STATEMENT OF GROSS ANNUAL RECEIPTS
YOUR OCCUPATIONAL LICENSE IS EXPIRING
Please complete and return this form to complete your renewal of your occupational license. To ensure receipt of a new license please return the documents requested in the accompanying letter along with payment (fees on reverse side).
PLEASE INDICATE BELOW YOUR GROSS RECEIPTS* ENDING DECEMBER 31, 2014 OR YOUR LAST FISCAL YEAR. IF YOU HAVE NOT BEEN IN BUSINESS FOR A FULL YEAR, PLEASE LIST THE GROSS RECEIPTS YOU HAVE ACCUMULATED AND INDICATE THE TIME FRAME.
I HEREBY CERTIFY THAT THE TOTAL GROSS RECEIPTS ON THE ABOVE ADDRESS ARE:
*For Business located within Raytown: use the TOTAL GROSS REVENUE generated by your company BEFORE ANY DEDUCTIONS are made for expenses commissions, taxes or any other items.
*For Business located outside of Raytown Use the TOTAL GROSS REVENUE generated by your company IN THE CITY OF RAYTOWN before any deductions are made for expenses, commissions, taxes, or any other items.
Vending machines include snacks, soda, candy, cigarettes, video games, copy machines and any machine that money is placed into. DO NOT INCLUDE LOTTERY TICKET MACHINES OR NON-PROFIT MACHINES.