City of Antioch
Finance Department
Phone (925) 779-7059
Email FinanceBusLic@ci.antioch.ca.us
Third and H Streets
City Hall, First Floor


CITY OF ANTIOCH

General Business Information

Legal Name of Business*
DBA†
Rental Location Address  
City* State* Zip*

Same as Business Address

Mailing Address
Mailing City* Mailing State* Mailing Zip*


Business Phone* E-Mail Address†
Web Address†
Date business started in the City of Antioch*
RadDatePicker
RadDatePicker
Open the calendar popup.
Ownership Type*
select


Rental Property Information

Please Note: If you have multiple single family homes that you need to register please put a one in the units field. You will need to fill out a separate application for each single family home that you are renting.

Rental Address # of Units      
Type of Business (Please be very specific)*


Business Type*
select
 


SIC*
select
 
State Contractor # if applicable   State Tax I.D.
Seller's permit#   Federal ID#  
 

Massage Certification # (if applicable)
Massage Expiration Date (if applicable)
RadDatePicker
RadDatePicker
Open the calendar popup.
 

 






Contact Information

Owner

   
Owner Name*  
Owner Address*
City* State* Zip*
Phone Social Security #   Driver's License No

Primary Contact

 
Contact Name†  
Contact Address  
City   State   Zip  
Phone   E-Mail  





Renewal Notice Delivery Method

Please select how you would like to receive renewal notices in the future:

Opt for Paper Only Opt for Email Only

Agreement

The undersigned, being authorized to make this Application, hereby declares to the best of their knowledge and belief that this is a true, correct, and complete information made pursuant to the Antioch Municipal Code. The undersigned also agrees to abide by all considerations and restrictions imposed under the Antioch Municipal Code. This business license does not authorize holder to engage in any business or profession for which other certificates or permits are required

Items marked with a † are non-confidential information and may be made public.

By submitting this application, I, declare under penalty of perjury that all information contained on this application is true and correct to the best of my knowledge.

Executed the .

Please sign your name below, using the mouse or your touch screen enabled device.