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2. Please include the following to ensure a smooth and fast process. If any of the following are required but not included, it will create a delay in issuing your BTR.
4. Articles of Incorporation, LLC papers/Fictitious Name statement
   Sunbiz.org
5. Any required state licenses/certifications
7. Local business tax schedule
   Article III- Local Business Tax Receipt Section 62-77

   Each receipt issued shall cover only one location, and only one of the occupations or business classifications set out in section 62-77 unless otherwise permitted under this article. The city reserves the right to inspect the business premises of any local business tax receipt holders business operation.
9. Business Name on Display at Store Front
10. Legal Business Name*
11. Oldsmar Address*
13. Phone Number
14. Mailing Address*

    Must include City, State and Zip

15. Business Owner's Name *
17. Cell Number
18. Email*
20. Manager's Name/Alt Contact*
21. Manager/Alt Contact Number*
22. Manager/Alt Contact Email
24. Building Owner's Name*
25. Phone Number*
26. Building Owner's Email
28. Federal Employer Identification Number (FEIN) or Owner's Social Security Number**
29. Have you applied for a Business Tax Receipt with the City of Oldsmar?*

    1. Yes

    1. No
31. When and for what business activity?
33. Website
34. Please explain in detail the nature of the proposed business*
36. Select one*

    1. Office
    2. Warehouse

    1. Manufacturing
    2. Retail

    1. Combination
    2. Other
38. If "combination" or "other" please explain
40. Please provide a description of the manufacturing or production activities your firm conducts. Describe the finished product and the equipment to be utilized. You will also be required to fill out the City of Oldsmar Industrial Wastewater Survey.
42. Size of business (square feet)
43. Days and hours of operation
44. Number of employees
46. Select one*

    1. I hereby certify that I will be making interior/exterior revisions (which would require building permits) in regards to this business location.
    2. I hereby certify that I will not be making interior/exterior revisions in regards to this business location.
48. Applicant/Owner Signature*
49. Date:
    Date:
51. In accordance with Florida State Chapter 442, Your Right To Know Law, City of Oldsmar Ordinance section 30-2, Hazardous Materials, businesses are required to report toxic substances to their local fire department as well as keep a list of the substances on file at the business location.
    If you have a chemical substance or mixture in a gaseous, liquid or solid state you must notify the City of Oldsmar fire rescue and provide the safety data sheet with your application. If not, please indicate below that you do not have any such hazardous substances in your business location and do not use any such materials in your manufacturing process.
53. City of Oldsmar Ordinance Section 30-2
    City of Oldsmar Ordinance Section 30-2
55. Please check one of the following:*

    1. Yes, I have notified the City of Oldsmar Fire Rescue of my business having hazardous substances on the site.
    2. No, I do not have any hazardous substances at my place of business.
57. I hereby certify that all of the information on this form is correct and true. I agree to comply with all applicable Land Development Regulations and city ordinances as they may apply to my proposed business. I agree to complete any Hazardous Substance reporting form, Industrial Development Report (IDR) or Industrial Wastewater Survey (IWS) that may be required as a result of my Business Tax Receipt application. I acknowledge that the fees for this Business Tax Receipt are non-refundable and that there is a ten (10) working day processing time for the review of a Business Tax Receipt application for approval or denial.
59. Any additional documentation
61. Signature of Owner or Designated Agent*
    By typing your name here, you are signing this form electronically. You agree you are submitting this affidavit for processing and is the legal equivalent of your manual signature on this form. You must be the legal business owner or authorized agent which match our registration records. Note: A notarized Letter of Authorization is required for an agent to sign the application or any other correspondence that calls for an agent signature.
62. Date:
    Date:
64. Please ensure you have attached copies of all required state licenses or certifications from other governmental agencies, i.e., DBPR, PCCLB Certification or License, Florida Department of Health, etc. Other documents required are copies of the Articles of Incorporation OR a Fictitious Name statement or affidavit.
    *The City of Oldsmar collects your Social Security Number or FEIN as required by Florida Statute. Social Security Numbers are also used as a unique numeric identifier and may be used for such purposes.
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74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit

* indicates a required field