____

   

Manufacturing***

_____%

 

  1. Are there Pool Tables, Juke Boxes, or other Amusement Devices on the Premises? (__Yes) (__No)

  2. Accounting Basis: (___Cash)(___Accrual)16. Accounting Year: (___Calendar) (___Fiscal)

17. No. Of Employees (W-2 Recipients)_____________ 18. Monthly Payroll $______________

 

 

 

1099 EMPLOYEES

19. Please List Employees Who Are Paid As Independent Contractors, Subcontractors, or other individuals who will be issued 1099 forms. Please use additional sheets if necessary.

___________________________________________________________________________________

NAME BUSINESS NAME MAILING ADDRESS

___________________________________________________________________________________

NAME BUSINESS NAME MAILING ADDRESS

 

 

 

 

PLEASE COMPLETE ITEMS #19-21 ONLY IF BUSINESS IS A SOLE PROPRIETORSHIP (SCHEDULE C FILER):

20. Owner(s) Name (s):______________________________21. Owner’s SSN:_________________

22. Owner’s Home Address:__________________________________________________________

Owner’s Date of Birth:_______________________

(mm/dd/yyyy)

 

23. IF BUSINESS IS A PARTNERSHIP, LLC, LLP, LP OR A CORPORATION (C or S Corp) PLEASE COMPLETE BELOW (IF BUSINESS IS A SOLE PROPRIETORSHIP, PLEASE SKIP TO ITEM #23):

Partners’, Members’ Title Date of Social Security Home

Or Officers’ Birth Number Address

 
 
 

 

  1. Name of Previous Owner (If Any):________________________

  2. Previous Business Address (If Any):______________________

 

Before the issuance of a Business Privilege License, you are required to register with the Zoning and

+Health Offices.

 

OFFICIAL USE ONLY

 

Zoning

 

Zoning Office Approval:

 

+Health

 

Health Office Approval:

+Required For: Food Service - Eating & Drinking – Vending – Refuse & Solid Waste Haulers – Exterminators – Itinerant Food Service

 

 

 

26. Rental Properties – List Each Rental Property Located Within the City of Reading :

Please attach additional sheets if necessary.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

 

 

 

26. I Hereby Certify That All Information and Statements Herein Are True and Correct and I/we have read the accompanying instructions.

 

If this form is not signed in the Citizens’ Service Center it must be NOTARIZED.

 

______________________________________________________________________________________

X

Proprietor/Partner/Member(s)/Officer(s) Signature Date

 

______________________________________________________________________________________

X

Partner/Member(s)/Officer(s) Signature (If Applicable) Date

NOTE: The facts set forth herein are made subject to the penalties of 18 PA C.S._Sec. 4904 relative to unsworn falsifications to authorities.

 

*If Business Is A Partnership, All Partners Must Verify Questionnaire Either By Personal Appearance At This Office For The Purpose Of Signing This Questionnaire Or By Separate Notarized Statement.

**Wholesale shall mean sales to dealers/distributors/vendors who resell the items purchased “AS-IS”. When a product is sold and then used in the construction of a new product, it is NOT considered wholesale.

***Manufacturing: If claiming a manufacturing exemption, a written request detailing the nature of the operation must be made within thirty

(30) days to the Municipal Operations Manager. An inspection of the operation is required prior to a decision being rendered. Acceptance or rejection of the request will be issued by the Municipal Operations Manager in writing. All gross receipts will be considered taxable until said decision regarding exemption is issued. No Manufacturing Exemptions shall be granted retroactively.

**** Amusement Device Licenses Must be Obtained the Day Devices are Brought on the Premises.

The license fee and business privilege tax are an annual license/tax. Notices will be mailed to you in January, on an annual basis, after your first year of business. If you do not receive these notices, it is your responsibility to notify us for a duplicate form.