Recorders Office
Application for Business License
This application must be submitted with the License fee associated with the type of business as
determined by the Town of Granville.
Official Business Name: ________________________________________________________________
Doing Business As: ____________________________________________________________________
B&O Department: _____________________________________________________________________
Corp. Individual
Gov.
LLC
LLP
PLLC
Partnership
Ownership Type :
Assoc.
Business Category:
Amusements
Financial (banks, etc)
Rentals to Residents
Manufacturer
Retailer
Rentals to Businesses
Service Business
Wholesaler
Restaurant
Home State: ________
FEIN/SSN: _________________________
Registered with the WV Secretary of State: __Yes __No
Physical Address Information
___________________
Address 1 Address 2
________________________ ____ __________ ___________ ____________
City State Zip Code Country County
________________________ __________________ __________________
Website Phone # Fax #
Mailing Address Information Same as Physical Address? __Yes __No
________________________________________ ___________________
Address 1 Address 2
________________________ ____ __________ ___________
City State Zip Code Country
Email application and pay by phone: csypolt@townofgranvillewv.gov 304-599-5080 or
send check to Town of Granville PO Box 119 Granville, WV 26534
________________________________________
Recorders Office
Operation in Granville
__________________
Operating in Granville since
Official Contact Information
(1) ___________________________________ _______________________
Name (Salutation, First, MI, Last, Suffix) Title
____________________ ___________________ ______________________
Phone #/ Ext (If Applicable) Fax # Email Address
(2) ___________________________________ _______________________
Name (Salutation, First, MI, Last, Suffix) Title
____________________ ___________________ ______________________
Phone #/ Ext (If Applicable) Fax # Email Address
Description of Products and Services (Additional information may be attached)
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
UNDER PENALTIES OF PERJURY, I declare, to the best of my knowledge and belief, that the Information submitted
(including accompanying schedules and statements) IS TRUE, CORRECT AND COMPLETE.
____________________________ ________________________ ______________
Preparers Signature Title Date
Email application and pay by phone: csypolt@townofgranvillewv.gov 304-599-5080 or
send check to Town of Granville PO Box 119 Granville, WV 26534
click to sign
signature
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