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2. Please note that a convenience fee of 2.50% with a minimum of $1.95 for credit cards or $1.50 for echecks will be added to the Business License Registration payment. When Business License Registration general information is submitted you will be taken to Forte Payment Systems for on-line payment. The Business License Registration amount of $75.00 and convenience fee will appear as separate charges on your billing statement. You will receive two (2) confirmation emails to complete the Business License Registration and payment process. One (1) verifying Business License general information and one (1) confirming credit card or echeck payment from Forte. If you do not receive two (2) confirmation emails the online process was not completed.
4. Corporate or Limited Liability Company (LLC) Name*
5. Primary Corporate / Business Street Address*
7. City, State and Zip*
8. Phone*
10. Local Jeffersontown, Kentucky Address or Employee's Work Location (if any)
12. Street
13. Phone
15. Federal Tax ID*
    If registering as an individual enter social security number.
16. Nature of Business*
18. Date business started or will start in Jeffersontown*
19. Number of Employees*
21. Corporate / Business Payroll Company
22. Contact*
24. Phone*
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field