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County of Fairfax - 2024 Business, Professional & Occupational License Application.
Company/Owner Name (
Last, First
):
*
Business Type:
*
Sole Proprietor
Partnership
Corporation
LLC
Other (please specify)
Trade Name/DBA:
*
Federal Employer Identification Number(FEIN)/SSN:
(Include dashes)
Date Business Began in Fairfax County:
*
Current Business Location:
*
Street
Apt/Suite
City
State
VA
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
ME
MD
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
WA
WI
WV
WY
Zip Code
Check if mailing address is same as location address
Mailing Address (if different from location):
*
Street
Apt/Suite
City
State
VA
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
ME
MD
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
WA
WI
WV
WY
Zip Code
Number of Employees at this location:
Business Contact Information:
Business Contact Name:
Phone Number:
Fax:
Email Address:
Is Business Operated from Leased Premises within Fairfax County?
Yes
No
Name of Owner of Premises:
Annual Rent:
ADDRESS OF OWNER OF PREMISES:
Street
Apt/Suite
City
State
VA
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
ME
MD
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
WA
WI
WV
WY
Zip Code
Provide a detailed description of business activity in Fairfax County:
*
NAICS Code:
Contractors, Builders & Developers, Architects and Engineers Only:
VA State License Number:
Expiration Date:
If
VA State License Number
and Expiration Date are not provided then
Individual Contractors, Builders and Developers under $1,000 per contract
must certify there is no requirement to have a VA state license. Individuals must possess a valid
Tradesman License
in order to waive their contractor license requirement.
Under penalty of law, the applicant certifies that he/she Is Not required to have a Commonwealth of Virginia license pursuant to
Virginia Code 54.1-1111 (B).
Virginia Workers' Compensation Acknowledgement Number:
Required for Retail Merchants Only:
State Tax Locality Code:
51059
Sales & Use Tax Account Number:
ENTER YOUR RECEIPTS:
In completing Boxes 1 through 4 below, all businesses except wholesale merchants must report gross receipts. Wholesale merchants may report gross purchases in lieu of receipts, if available.
1
Total 2023 Calendar Year Gross Receipts.
*
2
Exclusions for year 2023. You must submit the
Exclusion Worksheet
to claim any applicable exclusions.
*
3
Adjusted 2023 Gross Receipts.
*
4
If business began after 1-1-23, please report Gross Receipts estimate for 2024 (after allowable exclusions).
*
Enter owner name of business; if incorporated, give corporate name.
Enter trade name of business (doing business as).
If doing business in a name other than the Company/Owner Name,
this name must be registered with the Clerk of the Court of Fairfax County.
List Federal Employer Identification Number. If a business does
not have a Federal Employer Identification Number, list Social
Security Number (Required for IRS reporting).
Enter date business began or moved into Fairfax County.
Enter business location in Fairfax County.
Enter mailing address (if different from location).
This is where correspondence and tax bills will be sent.
Enter number of employees -
only at the location listed on this application.
Enter name, telephone number, and e–mail address of person
to contact if additional information is needed.
Describe the principal type of business such as consultant, attorney,
shoe store, beauty salon, towing service, etc. Define in detail all business
activities in which the company engages in Fairfax County. It may be
necessary to obtain more than one license if you engage in more than one activity.
Please input the NAICS Code as reported on the Federal or State Tax return.
The North American Industry Classification System (NAICS) is the standard now
used by Federal Statistical Agencies to classify businesses according to the
primary business activity of the business.
Gross receipts should be reported on a calendar year basis and use the same method of accounting that is used for federal tax purposes.
“Gross receipts” means the whole, entire, total gross receipts, without any deductions.
“Gross Purchases” means all goods, wares and merchandise received for sale at each definite place of business of a wholesale merchant.
Persons who collect Federal or State excise tax on motor fuel as part of gross receipts may deduct this tax.
Persons who collect Sales or Use tax as part of gross receipts may deduct this tax. Provide your sales or use
tax account number as assigned by the State.
Only 501C(3) & 501C(6) organizations may exclude business related income from gross receipts. Attach Forms 990 and 990T.
Only nonprofit organizations may exclude gifts, contributions, or membership dues received. Attach Forms 990 and 990T.
Sellers of computer hardware or software that is purchased for resale directly to United States Federal or State
Government entities as allowed by Title 58.1-3732, of the Code of Virginia, can deduct the original
cost of the equipment. Provide documentation supporting any exclusions from gross receipts.
Documentation would include, but would not be limited to, a complete description of property sold,
copies of invoices, purchase orders, and contracts.
Software developers as defined in Section 4-7.2-1(b)(1)(Z) of the Fairfax County Code whose gross receipts
are derived solely from design, development, or other creation of computer software for lease, sale, or license
performed from a definite place of business within Fairfax County may claim an exclusion. The exclusion is 100 percent
of the receipts derived solely from the lease, sale or license of the software products. Other related receipts
(such as training, maintenance, or integration) are not deductible. Documentation will be required to receive
this exclusion. Such documentation should include, but not be limited to, copies of software license agreements,
applicable sales contract, financial statements detailing gross receipts and description of work.
Please check appropriate box to determine business ownership type.
Business operating from leased premises ONLY: List annual rent paid.
Business operating from leased premises ONLY: List name and address of owners of premises.