AS ted ¥
itaetniate t jCF ae
pets Ur : a ‘ hy fein’

PRS

reed

Pts
Ma

ihe

APPLICATION FOR BUSINESS LICENCE

Class No. Licence No.

PLEASE PRINT IN BLACK.

Application is hereby made for a Business Licence. The following information conceming the
applicant and business is submitted.

NAME OF BUSINESS :

NAME OF CORPORATION OR INDIVIDUAL WHICH OWNS THE BUSINESS:

If Corporation owns business, Name of President:

OWNER’S MAILING ADDRESS & POSTAL CODE:

BUSINESS LOCATION:

OWNER’S TELEPHONE

SRS A AI CT) SADT EY SF
TARO SAD BLY FL TOTED Daly CAA CLPTIOES? ONES WOT TE THe

~ APPLICANT’S NAME
STATUS OF APPLICANT (OWNER, MANAGER, AGENT)

Have you held a Business Licence Before? yes/no Date issued

Where’?

Has your Business Licence ever been cancelled, refused or suspended? yes/no

Mo If so, why?