HORVATH (2)•
1992 BUSINESS LICENSE APPLICATION FORM
a i
BUS. LIC. NO.
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*APPROVED INITIALS DATE_1
*DENIED INITIALS DATE
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1. IS THIS BUSINESS LOCATED AT YOUR HOME:
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2. Business Name: 0AUel d . F—K 1 SZPR-ts ,,S
3. Business Address: 4. Mailing Address:
A\/E- Y/JLL E26 LA Q' O I CA
5. Business Phone:( ltd( ) : 6q ( 3
6. Owned By: CORPORATION PARTNERSHIP INDIVIDUAL
7. If Corporation or Partnership: Tax I.D.#
8. If Individual Owner: Social Security # ?n L41
9. Name of Owner RAkPI.O lM • FI0�2VA��_ Title: (31�'lF3iZ-
Or Officers ��1�, r
10. Type of _Business : W& L ORt er Sn is -no .Sags �9'C
11.)(SBE Resale Number: N e
12. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business Receipts for New Businesses Only:
$ Isav -- )=
B. Previous Year Gross Receipts For Established Businesses:
********GOOD ONLY FOR JANUARY 1,1992 THRU DECEMBER 31,1992*******
I HEREBY CERTIFY that all the information supplied by me is correct and
any licenses required by the County, State or Federal Government have been
issued_ mefjA=ar -41err full force and effect.
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box .1504
La Quinta, CA 92253
Date
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