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FOR OFFICE USE ONLY: <br /> Page 2 <br /> TAX ACCT. # f ,, <br /> CONTROL# Z�CP <br /> Corporation, LLC, or LP Information: <br /> Name (Must be Registered in California) Corp/LLC/LP # <br /> Names of Officers/Members <br /> President: Secretary: <br /> Vice President: Treasurer: <br /> Authorized Agent: Contact Phone#: <br /> Authorized Agent: Contact Phone# <br /> PLEASE NOTE: <br /> The Issuing of your Business License is for revenue purposes only. It does not relieve you from the responsibility of <br /> complying with the requirements of any other department of the City of Stockton and/or any other ordinance, law or <br /> regulation of the City of Stockton, State of California, or any other governmental agency. <br /> Business Licenses are not transferable. It is your responsibility to renew your Business License whether or not you receive a <br /> renewal notice. If you are no longer conducting business in the City of Stockton you must notify us in writing. <br /> I HAVE READ AND UNDERSTAND THE TERMS ABOVE• I HEREBY CERTIFY UNDER PENALTY OF PERJURY <br /> =THAT THE I MATION PROVIDED ON THIS APPLICATION IS TRUE AND CORRECT.. <br /> 0tvr4LO / - 7 - / S <br /> OwheAutrized-%n;r Title Date <br /> Owner/Authorized Signature Title Date <br /> Owner/Authorized Signature Title Date <br /> FOR OFFICE USE ONLY �n,�J 2013 <br /> Processed By: I Date: !, Business License Taxes Amount <br /> Dept/Div C c Must Approve or Deny Authori4a Signature and Date a Registration Tax <br /> tanning Approve�enied �S C—"7,�)� Mill Tax/Flat Rate Tax <br /> Building Approved Denied Penalty �o <br /> D Fire Approved D Denied 2 Prior Year(s)Taxes <br /> Police Approved D Denied D Total Due <br /> Other: Approved= Denied Expiration Date <br /> REMEMBER: TO PRINT A COPY FOR YOUR RECORD <br /> Revised 11/2010 <br />