LOCAL BUSINESS TAX RECEIPT APPLICATION FORM

Fiscal Year ____________________

INSTRUCTIONS:     City Ordinance requires all businesses to complete an annual Local Business Tax Receipt Application Form in order to be eligible to receive a Local Business Tax Receipt for the upcoming fiscal year.  All six (6) sections of the form that are applicable to your business shall be completed by the applicant for the form to be valid.

 

*Information contained herein shall be kept and disclosed in conformance with Section 119.07, Florida Statutes, and shall be used only for the purpose of determining eligibility in the City of North Lauderdale’s Local Business Tax Receipt application process.  PLEASE PRINT CLEARLY.

 

SECTION 1

BUSINESS TAX              NEW                                TRANSFER                                 RENEWAL

BUSINESS TYPE: (Check one)

  COMMERCIAL LOCATION       If you are operating your business from a commercial location, you will need:

1.        Copy of your Driver’s License,

2.        Copy of your Executed Lease Agreement,

3.        A Letter of Intent describing your business and how you will run it (hours of operation, days operating, etc.)

  RESIDENTIAL LOCATION         If you are operating your business from a residential location, you will need:

1.        Copy of your Driver’s License,

2.        Copy of your Warranty Deed,

3.        If you Rent, a notarized letter from your Landlord stating you have his/her approval to operate a business from that location.

4.        If you are governed by a Homeowner’s or Condominium Association, a notarized letter from the Association stating you have their approval to operate a business from that location.

5.        A Letter of Intent describing your business and how you will run it. NOTE: A business operating from a residence can obtain a local business tax receipt for telephone use and mail purposes only.  No employees/customers or inventory, storage of materials, chemicals, etc. on the property is allowed.

  APARTMENT RENTAL                If you are operating your business as apartment rentals, you will need:

1.        Copy of your Bill of Sale

BUSINESS NAME:_________________________________________ PHONE NO. (       )_________________

IF YOU ARE DOING BUSINESS in other than your legal name you are required to furnish a copy of:

1.        Fictitious Name Registration from the Florida Department of State (850) 245-6058 and /or

2.        Corporation Registration from the Florida Department of State (850) 488-9000.

BUSINESS LOCATION:______________________________________________ BAY/SUITE ____________________________

                                                                                City Address

OWNER’S NAME:__________________________________________________ PHONE NO. (       )_______________________

ADDRESS:______________________________________________________________________________________________

OWNER’S Social Security #_______________________________ Federal Employer Identification # ________________________

DRIVER’S License #_________________________________________________ Date of Birth ___________________________

MAILING ADDRESS (if other than Business Location):____________________________________________________________

TYPE OF OWNERSHIP

    SOLE PROPRIETORSHIP/INDIVIDUAL

Name_______________________________________________________ Phone No. (       )_________________________

Address___________________________________________________________________________________________

    PARTNERSHIP

Name of General Partner_________________________________________ Phone No. (       )_________________________

Address___________________________________________________________________________________________

 

SECTION 1 cont’d

    CORPORATION – List names & addresses of all Officers & Board of Directors on a separate sheet & submit with this application.

Name of Registered Agent_______________________________________ Phone No. (       )_________________________

Address___________________________________________________________________________________________

LIST Local Agent/Manager Information

Name of Registered Agent_______________________________________ Phone No. (       )_________________________

Address___________________________________________________________________________________________

SECTION 2          Information provided below must be in sufficient detail to enable the City to properly classify the business.  All additional/supplemental goods or services sold must be listed.

DESCRIPTION of Primary Business Activity_____________________________________________________________________

ADDITIONAL/Supplemental Services or Products provided:________________________________________________________

__________________________________________________________________________________________

MACHINES:                                                                MISCELLANEOUS:                                                      

Number of Machines:                  Type                                                   _____________     NUMBER of Brokers/Salesman

_____________     Trade Machines                                                   _____________     NUMBER of Employees

_____________     Automatic Wash/Dry Machines                       _____________     NUMBER of Nozzles (Gas Stations Only)

_____________     Automatic Game/Device_____________________________     NUMBER of Vehicles (Only one (1) business vehicle permitted with proof of insurance for Business Home Use.)

_____________     Billiard/Pool Table                                               _____________     NUMBER of Chairs (Barber/Beauty/Nail Salons, etc.)

_____________     Other: ________________________            _____________     RETAIL Value of Inventory

SIGNS:                                                                          _____________     SEATING Capacity

Number____________     Size______________                             _____________     SQUARE Footage of Premises

Number____________     Size______________                             _____________     OTHER  _____________________________

SECTION 3          Special certificates/documents required by State Laws:

_____________     STATE Registration                                            _____________     PROOF of Insurance

_____________     PROFESSIONAL License                                   _____________     PROOF of Workers Compensation

_____________     PROOF of Bonds                                                 _____________     COUNTY Health Permit

_____________     Other: ________________________

SECTION 4          Under certain circumstances, and subject to proper documentation, certain persons or groups may be eligible for exemptions to the local business tax.  Please complete the following information if you are applying for a Local Business Tax Receipt and wish to be considered for an exemption.

_____________     DISABLED Veterans of War (including

                                    unremarried spouse) (F.S. 205.171(1)                _____________     WIDOW with minor(s) (F.S.205.162(1)

_____________     PERSON age 65 or older (F.S.205.162(1)           _____________     DISABLED Person (F.S. 205.162(1)

_____________     Other: ________________________            _____________     FUNDRAISING Activity (F.S. 205.192)

PLEASE NOTE:  Additional certificates/documents may be required by the State of Florida or the City of North Lauderdale.  These documents must be provided prior to the issuance of a Local Business Tax Receipt.  You will be notified what documents are required to substantiate your claim of an exemption.

Please contact the Community Development Department with any questions at (954) 724-7069

SECTION 5          To be completed by all businesses

AFFIDAVIT

For LOCAL BUSINESS TAX RECEIPT

STATE OF FLORIDA                         )

                                                                )SS.

COUNTY OF BROWARD              )

 

Before me, the undersigned authority, personally appeared__________________________________________ having

                                                                                                                                            (Name)

been duly cautioned and sworn deposes and states:

 

1.        I am applying for a Local Business Tax Receipt on the basis of the information contained herein for the following type of business/home use:

______________________________________________________________________________________________

  1. I acknowledge that I will be conducting a business and/or home use occupation in accordance with the provisions of Chapter 86 of the Code of Ordinances of the City of North Lauderdale and agree to:

(a)           Allow the City to perform any inspections required for use by the business for which the Local Business Tax Receipt is being secured.

(b)           To provide all documentation required to permit the City to confirm any statements contained herein.

(c)           To conform with any requirements contained within the City Code or State or Federal Law.

  1. If applying for a Local Business Tax Receipt for Home Use:

(a)                 I reside at_____________________________________________________________ North Lauderdale, Florida.

                                                                            (Address)

(b)                 I acknowledge that I cannot store at my residence any materials, supplies or equipment required for my business/home occupation.  Any required equipment, materials or supplies are located at the following address and are permitted within the applicable zoning district:______________________________________________

(c)                 I acknowledge that I cannot store more than one (1) vehicle at my property and vehicle must conform to City Code relating to weight, class, etc.  Any additional vehicles are located at the following address and are permitted within the applicable zoning district:_________________________________________________________

  1. I acknowledge that if I am found in violation of Chapter 86 of the Code of Ordinances of the City of North Lauderdale relating to local business tax receipts, that my receipt may be revoked.
  2. I hereby affirm that all information contained herein is true and complete to the best of my knowledge.

 

Date______________________________                                         ___________________________________________________

                                                                                                                                                                        Acknowledger’s Signature

STATE OF FLORIDA

COUNTY OF________________________

 

The foregoing instrument was acknowledged before me, the undersigned notary public, this_____ day of _______________ 200____ ,

by ___________________________________________________________________ .

                                                (Name of Acknowledger)

 

____________________________________________________

                    Notary Public, State of Florida

 

NOTARY PUBLIC SEAL OF OFFICE:

                                                                                                  Personally known to me

                                                                                                  Produced Identification:

                                                                                                      _______________________________

 

 

 

My Commission Expires

SECTION 6

 

The City of North Lauderdale’s Local Business Tax Receipt Year begins October 1 of each year and expires September 30th of the following year.  Renewal Notices are usually sent the first week in July and payment must be received by September 30th in order to avoid delinquent fees that could amount to 25% of your business tax fee.  In addition, should a payment not be received within 150 days of receipt of the initial notice, a penalty fee of $250 will also be assessed in order to renew your Local Business Tax Receipt.  This is mandated by Florida State Statutes.

 

FEES AND PENALTIES:

LOCAL BUSINESS TAX RECEIPT FEE:

This fee is due when all requirements have been met and appropriate approvals obtained.  You will then be notified that an invoice has been generated in which you will have 30 days to submit payment for your business.  All fees must be paid before the Local Business Tax Receipt is issued.

 

 

 

LOCAL BUSINESS TAX RECEIPT INITIAL APPLICATION FEE:  This fee is due when a new Local Business Tax Receipt Application Form is submitted.

 

$30.00

 

 

BUSINESS USE INSPECTION FEE:

This fee is due when a new Local Business Tax Receipt Application Form is submitted and before inspections ($65.00 each) can be scheduled. (Not for renewals.)

 

$325.00

 

 

LOCAL BUSINESS TAX RECEIPT TRANSFER FEE:  Fee shown on Local Business Tax Receipt Invoice and due upon receipt.  *10% of business tax fee (minimum $3.00, maximum $25.00)

 

10%*

 

 

LOCAL BUSINESS TAX RECEIPT RENEWAL FEE:  This Fee is due EACH year upon renewal and will be shown on your Local Business Tax Receipt invoice along with your regular Business Tax Fee.  All renewals will be charged this fee.

 

$15.00

 

 

LOCAL BUSINESS TAX RECEIPT PENALTY FEE:  If a business tax fee is not paid within 150 days of receipt of initial notice of tax due, a penalty fee will be assessed.  Penalty fees must be paid before issued.

 

$250.00

 

 

LOCAL BUSINESS TAX RECEIPT DELINQUENT FEE: 

If paid in October

If paid in November

If paid in December

If paid in January

If paid later than 150 days after receipt of initial notice

Penalty fees must be paid before issued.

 

 

10%

15%

20%

25%

 

Please contact the Community Development Department with any questions:

701 SW 71st Avenue, North Lauderdale, Florida 33068

Monday – Friday                            8AM to 5PM

Telephone:  (954) 724-7069            Fax:  (954) 720-2064