New Business License Application
Caroline County Commissioner of the Revenue
Sharon W. Carter
New Business License Application
ABOUT SSL CERTIFICATES
Fields marked with * are required
Not for use by contractors
Not for use by Organized Events
No license shall be issued until all required information and payments are received.
For information contact: Sharon Carter at
scarter@co.caroline.va.us
or (804) 633-8042
Applicant:
*
Applicant Name:
*Title:
*Trading as Name:
Business Address:
*Street Number:
Direction:
*Street Name:
*St. Type
Suite:
Floor:
*City:
*State:
*Zip Code:
(xxxxx-xxxx)
Mailing Address:
If it is the same as above, check here:
*Address:
*City:
*State:
*Zip Code:
(xxxxx-xxxx)
*E-Mail Address:
*Federal ID Number:
OR
*Social Security Number:
*Business Phone:
*Emergency Phone:
Start Date in Caroline:
Virginia Sales and Use Number:
*Year: (xxxx)
*Month:
Day:
*Estimated Gross Receipts to December 31: $
*
Description of Business Activity (work performed, services provided)
:
*Describe how you will make your revenue (example: products sold, services rendered, commissions, fees).
If application is a corporation, list officers and registered agent:
President:
Secretary:
Treasurer:
Registered Agent and Contact Address
Agent Name:
Agent Address: