CITY OF CULLMAN, ALABAMA
BUSINESS APPLICATION
(CONFIDENTIAL)
NOTE: Both forms with payment must be submitted.

Complete and Mail/Fax/Email to:
City of Cullman
P.O. Box 278
Cullman, AL  35056-0278

Email: cullrev@cullmancity.org

Telephone: (256) 775-7109
Fax: (256) 775-7132
Applicant Complete This Box

FEIN:
AL TAX #:


FORM OF OWNERSHIP (Check One)

Sole Prop.
 Corporation

LLC
 Partnership

Prof Assoc
 Other
Application Type: New  Owner Change  Name Change  Location Change  Renewal
Legal Business Name:
Trade Name (If different from above)
Business Activities: (Brief description.)
Physical Address: (City)    (State)    (Zip) 
Mailing Address:   (City)    (State)    (Zip) 
Telephone:     (Business)    (Fax)
                       (Home)        (Cell)
____________________________________________________________
.
Name & Phone # for Contact Person ()
Email Address for Contact Person

List Following for Owner(s), Partners, or Owners  (Attach separate sheet if necessary.)
 Name                                                 Residence Address
      
     
____________________________________________________________
 .
Date Business Activity Initiated or Proposed in Cullman:

This application has been examined by me and is, to the best of my knowledge, a true and complete representation of the above named entity and person(s) listed.

Date:_________  Signature:______________________________________ Title:_________________


PLEASE CHECK TO MAKE SURE ALL INFORMATION PRINTED CORRECTLY BEFORE SUBMITTING.
SHOULD THERE BE ANY QUESTIONS CONCERNING THE COMPLETION OF THIS FORM OR THE LICENSING AND/OR REGISTRATION PROCESS, PLEASE CALL THE NUMBER ON THE TOP OF THIS FORM OR EMAIL THE BUSINESS LICENSE DEPARTMENT TO OBTAIN MORE DETAILED EXPLANATION.