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APPLICATION FOR PREPARED FOOD & BEVERAGE TAX
CHOOSE THE APPROPRIATE ENTITY
CHOOSE THE APPROPRIATE ENTITY
       
APPLICANT INFORMATION
APPLICANT INFORMATION
AGENT INFORMATION
AGENT INFORMATION
PHYSICAL ADDRESS OF BUSINESS
PHYSICAL ADDRESS OF BUSINESS
If Mailing Address is different than business/physical address, enter it here:
OTHER CONTACT INFORMATION
OTHER CONTACT INFORMATION
DATE
DATE
GROSS RECEIPTS INFORMATION
GROSS RECEIPTS INFORMATION
VENDOR TYPE
VENDOR TYPE
Please contact the Franklin County Planning & Community Development Office at 540-483-3027 for more information.
*By typing your name, you are certifying that you have read and agree with the following statement in its entirety. I agree that my typed name on this document is the legally binding equivalent to my handwritten signature. I will not, at any time in the future, repudiate the meaning of this signature or claim that this signature is not legally binding.

*By typing your name, you are certifying that you have read and agree with the following statement in its entirety.

I agree that my typed name on this document is the legally binding equivalent to my handwritten signature. I will not, at any time in the future, repudiate the meaning of this signature or claim that this signature is not legally binding.