Commercial Business License Application

City of Douglasville
General Requirements and Information for Obtaining an
Occupational Tax Certificate
The physical location of the business must fall within the jurisdiction of the City of Douglasville. P.O. Boxes are not considered valid
locations for a business (They can be used for mailing purposes)
Home Offices/Occupations – Must provide a current utility bill (Gas, Water, or Electric) as a proof of residency as well as a copy of a valid
Georgia Driver’s License/Identification Card. The addresses on both the Driver’s License/ID Card and the Utility Bill must match the
business location address on the application. If utility bills are in another individual’s name then a letter from that individual must state
your residency at that location and have it signed and dated by both individuals in front of a public notary.
Commercial Businesses – Must provide a copy of a current signed and dated lease agreement, bill of sale, or deed for the location
printed on the application. A copy of a Driver’s License/Identification Card must also be provided upon submitting this application.
Corporations/LLCs – Must provide a copy of their active/compliant Articles of Incorporation [INC] or Articles of Organization [LLC] from
the Georgia Secretary of State. If a foreign entity the appropriate documents must also be provided from their respective Secretary of
State.
Partnerships – Must provide a signed and dated partnership agreement stating the percentage of ownership per –individual.
Professional Licensure – If your occupation requires state licensure [See Attached Professional Licensure List] then you must provide the
appropriate certificates/licenses upon submitting this application. All licenses should be current and active. If there are multiple licensed
professionals you must submit a copy of each individuals Driver’s License/Identification Card as well as their State License.
*A regulatory fee may be applied to each licensed individual, please see the regulatory fee structure attached*
Restaurants, Body Art Establishments, Swimming Pools, and Mobile Home Parks – Must receive approval and certification from
Douglas County Public Health [Cobb/Douglas Center for Environmental Health]
Douglas County Courthouse
8700 Hospital Drive, First Floor
Douglasville GA, 30134
(770) 920 7311
www.CobbandDouglasPublicHealth.org
Second Hand, Pawn Shops, Selling of Used or Refurbished Goods – Must submit a Second Hand Dealer Questionnaire with this
application. From there Detective Mac Abercrombie with the Douglasville Police Department will determine whether or not a Second
Hand Dealer’s Permit will be required. The Questionnaire is not the application for a Second Hand Dealer’s Permit; it is a way to
determine whether or not the business activities being conducted will require such a permit. You may be denied approval at any time for
any reason per the discretion of the Chief of Police and other authorized individuals at the Douglasville Police Department.
The initial occupational tax fee is based on a full-year anticipated gross receipt amount. A non-prorated, nonrefundable administrative fee of
$50.00 shall be required on all business and occupation tax accounts for the initial start-up, renewal, or reopening of those accounts. At renewal
time you will report actual gross receipts, plus the $50.00 administrative fee. Practitioners of professions shall elect as their entire occupation tax
one of the following: Report office gross receipts, plus a $50.00 administrative fee per office, or elect to pay a flat fee of $300.00 per each
professional, plus a $50.00 administrative fee per office. Payment is due at time of application and is payable by cash, check, Visa or MasterCard.
Application process is approximately 10 business days. Any construction will require a certificate of occupancy (CO) before an occupational tax
certificate will be issued, which may run beyond the 10 business days. Certificate will be sent to the mailing address on the application upon
approval.
An administrative fee of $10.00 shall be required on all business and occupation tax accounts for the transfer of the registration certificate to a
new business location for the same owner to operate the same business under the same name at the new location for the remainder of the
existing license period.
Occupational Tax Certificates (business licenses) are only valid until December 31st, of each year. Renewals are mailed out beginning the month
of September of each year for current licenses and renewal payment is accepted until March 31st of the following year without late penalties.
Please renew early to keep your business license active. Please notify us of any changes with your business, i.e.; business purchased, name and/or
ownership change, location change, partnership, corporation, business closing, etc. All changes should be submitted in writing.
Our City’s Ordinances & Laws Can Be Found Online at the Following Website
http://www.ci.douglasville.ga.us/
Go to the “I Want To…” tab and click on “Read the Code of the City of Douglasville”
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 1 of 17
For Office Use Only
City of Douglasville
6695 Church St. P.O. Box 219 Douglasville GA, 30133
Occupational Tax Registration For Commercial Business
SIC Code: __________ Tax Rate: _________
Fees Due: __________ Classification Desc:
_____________________________________
_
Business Name [DBA]
Corporation Name [If Applicable]
Physical Business Address
Street
t
Suite #
City, State, Zip Code
Street
t
Suite #
City, State, Zip Code
Street
t
Suite #
City, State, Zip Code
Mailing Address [If Different]
Corporate Office Address
Restaurant
Yes
No
Restaurants Must Contact Andre’ Westfield With Cobb &
Douglas Environmental Health
P# (770) 920-7316 Email: [email protected]
Business Phone
Ownership Type:
Serving Alcohol
LLC
No
If You Plan to Serve/Sell Alcohol You Must Contact Mandy Pope
P# (678) 449-3086
Email: [email protected]
Fax
Corporation
Yes
Secondary Phone
Partnership
Sole Proprietor
Other
Corporations and Limited Liability Companies must provide
the Appropriate State Documents Upon Submission of This
Application.
Domestic Entities Must Contact the Georgia Secretary of State
in Order to Register Corporation / Limited Liability Company
P# (404) 656-2817
Website: www.sos.georgia.gov
Federal Tax ID
Do You Plan to Buy, Sell or Trade in Any Used Goods?
Yes
Anticipated Gross Receipts For 12 Months
$
Or I am a Professional Under O.C.G.A. Sect. 48-13-9c and I
Therefore Elect to Pay a Flat Fee of $300.00 Plus the $50.00
Non-Refundable Administration Fee.
This Does Not Include Other Regulatory Fees That May Be Assessed
If Tax Exempt Appropriate Documents Must Be Provided
No
This Includes any Reselling of Refurbished Goods and
nd
Electronics. If You Answer Yes a 2 Hand Dealers Permit
Questionnaire Must Be Completed & Submitted With This
Application.
This is in Accordance to Sec. 26-500 Subsections 1 and 2 of the City
of Douglasville Ordinances
Detailed Explanation of Business Activities to Be Conducted at the Business Location
Primary Business Activity Which Will Generate the Most Revenue
Is There Another Business Currently at The Aforementioned Location?
Yes
No
If Yes, Type/Print the Name of the Business Above
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 2 of 17
Representative of Business
This Application Was Last Updated July 28, 2014 and is
Subject to Change in Order to Comply with Federal, State,
and Local Laws & Regulations.
Official Title
Occupational Tax Contact Information
Name
Last
First
Street
t
Suite #
Lori Martin
Finance Department
City of Douglasville
Middle
Address
Phone
DOB
City, State, Zip Code
License
P# (678) 449 3078
F# (678) 449 3079
Email: [email protected]
Mail to:
P.O. Box 219
Douglasville GA, 30133
Email
Representative of Business
Please Direct Any Questions to the Above Individual
Regarding City Ordinances, Occupational Tax and other
Related Business.
Official Title
Name
Last
First
Middle
Street
t
Suite #
City, State, Zip Code
Address
Phone
DOB
License
Email
Only Fill Out the Below Information if it Applies to You
Business Name Change
Previous (Original Name)
New Name (DBA)
Business Ownership Change
New Owner’s Name(s)
[Corporation Name if Applicable]
New Owner’s Address(es)
[Corporate Office Address if Applicable]
Street
t
Suite #
Street
t
Suite #
City, State, Zip Code
Street
t
Suite #
City, State, Zip Code
City, State, Zip Code
Business Location Change
(A $10.00 Location Change Fee Will Be Assessed)
Previous Business Address
New Business Address
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 3 of 17
Applicant’s Signature
Applicant’s Printed Name
Date Signed
In making the above representation under oath, I understand that any person who knowingly and willfully makes a false,
fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the
Official Code of Georgia.
I hereby declare that the above information is true and correct and the anticipated gross receipt amount is projected to the
best of my knowledge and that I will comply with Federal, State, and Local laws and regulations.
This application must be signed by the business owner, partner, or an authorized representative of the business or corporation
Applicant’s Signature
Applicant’s Printed Name
Date Signed
For Notary Use Only
Subscribed and Sworn Before Me on This the
Notary Public
Day of
in the Year of
Notary Seal
My Commission Expires
Official Approvals/Denials For Application
Fees Paid
Yes
No
Department
Receipt No:
Signature
Date
Building Department
Zoning & Development
Fire Commissioner
DVPD Code Enforcement
Comments:
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 4 of 17
State of Georgia
Department of Revenue
1800 Century Boulevard
Atlanta, Georgia 30345
Official Addendum to Business Occupancy License Application
Required Fields
Name of Business (Legal Name or Trade Name):
Mailing Address if Different From the Physical Address:
Actual Physical Address of Each Location of Such Business if Different From the Mailing Address:
Sales Tax ID #, if Your Business is Required to Have One by Law:
Applicable North American Industry Classification System Code Number (Please list all NAICS):
NOTICE:
Upon completion or refusal to complete this form by the taxpayer, the municipality or county shall provide written notice
to the taxpayer that the above information will be submitted to the Georgia Department of Revenue.
The failure or refusal to complete this form by the taxpayer shall not toll or extend the time of payment established for
such occupation tax or regulatory fee under Code Section 48-13-20.
In accordance with O.C.G.A. §§ 48-2-15 and 48-7-60, all taxpayer information provided on this Form shall be
confidential and privileged.
In compliance with O.C.G.A. §§ 48-1-2 and 48-8-33, the Commissioner of the Georgia Department of Revenue shall
collect all sales tax remitted in Georgia.
Any questions or comments regarding the collection of sales tax or this Form should be directed to the Georgia
Department of Revenue at (404) 417-6605 or sent to Tax Law & Policy, 1800 Century Blvd., NE, Atlanta, GA 30345.
An Equal Opportunity Employer
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 5 of 17
DOUGLASVILLE POLICE DEPARTMENT
PO Box 219, Douglasville, GA 30133
6730 Church Street, Douglasville, GA 30134
(770) 920-3010 PHN (770) 920-0734 FAX
www.ci.douglasville.ga.us
EMERGENCY CONTACT INFORMATION FORM
Date:
Address
City
State
L-------------------------------------~
D
Zip Code
I
L--------~
(Include Suite Numbers in the Business Address field)
Business Phone Number
Type of Business
Is there an Alarm?
0
O
Yes
No
Alarm Company Name and Phone No:
Business or Owner Email Address
Special Instructions (i.e., Gate Code, Hidden Key, Dogs Present. etc.)
EMERGENCY INFORMATION FOR POLICE AND 911
In case of emergency during non-business hours. attempt to contact the following people in the order they appear below
Name
Cell Number
Alt Number
Name
Cell Number
Alt Number
Name
Cell Number
Alt Number
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
L
_ _~
____j
Page 6 of 17
Affidavit Verifying Status
For Douglasville City Public Benefit Application
By executing this affidavit under oath, as an applicant for a City of Douglasville, Georgia
Business License or Occupation Tax Certificate, Alcohol License, Taxi Permit or other public
Benefit as referenced in O.C.G.A. Section 50-36-1, I am stating the following with respect to my
Application for a City of Douglasville, Business License or Georgia Occupational Tax Certificate,
Alcohol License, Taxi Permit or other public benefit (circle one) for
__________________________.
[Name of natural person applying on behalf of individual, business, corporation, partnership, or
other private entity]
1)
________ I am a United States citizen
OR
2) ________ I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or
non-immigrant under the Federal Immigration and Nationality Act 18 years of age or older and lawfully present in
the United States.*
In making the above representation under oath, I understand that any person who
knowingly and willfully makes a false, fictitious, or fraudulent statement or
Representation in an affidavit shall be guilty of a violation of Code Section 16-10-20 of the Official Code of Georgia.
Signature of Applicant:
Date
_____________________
________
Printed Name:
_____________________
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
_____DAY OF ____________, 20___
*__________________________________
Alien Registration number of non-citizens
Notary Public
My Commission Expires:
*Note: O.C.G.A. § 50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8
U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal
definition of “alien”, legal permanent residents must also provide their alien registration number. Qualified aliens that do not
have an alien registration number may supply another identifying number below:
__________________________________
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 7 of 17
Secure and Verifiable Documents Under O.C.G.A. § 50-36-2
Issued August 1, 2012 by the Office of the Attorney General, Georgia
The Illegal Immigration Reform and Enforcement Act of2011 ("UREA") provides that "(n]ot
later than August 1, 2011, the Attorney General shall provide and make public on the
Department of Law's website a list of acceptable secure and verifiable documents. The list shall
be rev"iewed and updated annually by the Attorney General." O.C.G.A. § 50-36-2(f). The
Attorney General may modify this list on a more frequent basis, if necessary.
The following list of secure and verifiable documents, published under the authority of O.C.G.A.
§ 50-36-2, contains documents that are verifiable for identification purposes, and documents on
this list may not necessarily be indicative of residency or immigration status.
•
A United States passport or passport card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
A United States military identification card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
A driver's license issued by one of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Marianas
Islands, th~ United States Virgin Island, American Samoa, or the Swain Islands, provided
that it contains a photograph of the bearer or lists sufficient identifying information
regarding the bearer, such as name, date of birth, gender, height, eye color, and address to
enable the identification of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
An identification card issued by one of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Marianas
Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided
that it contains a photograph of the bearer or lists sufficient identifying information
regarding the bearer, such as name, date of birth, gender, height, eye color, and address to
enable the identification of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
A tribal identification card of a federally recognized Native American tr:ibe, provided that
it contains a photograph of the bearer or lists sufficient identifying information regarding
the bearer, such as name, date of birth, gender, height, eye color, and address to enable
the identification of the bearer. A listing of federally recognized Native American tribes
may be found at:
http://www.bia.gov/WhoWeAre/BIA/OIS/TribalGovernmentServices!TribalDirectorylind
~x.htm [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
A United States Permanent Resident Card or Alien Registration Receipt Card [O.C.G.A.
§ 50-36-2(b)(3); 8 CFR § 274a.2]
•
An Employment Authorization Document that contains a photograph of the bearer
[O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
A passport issued by a foreign government [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 8 of 17
•
A Merchant Mariner Document or Merchant Mariner Credential issued by the United
States Coast Guard [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
•
A Free and Secure Trade (FAST) card [O.C.G.A. § 50-36-2(b)(3); 22 CFR § 41.2]
•
A NEXUS card [O.C.G.A. § 50-36-2(b)(3); 22 CFR § 41.2]
•
A Secure Electronic Network for Travelers Rapid Inspection (SENTRI) card [O.C.G.A:
§ 50-36-2(b)(3); 22 CFR § 41.2]
•
A driver's license issued by a Canadian government authority [O.C.G.A. § 50-36-2(b)(3);
8 CFR § 274a.2]
•
A Certificate of Citizenship issued by the United States Department of Citizenship and
Immigration Services (USCIS) (Form N-560 or Form N-561) [O.C.G.A. § 50-36-2(b)(3);
6 CFR § 37.11 ]
•
A Certificate of Naturalization issued by the United States Department of Citizenship and
Immigration Services (USCIS) (Form N-550 or Form N-570) [O.C.G.A. § 50-36-2(b)(3);
6 CFR § 37. 11]
•
Certification of Report of Birth issued by the United States Department of State (Form
DS-1350) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]
•
Certification of Birth Abroad issued by the United States Department of State (Form
FS-545) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]
•
Consular Report of Birth Abroad issued by the United States Department of State (Form
FS-240) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]
•
An original or certified copy of a birth certificate issued by a State, county, municipal
authority, or territory of the United States bearing an official seal [O.C.G.A. § 50-362(b)(3); 6 CFR § 37.11]
•
In addition to the documents listed herein, if, in administering a public benefit or
p[ogram, an agency is required by federal law to accept a document or other form of
identification for proof of or documentation of identity, that document or other fonn of
identification will be deemed a secure and verifiable document solely for that particular
program or administration of that particular public benefit. [O.C.G.A. § ~0-36-2(c)]
1
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 9 of 17
Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d)
Compliance Deadline Schedule
. Private employers applying for a[n] business 1icense, occupational tax certificate, or other
document required to operate a business must complete the above-referenced affidavit in
compliance with the following schedule:
•
If you are an employer (including any individual, firm, or corporation) employing
more than five hundred (500) employees, you must complete an affidavit between
January l, 2012, and June 30,2012.
•
If you are an employer (including any individual, firm, or corporation) employing
more than one hundred (100) employees, you must complete an affidavit between
July 1, 2012, and June 30, 2013.
•
If you are an employer (including any individual, firm, or corporation) employing
more than ten (10) employees, you must complete an affidavit on or afterJuly, 1,
2013.
Pursuant to O.C.G.A. § 36-60-6(f), the office of the Georgia Attorney General will
post the appropriate Private Employer Affidavit form on the Department of Law's
official website pursuant to the above-referenced compliance schedule.
The Affidavit form should be sent to the entity within Georgia with whom you are
doing business. A copy of the affidavit form need not be sent to the Georgia Attorney
General's Office.
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 10 of 17
------·---
List of states that verify immigration status prior to issuance of a driver's license or I. D.
card and only issue to persons lawfully present in the United States, as required by
O.C.G.A Section 13-l0-91(b)(5).
Compliant
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Mkhigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Vermont
Virginia
West Virginia
Wisconsin
Wyoming
City of Douglasville, Georgia
Non-Compliant
Alaska
Idaho
Illinois
Massachusetts
New Jersey
New Mexico
New York
Rhode Island
Utah
Washington
Compliance Verification Pending
Maryland
Occupational Tax Certificate Application for Commercial Business
Page 11 of 17
------·-;;;
Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d)
TAX
CERTIFICATE
By executing this affidavit under oath, as an applicant for a(n) OCCUPATIONAL
----,------[business license, occupational tax certificate, or other document required to operate a business]
as referenced in O.C.G.A. § 36-60-6(d), from - : - - -THE
- : - -CITY
- : - - -OF
- : cDOUGLASVILLE
---:::-----:---:---:-[name of county or municipal co1poration], the undersigned applicant representing the private
employer known as
[printed name of
private employer] verifies one of the following with respect to my application for the above
mentioned document:
1. Only fill out this section if the current date is on or before June 30, 2013. Select Only One.
(a)
On January I" of the below signed year the individual, firm, or corporation
employed one hundred (100) or more employees. If the employer selected l(a)
please jill out Section 3 below.
(b)
On January I" of the below signed year the individual, firm, or corporation
employed less than one hundred (100) employees.
2. Only fill out this section if the current date is on or after July 1, 2013. Select Only One.
(a)
On January I" of the below signed year the individual, firm, or corporation
employed more than ten (I 0) employees. If the employer selected 2(a) please fill
out Section 3 below.
(b)
On January I'' of the below signed year the individual, firm, or corporation
employed ten (10) or fewer employees.
3. The employer has registered with and utilizes the federal work authorization program in
accordance with the applicable provisions and deadlines established in O.C.G.A. § 36-606(a). The undersigned private employer also attests that its federal work authorization user
identification number and date of authorization are as listed below:
Federal Work Authorization User Identification Number
Date of Authorization
In making the above representation under oath, I understand that any person who knowingly and
willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall
be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties allowed by such
statute.
Executed on the _date of _ _ ___, 201
in _ _ _ _ _ _ _ (city), _ _ _(state)
Signature of Authorized Officer or Agent
Printed Name of and Title of Authorized Officer or Agent
SUBSCRIBED AND SWORN BEFORE ME
ON TillS THE
DAY OF
, 201_.
NOTARY PUBLIC
My Commission Expires:
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 12 of 17
CITY OF DOUGLASVILLE
SANITATION DEPARTMENT
6695 CHURCH STREET
DOUGLASVILLE, GA 30134
PHONE: 770-920-3005
FAX: 770-920-3006
EMAIL: [email protected]
OFFICE HOURS: MONDAY – FRIDAY 7:00 AM – 4:00 PM
ACCOUNT #:
SANITATION REQUEST - FRONT LOAD COMMERCIAL CUSTOMERS
NEW ACCOUNT: [ ]
INCREASE: [ ]
DECREASE: [ ]
CANCEL: [ ]
START DATE:
INC DATE:
DEC DATE
END DATE:
HOME TELEPHONE NO.:____________________
BILLING & MAILING ADDRESS:
NAME:
ADDRESS:
CITY, STATE & ZIP
CONTACT:
PHONE:
FAX:
EMAIL: ____________________________________________________________________________
SERVICE LOCATION:
NAME:
ADDRESS:
CITY, STATE & ZIP
CONTACT:
PHONE:
FAX:
************************************************************************************
FRONT END [ ]
TYPE OF SERVICE REQUESTED:
DUMPSTER SIZE:
QUANTITY:
SERVICE FREQUENCY:
DEPOSIT:
|
|
|
|
************************************************************************************
SPECIAL INSTRUCTIONS:
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 13 of 17
TERMS AND CONDITIONS
ACCOUNT NO: ____________________
COMPANY NAME:_________________________________________
The City Of Douglasville is the exclusive franchise haul of all commercial and industrial waste within the
City limits.
COMMERCIAL:

Charges for the collection of commercial refuse shall be as fixed from time-to-time by the mayor
and council and shall be billed by the City of Douglasville Sanitation Department monthly.

Payments are due on the 21st of the month. Please submit payment and put your customer number on
your check. (Customer number is located under the mailing address on your statement.)
FAILURE TO PAY CHARGES WILL BE A VIOLATION OF THE CITY SANITATION CODE.
CITATION(S) FOR VIOLATION(S) WILL BE ISSUED BY THE CITY, AND SAID CITATION(S)
WILL BE RETURNABLE TO AND TRIED BEFORE THE MUNICIPAL COURT.
I certify that I have read the above statement and will abide by the terms and conditions of this contract.
CUSTOMER’S SIGNATURE
City of Douglasville, Georgia
DATE
Occupational Tax Certificate Application for Commercial Business
Page 14 of 17
CITY OF DOUGLSVILLE
SANITATION DEPARTMENT
6695 CHURCH STREET
DOUGLASVILLE, GA 30134
PHONE: 770-920-3005
FAX: 770-920-3006
EMAIL: [email protected]
OFFICE HOURS: MONDAY – FRIDAY 7:00 AM – 4:00 PM
PRICING:
SIZE
2YD
4YD
6YD
8YD
1X
$59.78
$72.78
$98.76
$132.55
2X
$72.78
$132.55
$197.55
$262.52
3X
$98.79
$197.55
$295.01
$392.50
4X
$132.55
$262.52
$393.50
$525.07
5X
$163.75
$328.81
$491.26
$655.02
6X
$
$
$
$783.69
Pricing is monthly X-means times per week
ADDITIONAL CHARGES:
Deposit : 2 months service amount
Pricing for extra pick up $28.75
3. Lock Kits: $67.85
1.
2.
SIZE & DIMENSION:




2Yd: 3’ deep X 3’ 5” high X 6’ wide
4Yd: 5’6” deep X 5’ high X 6’ wide
6Yd: 6’ deep X 5’ high X 6’ wide
8Yd: 6’ deep X 6’ 8” high X 6’ wide
PLEASE DO NOT OVERLOAD OR BLOCK ACCESS TO THE DUMPSTERS AS OUR
DRIVERS ARE ON A TIGHT SCHEDULE AND WILL PROCEED TO THE NEXT
SCHEDULED SITE FOR SERVICE AND POSSIBLY WILL NOT RETURN UNTIL THE
FOLLOWING BUSINESS DAY.
.
IN ORDER TO PROVIDE YOU WITH QUALITY SERVICE THAT FITS YOUR SPECIFIC
NEED & TO EXPEDITE SERVICE, PLEASE BE FAMILIAR WITH THE ABOVE
INFORMATION BEFORE SIGNING THIS DOCUMENT.
FOR FURTHER INFORMATION PLEASE CONTACT:
Melissa Dickinson 678-449-3146 OR EMAIL [email protected]
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 15 of 17
Office of Secretary of State Brian P. Kemp
Professional Licensing Boards Division
www.sos.state.ga.us/plb
The Professional Licensing Boards Division provides administrative support services to 35 professional
licensing boards that license more than 380,000 Georgians in over 64 trades and professions. The Boards
process applications, administer examinations, and when warranted, conduct investigations into
possible misconduct and suspend or revoke the licensure of practitioners.
The Professional Licensing Boards of Georgia are committed to protecting the health, safety and welfare
of all citizens through appropriate regulations of professions and businesses. The following is a list of
professions that obtain licenses through the Professional Licensing Boards:
A-E
F-P
P-Z
Accountants
Foresters
Pharmacists
Architects/Interior Designers
Funeral Service
Physical Therapists
Athlete Agents
General and Residential Contractors
Plumbing Contractors
Athletic Trainers
Geologists
Auctioneers
Hearing Aid Dealers
Barbers
Landscape Architects
Cemeteries
Librarians
Chiropractic Examiners
Licensed Practical Nurses
Conditioned Air Contractors
Low Voltage Contractors
Cosmetologists
Massage Therapists
Dentists
Nursing Home Administrators
Dietitians
Occupational therapists
Dispensing Opticians
Optometrists
Podiatrists
Private Detectives
Professional Counselors, Social
Workers, and Marriage and Family
Therapists
Psychologists
Registered Nurses
Security Guards
Speech Language Pathologists and
Audiologists
Used Motor Vehicle Dealers and Parts
Dealers
Utility Contractors
Veterinarians
Water/Wastewater Treatment Plant
Operators
Electrical Contractors
Engineers and Land Surveyors
Office of Secretary of State Brian P. Kemp
Professional Licensing Boards Division
237 Coliseum Drive
Macon, Georgia 31217-3858
(478) 207 2440
www.sos.state.ga.us/plb
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 16 of 17
Sec. 26-3. - Administrative and regulatory fee structure; occupation tax structure.
a)
A nonprorated, nonrefundable administrative fee of $50.00 shall be required on all business and occupation tax accounts
for the initial start-up, renewal, or reopening of those accounts.
b)
An administrative fee of $10.00 shall be required on all business and occupation tax accounts for the transfer of the
registration certificate to a new business location for the same owner to operate the same business under the same name
at the new location for the remainder of the existing license period under the same terms and conditions contained herein.
c)
In addition to the administrative fee, a non-prorated regulatory fee will be imposed as provided under O.C.G.A. § 48-13-9
on those applicable businesses. A regulatory fee may not include an administrative fee and is non-refundable. The
regulatory and administrative fees required by this section shall be paid in addition to any occupation tax required
under section 26-4
d)
The regulatory fee schedule for persons in occupations and professions is set forth as follows:
1.
Vehicles for hire, per registered operator .....$35.00
2.
Private ambulance, per provider .....50.00
3.
Dealers in precious metals, per applicant .....35.00
4.
Pawnbrokers, per applicant .....50.00
5.
Massage parlors, per applicant .....50.00
6.
Fortunetellers, per applicant .....50.00
7.
Flea markets, per location .....50.00
8.
Amusement centers, per location .....100.00
9.
Door to door solicitors, per location .....25.00
10. Peddlers and transient merchants, per location .....35.00
11. Adult entertainment, per location .....5,000.00
(For additional regulations see section 14-1000 et seq.)
12. Building and construction contractors, subcontractors, roofers, siding, security and fire alarm installers and
workers. Permit fees shall be as provided in a schedule adopted by the city council and on file in the office of
the building official, and are due for each permit issued.
Unless otherwise noted, all fees under this section are due annually and are payable prior to the conduct of any
business for the applicable time period.
(Ord. No. 95-39, § 1, 12-18-95)
City of Douglasville, Georgia
Occupational Tax Certificate Application for Commercial Business
Page 17 of 17