Applications, Permits, and Licensing

2. Section 1: Vendor Information
4. 1. Social Security Number

   (Owner SS# required for sole proprietorship, DBA's, & individuals)

5. 2. Taxpayer ID Number

   (Federal TIN used to file federal tax return)

7. 3. Payee Name*

   (as shown on your tax return)

9. 4. Business Name

   (If different from above - include DBAs here)

11. 5. Business Address:*
13. 6. City:*
14. 7. State:*
15. 8. Zip Code: *
17. 9. Phone:*
18. 10. Fax:
19. 11. Email Address:*
21. 12. Contact Name:*
22. 13. Contact's Title:*
26. Section 2: Vendor Tax Acknowledgement
28. 14. Does your business provide a physical service within the Town of Telluride?*

    1. Independent Contractor
    2. Contractor with Workers

    (Check all that apply)

29. 15a. Independent Contractors

    Attach Certificate of Liability Insurance OR Completed Independent Contractor Status Form

30. 15b. Contractors with Workers

    Attach Certificate of Liability Insurance AND Proof of Workers' Compensation Insurance 

31. 16. Is your business Incorporated?*

    1. Yes
    2. No
33. 17. Is your business filed as an LLC (Limited Liability Company)?

    1. Yes (Answer 17a)
    2. No (Skip to 18)
34. 17a. What is your LLC formed as?

    1. LLC (Answer 18)
    2. Partnership (Answer 18)
    3. Corporation (Skip to 19)
35. 18. Business Type (LLCs must answer this question as well)

    - Sole Proprietorship: Enter Owner's Name
    - Operated as a "DBA:" Enter Business Name
    - Partnership: Enter name used on tax return

36. 19. Upload a W9 Form.*
38. Telluride Business License Requirement

    If you have an office or perform a service in the Town of Telluride you must have an active Town of Telluride Business License. 

    If you do not have an active business license or yours recently expired, please visit bit.ly/totbusinesslicense to complete a Business License Application. 

    NOTE: It is unlawful for any person to operate any business in the Town of Telluride without a valid business license.

    PAYMENTS TO YOU MAY BE WITHHELD UNTIL DELINQUENT BUSINESS LICENSE FEES ARE RESOLVED.

40. 20. Do you have an office in the Town of Telluride?*

    1. Yes
    2. No
41. 21. Do you perform a service in the Town of Telluride?*

    1. Yes
    2. No (Skip to Section 3)
42. 22. Business license fees have been paid to the Town of Telluride and the certificate is not expired.

    1. Yes
    2. No (See above to apply)
44. 23. Town of Telluride Business License Number:
45. 24. Business License Expiration Date
49. Section 3: Mailing and Payment Addresses
51. 25. Mailing Address:
52. City:
53. State:
54. Zip Code:
56. 26. Payment Remittance Address:
57. City:
58. State:
59. Zip Code:
63. Section 4: Signature & Vendor Acknowledgement

    Under penalties of perjury, I herby certify the payee's above TIN is correct, the payee is not subject to backup withholding.

65. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. 

    1. I Agree
67. Electronic Signature*
68. Date*
    Date
70. Print Name & Title*
Leave This Blank:


72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit

* indicates a required field