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                                                    CITY OF MUSKEGON 
                                        BUSINESS REGISTRATION APPLICATION 
                                                  $30.00 REGISTRATION FEE 
Attach a Current Certificate of Occupancy and Fire Safety Audit Worksheet.  If you are non-profit, please enclose a Non-
Profit Status form. 
PLEASE TYPE OR PRINT (FOR QUESTIONS CALL;  (231) 724-6705) 
COMPLETE COMPANY NAME                                                       Check one box only: 
                                                                                Individual         Corp                 Partnership  
                                                                                Non-Profit      LLC                     Government  
                                                                                Other (Explain)  
BUSINESS NAME (or DBA if used) 
  BUSINESS CHARACTER/CATEGORY 
  FEIN# or SSN#                                  HOURS OF OPERATION                                       NUMBER OF EMPLOYEES 
                                                                                                           
BUSINESS PHONE                                                              START-UP-DATE 
 MAILING ADDRESS (for renewal and correspondence) 
 Number and Street: 
  City, State, Zip 
PHYSICAL ADDRESS OF BUSINESS IN MUSKEGON 
 Number and Street: 
 City, State,Zip: 
OWNER/MANAGER BUSINESS 
                                                                                        TITLE 
                                                                             
RESIDENCE ADDRESS                                                           HOME TELEPHONE 
Number and Street:                                                           
                                                                             
City, State, Zip                                                            BUSINESS TELEPHONE 
DRIVER LICENSE NUMBER 
 EMERGENCY CONTACT 
Name: 
  Address:                    Phone: 
  I certify that the above information is correct to the best of my knowledge. 
  
Signature of Applicant                                                                                                 Date