A
ttachment C:
October 4, 2022 Email
Email from Hollywood Cares team submitting the initial application for a City issued business license.
ATTACHMENT C
1 Courtney Christy
From: Shannon Anderson <[email protected]>
Sent: Tuesday, October 4, 2022 9:58 AM
To: Courtney Christy
Cc: Amelia Williamson; Jason Lee; Rob Smith; Lynel Washington Subject: HOLLYWOOD CARES FOUNDATION - Business License Application Attachments: Business_License_Application_HCF.pdf
CAUTION: This email originated from outside the City of Stockton. Do not click any links or open attachments if this is unsolicited email.
Good Morning, Courtney. Please let us know if all looks good on the attached application for you to walk it down and submit on our behalf — thank you again so much for that generous offer. I know you mentioned that fees were waived for nonprofits, but please do let us know if you need a cred it card or other form of electronic payment for any incidentals to get this through ASAP.
We very much appreciate your assistance with expediting the process! Warmest,
Shannon
ATTACHMENT C
FOR OFFICE USE ONLY:
ACCOUNT #
CUSTOMER ID #
LICENCE REF #
CLASS
ADMINISTRATIVE SERVICES DEPARTMENT
REVENUE SERVICES DIVISION–BUSINESS LICENSE TAX
425 North El Dorado Street • PO Box 1570 • Stockton, CA • 95201 Phone (209) 937-8313 Fax (209) 937-7184
Email: [email protected]
www.stocktonca.gov
BUSINESS LICENSE TAX APPLICATION
NEW LIC Number of Employees: Full Time Part Time Temporary Square Footage CHANGE Change From Date of Change Bus Lic #
NOTE: Any change in ownership, address, or business activity, requires a new application. The City of Stockton does not guarantee that information on this form will be exempt from disclosure under the Public Records Act.
BUSINESS INFORMATION:
1. Business Name (DBA) Phone ( )
2. Business Address Ste/ Apt # City State Zip
(Cannot be PO Box per CA Bus & Prof Code Section 17538.5) (List address where each individual consent to receive service of process AB2184 Sec 1600.)
3. Business Mailing Address Ste/Apt # City State Zip
(If different from the service process address/Business address)
4. Business Email Address
5. Business involved in renting residential or commercial real estate (Stockton only):
Property Address
Property Owner Parcel #
6. Detail Description of Business Activity
7. Standard Industrial Classification (SIC): Major Group:
8. Are you Chamber of Commerce Green Certified? Yes No___ (For information contact Chamber of Commerce (209) 547-2770)
9. Start date in the City of Stockton Estimated Monthly Gross Receipts in Stockton $
10. Contractor’s only: Project Amount CA Contractor’s License # Classification Expiration Date Annual Quarterly Contractors License
11. Seller’s Permit # SS# or Tax ID #
12. Check One: Single Owner Partnership Corporation LP LLC OWNER(S) INFORMATION: (The following personal information is not public and will not be shared in accordance with city policy OL-103.) Proof of compliance with Business and Professions Code Section 17538.5(b)(2)(A)(B) may be submitted in lieu of home address.
1. Name Address
City State Zip Home Phone ( )
Date of Birth Driver’s Lic or Other I.D.# State
2. Name Address
City State Zip Home Phone ( )
Date of Birth Driver’s Lic or Other I.D.# State
**ALTERED OR INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED** ✔
Hollywood Cares Foundation, Inc.
6390 DELONGPRE AVE PENTHOUSE 2 Los Angeles CA 90028
[email protected]
Non-profit youth development initiative
Services
✔
November '22 n/a
88-2250493
■
Jason Johnson 8833 Hollywood Blvd.
Los Angeles CA 90069 424 533-3441
08/16/1977 B3074646 CA
ATTACHMENT C
FOR OFFICE USE ONLY:
ACCOUNT #
CUSTOMER ID #
LICENSE REF #
CORPORATION, LLC, or LP INFORMATION: (Must be Registered in California) Name Corp/LLC /LP #
Names of Officers/Members
President: Secretary:
Vice President: Treasurer:
Authorized Agent: Contact Phone #
Authorized Agent: Contact Phone #
PLEASE NOTE:
The Issuing of your Business License is for revenue purpos es only. It does not relieve you from the responsibility of complying with the requirements of any other department of th e City of Stockton and/or any other ordinance, law or regulation of the City of Stockton, State of California, or any other governmental agency.
Business Licenses are not transferable. It is your responsibility to renew your Business License whether or not you receive a renewal notice. If you are no longer conducting business in the City of Stockton, you must notify us in writing.
To appeal a business license that has been denied see SMC 5.04.210.A.
I HAVE READ AND UNDERSTAND THE TERMS ABOVE • I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION PROVIDED ON THIS APPLICATION IS TRUE AND CORRECT.
Owner/Authorized Signature Title Date
Owner/Authorized Signature Title Da te
Disability Access and Education Fee (SB 1186)
**State Mandated Disability Access and Education Revolving Fund.
Under federal and state law, compliance with disability access laws is a serious and significant responsibility that applies to all California building owners and tenants with buildings open to the public. You may obtain inform ation about your legal obligations and how to comply with d isability access laws at the following agencies:
o The Division of the State Architect at www.dgs.ca.gov/dsa/Home.aspx. o The Department of Rehabilitation at www.rehab.cahwnet.gov. o The California Commission on Disability Access at www.ccda.ca.gov.
FOR OFFICE USE ONLY
Processed By: Date: Business License Taxes/Fees Amount
Dept/Div Checked Must Approve or Deny Authorized Signature and Date Registration Tax $24.00 Planning Approved Denied Mill Tax/Flat Rate Tax Building Approved Denied Penalty
Fire Approved Denied Prior Year(s) Taxes
Police Approved Denied **State Mandated Disability Access and Education Revolving Fund $4.00
MUD/StormwaterApproved Denied
Other: Approved Denied Total Due
Expiration Date
PLEASE RETAIN A COPY FOR YOUR RECORDS
HOLLYWOOD CARES FOUNDATION INC 88-2250493
Jason Johnson
Rob Smith
October 3, 2022CEO
ATTACHMENT C