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2. SECTION I: Business Information

4. Business Name
6. Business Address
8. Mailing Address
10. Business Phone
11. Business Email
13. Website

15. SECTION II: Owner/Manager Information

17. Business Owner
19. Owner Home Address
21. Owner Phone
22. Email

24. SECTION III: Federal and State Requirements

    Federal and State numbers can be obtained by logging onto www.business.utah.gov/registration.html (One Stop Business Registration).  The State Tax Commission office can be reached at 1(800) 662-4335. The Department of Commerce office can be reached at (801) 530-4849

26. Ownership Type
    -- Select One --CorporationPartnershipProprietorshipLLC
28. DBA
30. Business Registration Number
31. State Sales Tax Number
33. Employer Withholding Number
35. State License Type (if any)
36. Number
37. Expires
39. Federal License Type (if any)
40. Number
41. Expires

43. SECTION IV: Business Description

45. Home Occupation

    1. Yes
    2. No
46. Approximately how many people will visit the home per week
48. 1. Will there be any display or stock at the home?

    1. Yes
    2. No
50. 2. Will there be an additional employee other than residing family?

    1. Yes
    2. No
52. 3. Will hazardous materials or chemicals be used as part of the business or stored at the home?

    1. Yes
    2. No
54. If you answered yes to any of the questions above, please provide detailed information.
56. 4. Do you have adequate off street parking at your home for additional parking?

    1. Yes
    2. No
58. If no, how will you provide additional parking?
60. 5. What area of your home will be used for your business?
62. 6. What is the square footage of that area?
64. 7. Will there be any remodeling?

    1. Yes
    2. No
66. If yes, what is the permit number?
68. Please describe your business in detail

70. I have answered the above questions honestly and agree to comply with the Home Occupation Business regulations.

72. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
74. Electronic Signature
Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit

* indicates a required field