HomeMy WebLinkAboutBusiness License Application Form Master 110712County of Hawaii
DEPARTMENT OF FINANCE
Vehicle Registration & Licensing Division
101 Pauahi Street, Suite No. 5, Hilo, Hawaii 96720 -4224
(808) 961 -8351 • (808) 961 -8330 (FAX)
Date:
Business Name:
Address of Sales Location:
Mailing Address:
Type of License:
State of Hawaii GE Tax No.:
Owner Name(s):
Phone:
Email:
W -
Print Applicant Name
Applicant Signature
NOTICE: Issuance of this license does not relieve applicant from securing any necessary
approvals from other applicable government agencies, including the Hawai'i County
Planning Department.
I (We) do solemnly swear that the statements
contained in the foregoing application are true and correct and that I, as an individual or as an
officer of the corporation, or we, as members of the partnership or joint venture, have authority to
sign this application and to make the statements contained herein on behalf of the applicant.
Subscribed and sworn to before me this
day of 120
Notary Public, State of Hawaii
My commissions expires
For Office Use Only:
Auctioneer's Bond
Firearms Supplement
Purchasing, Wrecking, Rebuilding Supplement
SEQUENCE No. New No. Issued
County of Hawai'i is an Equal Opportunity Provider and Employer. Complaints of discrimination should be sent to:
USDA, Director, Office of Civil Rights, Washington, DC 20250 -9410. Or call (202) 720 -5964 (Voice and TDD).
Last Updated 11/07/12