Versiform Portal
General Information
Owner Information
Business Information
Sign and Submit
Payment Information
Application for Mercantile License
Application is hereby made for a MERCANTILE LICENSE for the year 2015 as required by Ordinance No. 850, dated November 24, 1970.
To complete the paper form instead, click
here
.
1. Name and Address (Springfield) under which business is conducted:
Business Name
*
Business Phone Number
*
Address
*
City
*
State
*
State
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Zip
*
Is this address also to be used as the mailing address for all future correspondence and tax forms?
*
Yes
No
2. Check whether business is:
Incorporated
Partnership
Individual
Application for Mercantile License
Application is hereby made for a MERCANTILE LICENSE for the year 2015 as required by Ordinance No. 850, dated November 24, 1970.
3. Give Name / Names and Addresses of True Owners:
To add an Owner, click 'Add Owner'.
First Name
*
Last Name
*
Phone Number
*
Email Address
*
Address
*
City
*
State
*
State
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Zip
*
Remove
Application for Mercantile License
Application is hereby made for a MERCANTILE LICENSE for the year 2015 as required by Ordinance No. 850, dated November 24, 1970.
4. Nature of Business
(Describe fully), including what products you sell:
*
5. Number of Employees at this Location:
*
6. Mailing Address for all future correspondence and tax forms:
Address
*
City
*
State
*
State
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Zip
*
Application for Mercantile License
Application is hereby made for a MERCANTILE LICENSE for the year 2015 as required by Ordinance No. 850, dated November 24, 1970.
Applicant First Name
*
Applicant Last Name
*
Applicant Email Address
*
Applicant Signature
Clear
Delete
Application Date
*
Payment Amount Due
Previous Page
Next Page
Submit
×
Map Spreadsheet Columns to Import