Cobb County Business License Division P.O. Box 649 Marietta ...

Cobb CountyBusiness License DivisionTaxicab Company ApplicationRevised 10/1066. Licensee Full Name: ___________________________ Title: ________________ SSN# _______________Business Phone: _________________ Home Phone: ____________ Alternate Phone/Cell: _____________(required)Home Address: _________________________________________________________________________City: ___________________________________ State: ___________________Zip : _________________7. Type of Ownership: Sole Proprietor ( ) Partnership ( ) Corporation ( )LLP ( ) LLC ( )8. If Sole Proprietor - Owner’s Name: ________________________________________________________Social Security # _____-____-_____ Date of Birth: _____________________________Home Address: _______________________________________Home Phone: ______________________City: ____________________________, State: ____________________Zip: _______________E-mail Address:____________________________ Cell Phone #__________________________________9. If Partnership or Limited Liability PartnershipPartnership or LLP Name: ________________________________________________________________A. Name of partner/member: _________________________________Social Security #______-____-_____Date of Birth: ___________________________ Percentage of Ownership: ________________________Home Address: ______________________________________________Home Phone:_______________City: ______________________________ State: __________________________Zip: _______________E-mail Address:____________________________ Cell Phone #_________________________________B. Name of partner/member: _________________________________Social Security #______-____-_____Date of Birth: ___________________________ Percentage of Ownership: ________________________Home Address: ______________________________________________Home Phone:_______________City: ___________________________________ State: _____________________Zip: _______________E-mail Address:_______________________________ Cell Phone #_______________________________* Include additional partners/members on separate attachment*U:\ComDev\GIS_Section\JosephPowell\contribute\downloads\Taxicabapp10NEWADDFeeIncreaseDRAFT.DOC