Sellers of Travel Addendum
This form must be submitted with a Business License Application form.
Please type or print in dark ink.
Registration fee: $202
BLS-700-322 (6/24/20) Page 1 of 2
For assistance or to request this document in an alternate format, please call 360-705-6705. Teletype (TTY) users may use the Washington State Relay Service by
calling 711.
UBI
Owner name
A
Proof of business registration Applicants from outside Washington only
If your business is located outside of Washington State, you must provide proof of a valid registration to conduct
business in your home state. Attach a copy of your current business registration document, or other ocial registration
certication provided by the registration oce in your home state.
B
Criminal history All applicants
Answer the questions below. If you answer “Yes,” attach a detailed explanation.
1. Within the last 5 years, in this state or any other jurisdiction, has the business entity, any business
owners, or any persons with controlling interest in this business had any action (ne, suspension,
revocation, censure, surrender, etc.) taken against any professional or occupational license,
certication, or permit? ........................................................................................................................
Yes No
2. Within the last 5 years, in this state or any other jurisdiction, has the business entity, any business
owners, or any persons with controlling interest in this business defaulted or been convicted of
or entered a plea of no contest to a gross misdemeanor or felony crime? (Don’t include trac
oenses.) .............................................................................................................................................
Yes No
3. Within the last 5 years, in this state or any other jurisdiction, have you had any civil court order,
verdict, or judgment entered against you? (Don’t include small claims decisions under $5,000.) ......
Yes No
C
Identication of authorized agents All applicants
Do you have employees, independent contractors or other outside agents who will sell travel under the authority of this
business location’s registration?
Yes No
If yes, list them below. Attach additional sheets in the same format if necessary.
Name
Business address
Street or route, city, state, zip code
Business telephone
number
( )
( )
( )
( )
( )
Continued on next page
State of Washington
Business Licensing Service
PO Box 9034
Olympia, WA 98507-9034
360-705-6741