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Customer

Business Address

Account Balance

My Business History

Transactions

New Business License Application

Home Based Business? Resident?

Business Info

Business Name:

Licensee Name:

Business Location

Unit # From:

To:

Street # From:

To:

Street Name:

Dir:

Business Mailing Address

Street #:

Unit #:

Address Line 1:

Address Line 2:

City:

Province/State:

Postal/Zip Code:

Phone:

Fax:

E-mail:

Business Description

Floor Space: Sq. Ft.

Zone Code:

Map/Seal #:

Business Type:

Bill To:

License Type:

Business Contact Information

Name:

Phone:

Fax:

E-mail:

Owner Information

Owner Type:

Single

Joint

Company

Owner:

Joint Owner:

Company:

Street #:

Unit #:

Address Line 1:

Address Line 2:

City:

Province/State:

Postal/Zip Code:

Phone:

Fax:

E-mail:

Rate

Code:

Number of Units:

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