City of Monterey Park

320 West Newmark Ave, Monterey Park, CA 91754
Attn: Bus. License Dept. (661) 570-5021

Business License Application



Business Information

Business Name
Attention
Business Location (Not P.O. Box)  
City State Zip

Same as Business Address

Mailing Address
Mailing City Mailing State Mailing Zip

Business Phone E-Mail Address Business Fax
Business Start Date
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Ownership:
select


Description of Business


Business Types:
select
Business Sub Type
select


Resale Number State I.D. Number
Federal I.D. Number

State Contractor License Number State Contractor Class Contractor Expiration
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Enter below names of Owners, Partners, or Corporate Officers

Contact 1

Title
Name  
Home Address
City State Zip
Phone Cell Phone1
SSN Driver's License No

Contact 2

Title
Name
Home Address
City State Zip
Phone Cell Phone2
SSN Driver's License No

Contact 3

Select Title
Name
Home Address
City State Zip
Phone Cell Phone3
SSN Driver's License No

In case of emergency, please contact:



Emergency Contact Name Emergency Contact Title
Emergency Home Phone Emergency Cell Phone
Emergency Contact Address


Vehicle Insurance Information


Company Name
Policy No.
Expiration Date
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Please upload a copy of the Proof of Insurance. File must be one of the following formats:PDF,JPEG,PNG or BMP
 

I declare under penalty of making a false certification that the foregoing information is true and correct to the best of my knowledge and belief.

Executed the I, By submitting this application I accept the conditions and declare under penalty of perjury the foregoing is true and correct.

Please sign your name below, using the mouse or your touch screen enabled device.