Commissioner of the Revenue, P.O Box 2260, Norfolk, VA 23501-2260  Tel: (757) 664-7886 Fax: (757) 441-1346

Important: All *  items are required information.

New Business License Application
Applicant:

* Business Name:

    

* Name of Person Completing:

* Trading As Name: 
Business Address:
* Street Number:    Direction:  * Street Name:   * St.Type: 
Suite:        Floor: 

* City:  

  * State:   * Zip Code:  -
Mailing Address:   If it is the same as above, check here:
Address1:   Address2:
City:         State:   Zip Code:  -

* E-mail Address:
* Federal ID Number:  -    OR   * Social Security Number: - -
* Business Phone: - -                 Emergency Phone: - -
Start Date in Norfolk:
* Year (XXXX):   * Month:   Day: 
* Estimated Gross Receipts to December 31: $
* Description of Business Activity (work performed, services provided):
* Describe how you will make your revenue (example: products sold, services rendered, commissions, fees, etc.)
If application is a corporation, list officers and registered agent:
President: 
Secretary: 
Treasurer: 
Registered Agent and Contact Address:
Agent Name: 
Agent Address: 
     

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