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2. *For retail businesses with only economic nexus.*
4. BUSINESS INFORMATION
6. Business Name*
8. Physical Address
10. City
11. State
12. Zip
14. Business Phone*
15. Business Fax
17. Business Web Address
19. Business Email*
20. Federal Employer ID
22. Check if applicable

    1. Business is in good standing with the Colorado Secretary of State to conduct business in Colorado
26. MAILING INFORMATION
28. Mailing Address
30. City
31. State
32. Zip
34. Reporting Frequency

    1. Monthly
    2. Quarterly
    3. Annually

    *Please note, you may only file annually if you have no retail sales and are only providing a service*

36. Does this business have an active account with the City of Wheat Ridge? If so, please list the account number below
38. Taxpayer Representative Name
39. Email
41. Location of Records
43. City
44. State
45. Zip
47. Business Type of Ownership (Check One)

    1. Sole Proprietorship
    2. Partnership
    3. Corporation

    1. LLC
    2. LLP
    3. Non-Profit Corporation (No Fee, Attach Proof)
49. If ownership type is not listed above please explain here
53. OWNER/OFFICER INFORMATION
55. Owner/President
56. Government Issued ID Number
58. Vice President
59. Government Issued ID Number
61. Date you started selling in Wheat Ridge
63. Description of Business

    Please give detail of types of service(s), product(s), and Nature of Business. 

67. 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 the City of Wheat Ridge tax laws and ordinances and, to the best of my knowledge and beliefs, are true, correct and complete.
69. Acknowledgement*

    1. I have read and understand the statement above
71. Name*
72. Title/ Capacity*
74. Date
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 Submit and Print

* indicates a required field