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City and County of Broomfield, One DesCombes Drive, Broomfield CO 80020 Finance Department, Sales Tax Division Sales Tax License Application NO FEE REQUIRED CART/KIOSK DEPOSIT $200.00 E-Mail: [EMAIL REDACTED] Web: www.broomfield.org/salestax [PHONE REDACTED] FAX [PHONE REDACTED] Licenses will not be issued unless this form is filled out completely. CART/KIOSK DEPOSIT MUST ACCOMPANY APPLICATION Please allow up to two weeks for processing of application. Please Print Business Information Business DBA Name (if Physical Business Business Web Mailing Information Contact Mailing Owner/Officer Information Type of Ownership Individual/Sole Proprietor_____ Partnership_____ Corporation_____ Trust_____ Type of Location Commercial__________ Home FEIN or Social Security State Sales Tax Reporting Frequency Quarterly_________ Annually_________ Registered with the Secretary of State in Colorado New Business in Broomfield Purchased Existing Business Date you will start business in Description of business (please detail types of services/products and nature of I declare under penalty of perjury, that this application has been examined by me and the statements made herein are made in good faith pursuant to Colorado tax laws and regulations, and to the best of my knowledge and belief, are true, correct and complete. Account Number Date