CITY OF RENO Annual License Renewal Application

LICENSE NUMBER: BUSINESS NAME:

LICENSEE NAME: BUSINESS LOCATION: MAILING ADDRESS:

R________________________ _________________________ _________________________ _________________________ _________________________

Last day to pay without penalty: 60 DAYS AFTER EXPIRATION DATE

Renewals will be accepted no more than 30 days prior to expiration date

This renewal application and payment must be received within 60 days after the expiration date or a 50% penalty will be assessed (RMC 4.04.140). All

license fees and applicable penalties must both be paid and this entire form completed before the next annual license or renewal will be issued. The

information you provide is subject to audit. Any underpayment of fees is also subject to a 50% penalty.

------------------------------------------------------------------------------------------------------------------------------------------------PLEASE READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING.

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Gross Receipts Based Licenses: Use the total amount of gross receipts within the City of Reno for the 12-month period ending on the license expiration date using the following gross receipt based fee schedule to calculate the license fee:

Total Gross Receipts $ _________________

If total "Gross Receipts" are: $ 0 through $20,000 $ 20,001 through $ 100,000 $ 100,001 through $5,000,000 Over $5,000,000

Then license fee is: $ 60 $ 130 $ 130 plus .00085 times amount over $100,000 $ 4,295 plus .00065 times amount over $5,000,000

$$

TOTAL LICENSE FEE PENALTY (If paid after grace period, 50% of fees due) TECHOLOGY FEE

TOTAL AMOUNT DUE – Pay this amount. $

Be sure to include account number on check.

Keep a copy of this form for your records.

$

______________________________ _______________4.00 _

_______________

Updated: 06.26.17

INSTRUCTIONS Please read before completing form.

1. Verify all printed information on reverse side, and make any changes or corrections as necessary.2. Complete reverse side of form, filing in the number of items for each activity. Calculate the license

fees due for each activity, and subtotal for each category.3. Total the license fees for each category and enter in the spaces indicated.4. Compute any penalty due and enter in the designated space on the reverse side.5. Calculate Total Amount Due (please include technology fee).6. Complete remainder of form, sign, and date.7. Mail completed form and payment (be sure to include your license number on your check) for

Total Amount Due payable to:

City of Reno - Business License Division One East First Street PO Box 1900 Reno, NV 89505

Authorized Signature:__________________________ Print Name:__________________________________ Title: _______________________________________

Date________________ Phone ______________

Page 2

CERTIFICATIONI hereby declare that this application and its supporting data have been examined by me and are true

and correct to the best of my knowledge and belief. I acknowledge that the City relies on this information in its conduct of City business and in its management of fiscal affairs. Inaccurate statements of operational or financial data may harm the City, and I may be unable to later change the data for my remedy or benefit. I acknowledge that the information I provide is subject to audit and that this business

may be inspected (RMC 4.04.190). Signed personally and with authority to bind the above business.

BUSINESS STATUS: Federal Tax Identification Number (EIN): _______________________ If business has been sold; date sold: __________________________ Name and address of new owner: ____________________________

____________________________

No longer in business in Reno; please provide date business closed: ____________________

For other changes (legal status, owners/officers, new locations, mailing address, phone numbers, etc), please include new information on an attached sheet and mail in with this form, or contact the City License Office at (775) 334-2090. You can also visit www.reno.gov/businesslicense to obtain the proper forms and additional information.

Definition of Gross Receipts - RMC Section 4.04.008Gross receipts as used in connection with the determination of license fees, means the total amount received for all goods sold or for the performance of any act or service within the City. Gross receipts shall include all receipts, cash, credits, services or property received without any deduction for the cost of property sold, cost of materials used, labor or service costs, interest paid or payable, losses or any other expense whatsoever. See RMC 4.04.008 for exclusions (www.municode.com).