* Required        

DBA
Business Name
Business Address (Must be physical location, not a Post Office Box)	Verifying Address... Verified! Not recognized as a valid USPS address. Valid USPS address but is missing UNIT/STE #. Valid USPS address but UNIT/STE # is not recognized. PO Box is not allowed in business address. Verify Address Edit
Mail Address	Same as address above
	Verifying Address... Verified! Not recognized as a valid USPS address. Valid USPS address but is missing UNIT/STE #. Valid USPS address but UNIT/STE # is not recognized. PO Box is not allowed in business address. Verify Address Edit
Business Description
Ownership Type	Corporation Ltd Liability Co Ltd Partnership Partnership Sole Proprietorship Trust
Employee Count (must be 1 or greater) *
Enter gross receipts estimate *
Start Date in City of Rancho Cucamonga (estimate if in the future)
Contact Information
Phone
Phone 2
Fax
Website
Email Address
California Seller's Permit
FEIN
SEIN
Contact Preference	Contact me by email whenever possible, in order to ensure timely notices and help protect the environment by conserving resources.
State License Information (Contractor, Medical, CAMTC, etc.)
State License #
State License Type
State License Expire Date
State License Verification *
Additional Information
Are you a business that is a regulated industry with storm water discharge requirements in accordance with the SB205 NPDES permit program? If yes, please provide the SIC # and NPDES Permit # below. *	Yes No
SIC #
NPDES Permit #
If your business is located in a residential zone within Rancho Cucamonga, have you completed and attached the required Home Occupation Permit? *	Yes No
If your business is located in a commercial or industrial zone within Rancho Cucamonga, have you completed and attached the required Business License Questionnaire Form? *	Yes No
If your business is located in a commercial or industrial zone within Rancho Cucamonga, have you attached the required copy of the executed lease agreement? *	Yes No
If your business involves food preparation and/or sales, have you attached the required San Bernardino County Health Permit? *	Yes No
File Attachments (if required).  More Info
Business License Questionnaire
File Description
	*This file type is not allowed. List of supported file types.
Home Occupation Permit
File Description
	*This file type is not allowed. List of supported file types.
Lease Agreement
File Description
	*This file type is not allowed. List of supported file types.
San Bernardino County Health Permit
File Description
	*This file type is not allowed. List of supported file types.
*Cumulative file size can not exceed 89MB. Please reduce the size of your files and try again.