Business License Application - City of Martinsville, Indiana

Name of Applicant*

Official Name of Business*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Owner(s)/Operator(s)*

Home Phone

Home Address*

Street Address Address Line 2 City State ZIP Code

Is this a home occupation?

Yes
No

Do you have an Alarm System

Yes
No

Please supply us with a written description of what the home occupation consists of.

Principle contacts to be called in case of an emergency or business irregularity after closing hours. List them in the order of preference in which you wish them to be contacted. Also indicate if key holder must be listed.

Name	Address	Phone #	Key Holder (Y/N)	Over the age of 18? (Y/N)

Are there any hazardous product(s) that may be harmful to life or safety on the Premises?

Yes
No

If YES attached Material Safety Data Sheets (MSDS Forms).

These will be forwarded to the Fire Department.

Max. file size: 128 MB.

Any FOREIGN CORPORATION must submit Certificate of Authority from Indiana Secretary of State.

Describe how the solid waste will be managed

Nature of this business

Pls specify