CITY OF CANTON OCCUPATION TAX APPLICATION

CITY OF CANTON OCCUPATION TAX APPLICATION GENERAL BUSINESS INFORMATION Business Name Business Street Address Business Mailing Address (if different from above) Business Phone Number Business E-mail Address Business Fax Number Business Website Information OWNERS INFORMATION (1) Owners Name (1) Owners Address Phone Number E-mail Address (2) Owners Name (2) Owners Address Phone Number E-mail Address BUSINESS TAX INFORMATION Total Number of Employees Part Time Full Time (Include Owners) SIC (Standard Industry Code) Tax Class E-Verify Number Federal EIN: State STN: State TIN: You can apply for your Federal Employer Identification Number (Federal EIN) by visiting the Internal Revenue Service Website www.irs.gov Contact Number: 1-800-829-4933 You can apply for your State Sales Tax Number (State STN) and your State Tax Identification Number (State TIN) by visiting The Georgia Department of Revenue Website www.dor.georgia.gov Contact Number: 1-877-423-6711

OCCUPATION TAX APPLICATION PAGE 2 BUSINESS INFORMATION Date Business Opened or Plans to Open: Description of Business: Name of Sanitation Provider: Home Based Business: Yes No OCCUPATION TAX FEES Directions to Calculate Occupational Taxes by Gross Receipts: Determine Yearly Gross Receipts (January thru December) Estimate Yearly Gross Receipts if New Business Determine SIC Code (See Chart) Determine Tax Class Variable (See Chart) Multiply Gross Receipts by Tax Class Variable Add $25.00 Administrative Fee Calculate Taxes Due X + $25.00 Gross Receipts (Multiplied By) Tax Class Administrative Variable Fee Professional Occupation Tax Disclaimer and Signature = Occupational Taxes Due *Minimum Fee $125.00 = $300.00 *Flat Fee I have read and received a copy of the City of Canton Occupational Tax Ordinances and I will comply with the City of Canton Occupational Tax Ordinances. I certify information provided is correct to the best of my knowledge and records shall be available for inspection as specified in the City of Canton Occupational Tax Ordinances. Signature Date OFFICE USE ONLY (DO NOT WRITE IN THIS SECTION) Zoning District Approved By: Date: Planning and Zoning Department Occupation Tax Application Approved By: Date: Tax and Licensing Department Occupation Tax Certificate Number:

Status of Citizenship Compliance Affidavit Pursuant to O.C.G.A. 50-36-1(e)(2) Pursuant to the Georgia Security and Immigration Compliance Act, O.C.G.A. 50-36-1, every agency in the State of Georgia providing public benefits through any local, state, or federal program is responsible for verifying the lawful presence of citizen applicants for said benefit. By executing this affidavit under oath, as an applicant for a City of Canton: o Alcohol License o Occupational Tax Certificate o Registration of a Regulated Business (gold dealer, pawn shop) the undersigned applicant verifies one of the following with respect to this application for a public benefit: o I am a United Stated citizen. o I am a legal permanent resident of the United States. o I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency. My alien number issued by the Department of Homeland Security or other federal immigration agency is: The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A. 50-36-1(e)(1), with this affidavit. In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute. Signature of Applicant Printed Name of Applicant SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF,. Notary Public My Commission Expires

Private Employer Exemption Affidavit Pursuant to O.C.G.A. 36-60-6(d) By executing this affidavit, the undersigned private employer verifies that it is exempt from compliance with O.C.G.A. 36-60-6, stating affirmatively that the individual, firm, or corporation employs less than ten (10) employees and therefore, is not required to register with and/or utilize the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. 13-10-90. In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. 16-10-20, and face criminal penalties as allowed by such criminal statute. Business Name Title of Authorized Officer or Agent Signature of Applicant Printed Name of Applicant SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF,. Notary Public My Commission Expires

TAX CLASS CHART Variable Chart for Tax Class #1 Variable Chart for Tax Class #2 At Least But not more than Multiply by At Least But not more than Multiply by $0.00 $99,999.00 0.00085 $0.00 $99,999.00 0.00113 $100,000.00 $399,999.00 0.00066 $100,000.00 $399,999.00 0.0008766 $400,000.00 $699,999.00 0.0004913 $400,000.00 $699,999.00 0.00066 $700,000.00 $999,999.00 0.0004766 $700,000.00 $999,999.00 0.0006366 $1,000,000.00 $1,299,999.00 0.00045 $1,000,000.00 $1,299,999.00 0.0005966 $1,300,000.00 $1,999,999.00 0.0004328 $1,300,000.00 $1,999,999.00 0.0005857 $2,000,000.00 $3,499,999.00 0.000374 $2,000,000.00 $3,499,999.00 0.000502 $3,500,000.00 $5,999,999.00 0.0003576 $3,500,000.00 $5,999,999.00 0.0004744 $6,000,000.00 $13,999,999.00 0.0003061 $6,000,000.00 $13,999,999.00 0.0004223 $14,000,000.00 $99,999,999.00 0.0002662 $14,000,000.00 $99,999,999.00 0.0003538 Variable Chart for Tax Class #3 Variable Chart for Tax Class #4 At Least But not more than Multiply by At Least But not more than Multiply by $0.00 $99,999.00 0.00141 $0.00 $99,999.00 0.00169 $100,000.00 $399,999.00 0.0011 $100,000.00 $399,999.00 0.00132 $400,000.00 $699,999.00 0.0008233 $400,000.00 $699,999.00 0.00099 $700,000.00 $999,999.00 0.0007933 $700,000.00 $999,999.00 0.00095 $1,000,000.00 $1,299,999.00 0.0007433 $1,000,000.00 $1,299,999.00 0.0008933 $1,300,000.00 $1,999,999.00 0.0007371 $1,300,000.00 $1,999,999.00 0.0008828 $2,000,000.00 $3,499,999.00 0.000632 $2,000,000.00 $3,499,999.00 0.000752 $3,500,000.00 $5,999,999.00 0.0005904 $3,500,000.00 $5,999,999.00 0.0007124 $6,000,000.00 $13,999,999.00 0.0005282 $6,000,000.00 $13,999,999.00 0.0006388 $14,000,000.00 $99,999,999.00 0.0004423 $14,000,000.00 $99,999,999.00 0.0005305 Variable Chart for Tax Class #5 Variable Chart for Tax Class #6 At Least But not more than Multiply by At Least But not more than Multiply by $0.00 $99,999.00 0.00197 $0.00 $99,999.00 0.00226 $100,000.00 $399,999.00 0.0015433 $100,000.00 $399,999.00 0.00176 $400,000.00 $699,999.00 0.00115 $400,000.00 $699,999.00 0.00132 $700,000.00 $999,999.00 0.0011133 $700,000.00 $999,999.00 0.0012666 $1,000,000.00 $1,299,999.00 0.00104 $1,000,000.00 $1,299,999.00 0.00119 $1,300,000.00 $1,999,999.00 0.0010271 $1,300,000.00 $1,999,999.00 0.0011728 $2,000,000.00 $3,499,999.00 0.000878 $2,000,000.00 $3,499,999.00 0.0010033 $3,500,000.00 $5,999,999.00 0.0008308 $3,500,000.00 $5,999,999.00 0.0095 $6,000,000.00 $13,999,999.00 0.0007392 $6,000,000.00 $13,999,999.00 0.0008448 $14,000,000.00 $99,999,999.00 0.0006193 $14,000,000.00 $99,999,999.00 0.0007077 SIC CODES

SIC No. Description Tax Class SIC No. Description Tax Class 1 Agricultural Production-Crops 4 45 Transportation by Air 1 2 Agricultural Production-Livestock 2 46 Pipe Lines, except Natural Gas 2 7 Agricultural Services 4 47 Services Incidental to Transportation 2 8 Forestry 2 48 Communication 2 9 Fishing, Hunting and Trapping 3 50 Wholesale Trade-Durable Goods 2 10 Metal Mining 1 51 Wholesale Trade-Nondurable Goods 1 Retail Trade-Building Materials,Hardware, 11 Anthracite Mining 1 52 Garden 12 Bituminous Coal and Lignite Mining 1 Supply and Mobile Home Dealers 1 13 Oil and Gas Extraction 5 53 Retail Trade-General Merchandise Stores 1 14 Mining and Quarrying of Non-metallic 54 Retail Trade-Food Stores 1 Retail Trade-Automotive Dealers and Minerals except fuels 2 55 Gasoline 15 Building construction-general Contractors 2 Service Stations 1 16 Construction other than Building-General Contractors 2 56 Retail Trade-Apparel and Accessory Stores 2 17 Construction-Special Trade Contractors 4 57 Retail Trade-Furniture, Home Furnishings and 20 Manufacturing-Food and Kindred Products 1 Equipment Stores 2 22 Manufacturing-Textile Mill Products 2 58 Retail Trade-Eating and Drinking Places 2 23 Manufacturing-Apparel and Other Finished Textile Products 2 59 Retail Trade-Other 2 24 Manufacturing-Lumber & Wood Products, except Furniture 1 60 Banking 6 25 Manufacturing-Furniture and Fixtures 2 61 Credit Agencies Other than Banks 6 26 Manufacturing-Paper and Allied Products 2 62 Security and Commodity Brokers, Dealers, Exchanges 27 Manufacturing-Printing, Publishing and Allied Industries 4 and Services 5 28 Manufacturing-Chemicals and Allied products 3 65 Real Estate 6 29 Manufacturing-Petroleum and Related Products 3 66 Combinations of Real Estate, Insurance, Loans or 30 Manufacturing-Rubber and Miscellaneous Plastic Products 2 Law Offices 5 31 Manufacturing-Leather and Leather Products 2 67 Holding and Other Investment Offices 6 Manufacturing-Stone, Clay, Glass, and Concrete 32 Products 4 72 Services-Personal 5 33 Manufacturing-Primary Metal Industries 4 73 Services-Business 5 Manufacturing-Fabricated Metal Products, Automotive Repair, Automotive Services, 34 except Machinery 2 75 and Garages 3 and Transportation Equipment 76 Miscellaneous Repair Services 3 35 Manufacturing-Machinery, except Electrical 4 78 Services-Motion Pictures 5 Manufacturing-Electrical and Electrical 36 Machinery, 79 Services-Amusement and Recreation except Equipment, and Supplies 2 Motion Pictures 4 37 Manufacturing-Transportation Equipment 2 80 Health Services 5 38 Manufacturing-Measuring, Analyzing, and Controlling 81 Legal Services 6 Instruments, Photographic, Medical, and Optical Goods; 82 Educational Services 5 39 Watches and Clocks 3 83 Social Services 6 Manufacturing-Miscellaneous Manufacturing Museums, Art Galleries, Botanical and Equipment 2 84 Zoological Gardens 5 40 Railroad Transportation 4 86 Membership Organizations 6 Local and Suburban Transit and Interban Accounting, Auditing, and Bookkeeping 41 Highway 893 Services 6 Passenger Transportation 4 899 Services-Not Elsewhere Classified 5 42 Motor Freight Transportation and Warehousing 3

CITY OF CANTON COMMUNITY DEVELOPMENT HOME OCCUPATION PERMIT ACKNOWLEDGEMENT By affixing my signature below, I hereby Acknowledge and affirm that I have been provided a copy of the City of Canton s zoning standards as they apply to home occupation permits. I hereby agree to fully comply with said standards (as established in Section 8-8-D-88, Home Occupation), and if found in violation, understand that my business license may be revoked immediately in addition to other penalties under law. Name of Business Address of Business Signature Date HOME OCCUPATION STANDARDS Section 8-8-D-88 1. The use shall be carried on wholly within the principal building. The attachment of an accessory building by breezeway, roof, or similar structure shall not be deemed as sufficient for the accessory building to be considered as a portion of the primary building. 2. Not more than 25 percent of the floor area, not to exceed 500 square feet, of the principal building shall be used for the conduct of the home occupation. 3. No merchandise or articles shall be displayed for advertising purpose, nor be displayed in such a way as to be visible from outside the dwelling. 4. No equipment or business vehicles may be stored or parked on the premises except that one business vehicle (the carrying capacity of which shall not exceed 1 ½ tons) used exclusively by the resident may be parked in a carport or garage.

5. There shall be no alteration of the residential character of the building or premises. 6. The number of persons who are not residents living on the premises shall not exceed one. 7. One off-street paved parking space shall be provided in addition to the required parking for residential use of the building. 8. No motor power, other than electrically operated motors, shall be used and the total horsepower of such motors shall not exceed three horsepower or one horsepower for any single motor. 9. No nameplate or sign shall be displayed upon the premises except one unlighted sign not exceeding one square foot in area and located not less than 20 feet from any property line.