Occupational License Checklist

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Occupational License Checklist In order to obtain an Occupational License from the City of Thibodaux the following steps must be taken before submitting application, required attachments and payment to the Tax Collector: Obtain an Occupational License packet from: City of Thibodaux Tax & License, Finance Dept 310 West 2 nd St. PH.: (985) 446-7221 FAX: (985) 446-7242 http://ci.thibodaux.la.us Download the packet from the web in Adobe (*.pdf) format. Obtain an Occupancy Permit (required attachment) from: Department of Public Works City Inspector 1219 Henry S. Thibodaux St. PH.: (985) 446-7208 FAX: (985) 446-7272 E-mail: cityinspector@ci.thibodaux.la.us Obtain a Board of Health Permit, if necessary (required by City Inspector prior to obtaining Occupancy Permit) from: Lafourche Parish Health Unit 2535 Veterans Blvd. PH: (985) 447-0954 FAX: (985) 447-0897 http://www.dhh.state.la.us/ Register for Sales Tax (proof of registration, required attachment, if applicable) with the following: State of Louisiana Dept. of Revenue www.rev.state.la.us Lafourche Parish School Board Sales & Use Tax Dept. 701 East 7 th St. PH: (985) 446-4023 http://lafourche.k12.la.us/email/search.asp?l=co_st Electrical, Plumbing & Mechanical License Applicants must obtain an Approval Letter (required attachment) from: Department of Public Works City Electrical, Plumbing & Mechanical Inspector 1219 Henry S. Thibodaux St PH.: (985) 446-7208 FAX: (985) 446-7272 E-mail: inspectorsoffice@ci.thibodaux.la.us It is the applicant s responsibility to check with the above authorities on the necessity for additional permits & licenses.

CITY OF THIBODAUX TAX & LICENSE, FINANCE DEPT P.O. BOX 5418 THIBODAUX, LA 70302 PH. (985) 446-7221 FAX: (985) 446-7242 APPLICATION FOR OCCUPATIONAL LICENSE Acct.# Date of Application: / / Date Opened: / / APPLICATION IS REQUIRED FOR: (check one) NEW BUSINESS NAME OF PRIOR OWNER: PURCHASE OF EXISTING BUSINESS NAME OF PRIOR BUSINESS: NATURE OF BUSINESS - DESCRIPTION OF SALES OR ACTIVITIES: BUSINESS NAME BUSINESS PHONE: OWNER'S NAME (Name of individual, partners or corporation) E-MAIL ADDRESS LOCATION ADDRESS MAILING ADDRESS 1. TYPE OF OWNERSHIP STREET NO. STREET NAME APT. / SUITE CITY/STATE ZIP P.O. BOX OR STREET NO. STREET NAME APT. / SUITE CITY/STATE ZIP PARTNERSHIP INDIVIDUAL NON-PROFIT CORPORATION GOVERNMENTAL OTHER SPECIFY: BUSINESS AUTHORIZATION / I.D. NUMBERS (IF APPLICABLE): A. CERTIFICATE OF OCCUPANCY NUMBER B. LAFOURCHE/THIBODAUX SALES & USE TAX NUMBER C. LOUISIANA STATE I.D. NUMBER D. FEDERAL EMPLOYER I.D. OR OWNER'S SOCIAL SECURITY NUMBER E. NON-PROFIT 501 ( C) NUMBER OFFICERS/OWNERS: NAME TITLE SOCIAL SECURITY NUMBER RESIDENT ADDRESS TELEPHONE NUMBER NAME TITLE SOCIAL SECURITY NUMBER RESIDENT ADDRESS TELEPHONE NUMBER NAME TITLE SOCIAL SECURITY NUMBER RESIDENT ADDRESS TELEPHONE NUMBER NEW BUSINESS (Office Use Only) CLASS TABLE CLASS DESCRIPTION QTY. AMOUNT CHAIN STORES: TOTAL STORES: LOCAL STORES/UNITS (Cash/Check #) TOTAL DUE I affirm that the information given on this application is true and correct. I will report any change in business ownership, operation, and / or address immediately. Received by: SIGNATURE OF APPLICANT DATE SIGNATURE OF PREPARER DATE

CITY OF THIBODAUX POLICE DEPARTMENT 1309 CANAL BOULEVARD P.O. BOX 1338 THIBODAUX, LOUISIANA 70302 TELEPHONE: (985) 446-5021 FAX: (985) 446-7214 Please Print EMERGENCY BUSINESS FORM Business Name: Business Address: Business Phone Number (985) - E-mail Address: @ Owner of Building Owner s Home Phone Number: - - Alarm Company NO / YES (circle one) If Yes, Alarm Company Alarm Company s Phone Number - - EMERGENCY CONTACTS / KEYHOLDERS FOR AFTER HOURS/WEEKENDS/HOLIDAYS 1. Home PS - - 2. Home PS - - 3. Home PS - - 4. Home PS - - 5. Home PS - - List any information the officer should be aware of in reference to your building.

TAX & LICENSE, FINANCE DEPT P.O. BOX 5418 THIBODAUX, LA 70302 ANNUAL CHAIN STORE TAX REPORT NAME: MAILING ADDRESS: E-MAIL ADDRESS: KIND OF BUSINESS: (STATE IF GROCERY, DRY GOODS, DRUGS, DEPT.STORE, ETC.) THIBODAUX STORES Opening Date NAME STREET ADDRESS If New Total Stores Operating in Thibodaux, Listed Above, as of January 1, Current Year Total Stores Operating Wherever Located Including Above, Under Same General Management, Supervision, Ownership or Control as of January 1, Current Year NOTE: Opening Date to be Shown Opposite Name and Address and Tax to be Paid as Explained in Line 5 on Reverse Side COMPUTATION OF TAX Amount of Tax $ (SEE EXPLANATION ON BACK) Interest Total Thibodaux Stores Penalty Rate of Tax $ TOTAL $ I affirm that the information given on this report is true and correct. Signature Date

LICENSE TAX SCH EDULE Belonging to a chain or group having: ( 1) Not more than 10 Stores $10.00 per store in Thibodaux (2) More than 10, but not mor e than 35 stores $15.00 per store in Thibodaux (3) More than 35, but not more than 50 stores $20.00 per store in Thibodaux (4) More than 50, but not more than 75 stores $25.00 per store in Thibodaux (5) More than 75, but not more than 100 stores $30.00 per store in Thibodaux (6) More than 100, but not more than 125 stores $50.00 per store in Thibodaux (7) More than 125, but not more than 150 stores $ 100.00 per store in Thibodaux (8) More than 150, but not more than 175 stores $150.00 per store in Thibodaux (9) More than 175, but not more than 200 stores $200.00 per store in Thibodaux (10) More than 200, but not more than 225 stores $250.00 per store in Thibodaux (11) More than 225, but not more than 250 stores $300.00 per store in Thibodaux (12) More than 250, but not more than 275 stores $350.00 per store in Thibodaux (13) More than 275, but not more than 300 stores $400.00 per store in Thibodaux (14) More than 300, but not more than 400 stores $450.00 per store in Thibodaux (15) More than 400, but not more than 500 stores $500.00 per store in Thibodaux (16) More than 500 stores $550.00 per store in Thibodaux 1. RATE OF TAX The rate of tax is determined from the total retail stores operated under the same general management, supervision, ownership or control, wherever located, including the Thibodaux stores covered by this report. Refer to the License Tax Schedule above. 2. MEASUR E OF TAX The measure, or the amount of tax due the City of Thibodaux, is determined by applying the rate of tax to the total retail stores in Thibodaux. 3. EXAMPLE If an operator of a total of 36 retail stores located in Texas, New York, Alabama, and Louisiana, operates 2 stores in Thibodaux, the amount of chain store tax would be computed as follows: The license tax schedule above shows that the rate of tax on a chain of between 35 and 50 stores is $20.00 per Thibodaux store. Therefore, the amount of tax due would be 2 Thibodaux stores at $20.00 each or a total of $40.00 4. INTEREST AND PENALTY If return is not filed and the tax paid before March First each year there will be added to the tax interest at the rate of 12% per annum, until paid and penalty at the rate of 5% for each thirty days or fraction thereof of delinquency not to exceed 25% in the aggregate. 5. NEW STORES OPENE D The rate of tax for stores opened in Thibodaux after January 1 shall DURING TAXABLE be the same as though the new stores were added to the number in YEAR operation on January 1 st. If a store is opened in Thibodaux after June 30 th of any year, the rate applicable to such store for the first year shall be one-half of the rate determined as hereinabove provided. This report must be made to the Tax & License, Finance Dept, Thibodaux, Louisiana. The remittance to cover the tax evidenced by this report must be mailed to the Tax & License, Finance Dept before March 1 st.

CITY OF THIBODAUX - OCCUPATIONAL LICENSE TAX TABLES Table 1 - Retail Dealers Table 2- Wholesale Dealers Table 3 - Lending Businesses R.S. 47:354 The Annual R.S. 47:355 The Annual R.S. 47:354 The Annual If the Gross Sales But License If the Gross Sales But License If the Gross Sales But License Are as much as Less than Shall Be Are as much as Less than Shall Be Are as much as Less than Shall Be $ 0 5,000 $10.00 $ 0 100,000 $50.00 $ 0 250,000 $50.00 5,000 10,000 $15.00 100,000 150,000 $75.00 250,000 500,000 $100.00 10,000 15,000 $20.00 150,000 250,000 $100.00 500,000 750,000 $150.00 15,000 20,000 $25.00 250,000 500,000 $150.00 750,000 1,000,000 $200.00 20,000 25,000 $30.00 500,000 600,000 $200.00 1,000,000 1,250,000 $250.00 25,000 30,000 $35.00 600,000 800,000 $250.00 1,250,000 1,500,000 $300.00 30,000 40,000 $40.00 800,000 1,000,000 $300.00 1,500,000 1,750,000 $350.00 40,000 50,000 $50.00 1,000,000 1,500,000 $400.00 1,750,000 2,000,000 $400.00 50,000 75,000 $60.00 1,500,000 2,000,000 $500.00 2,000,000 2,250,000 $450.00 75,000 100,000 $90.00 2,000,000 2,500,000 $700.00 2,250,000 2,500,000 $500.00 100,000 150,000 $120.00 2,500,000 3,000,000 $900.00 2,500,000 3,000,000 $550.00 150,000 200,000 $180.00 3,000,000 4,000,000 $1,000.00 3,000,000 3,500,000 $600.00 200,000 250,000 $250.00 4,000,000 5,000,000 $1,250.00 3,500,000 4,000,000 $650.00 250,000 300,000 $300.00 5,000,000 5,500,000 $1,800.00 4,000,000 4,500,000 $700.00 300,000 400,000 $360.00 5,500,000 6,000,000 $2,400.00 4,500,000 5,000,000 $750.00 400,000 500,000 $500.00 6,000,000 6,500,000 $3,000.00 5,000,000 5,500,000 $800.00 500,000 600,000 $650.00 6,500,000 7,000,000 $3,600.00 5,500,000 6,000,000 $850.00 600,000 750,000 $800.00 7,000,000 7,500,000 $4,200.00 6,000,000 6,500,000 $900.00 750,000 1,000,000 $900.00 7,500,000 8,000,000 $4,800.00 6,500,000 7,000,000 $950.00 1,000,000 1,500,000 $1,200.00 8,000,000 9,000,000 $5,200.00 7,000,000 7,500,000 $1,000.00 1,500,000 2,000,000 $1,800.00 9,000,000 10,000,000 $5,600.00 7,500,000 8,000,000 $1,050.00 2,000,000 2,500,000 $2,400.00 10,000,000 11,000,000 $6,000.00 8,000,000 8,500,000 $1,100.00 2,500,000 3,000,000 $3,000.00 11,000,000 12,000,000 $6,400.00 8,500,000 9,000,000 $1,150.00 3,000,000 3,500,000 $3,600.00 12,000,000 13,000,000 $6,800.00 9,000,000 9,500,000 $1,200.00 3,500,000 4,000,000 $4,200.00 13,000,000 14,000,000 $7,200.00 9,500,000 10,000,000 $1,250.00 4,000,000 4,500,000 $4,800.00 14,000,000... $7,500.00 10,000,000 11,000,000 $1,350.00 4,500,000 5,000,000 $5,400.00 11,000,000 12,000,000 $1,450.00 5,000,000 5,500,000 $6,000.00 Table 5 - Public Utilities 12,000,000 13,000,000 $1,550.00 5,500,000... $6,200.00 R.S. 47:358 The Annual 13,000,000 14,000,000 $1,650.00 If the Gross Sales But License 14,000,000 15,000,000 $1,750.00 Table 4 - Commission / Brokerage Agent Are as much as Less than Shall Be 15,000,000 16,000,000 $1,850.00 R.S. 47:357 The Annual 16,000,000 17,000,000 $1,950.00 If the Gross Sales But License $ 0 20,000 $50.00 17,000,000 18,000,000 $2,050.00 Are as much as Less than Shall Be 20,000 25,000 $60.00 18,000,000 19,000,000 $2,150.00 25,000 37,500 $75.00 19,000,000 20,000,000 $2,250.00 $ 0 15,000 $50.00 37,500 50,000 $115.00 20,000,000 25,000,000 $2,500.00 15,000 20,000 $70.00 50,000 75,000 $150.00 25,000,000 30,000,000 $3,000.00 20,000 25,000 $90.00 75,000 100,000 $200.00 30,000,000 35,000,000 $3,500.00 25,000 30,000 $112.00 100,000 150,000 $300.00 35,000,000... $3,700.00 30,000 40,000 $137.00 150,000 200,000 $450.00 40,000 50,000 $180.00 200,000 250,000 $650.00 Table 6 - Hotels, Motels, etc. 50,000 65,000 $225.00 250,000 500,000 $750.00 Rooms @ $2.00 per unit 65,000 80,000 $300.00 500,000 750,000 $1,500.00 80,000 100,000 $360.00 750,000 1,000,000 $2,250.00 Table 7 - Professionals 100,000 125,000 $450.00 1,000,000 1,250,000 $3,000.00 License fees are one-tenth of one percent 125,000 150,000 $600.00 1,250,000 1,500,000 $3,750.00 of the annual gross receipts. 150,000 175,000 $675.00 1,500,000 1,750,000 $4,500.00 Minimum - $25.00 Maximum - $2,000.00 175,000 200,000 $750.00 1,750,000 2,000,000 $5,250.00 200,000 250,000 $900.00 2,000,000 2,250,000 $6,000.00 Table 8 - Chain Store 250,000 300,000 $1,050.00 2,250,000 2,500,000 $6,900.00 Belonging to a chain Per Store in 300,000 350,000 $1,200.00 2,500,000... $7,500.00 or group having: Thibodaux 350,000 400,000 $1,400.00 (1) Not more than 10 stores $10.00 400,000 450,000 $1,600.00 Flat Fees: (2) More than 10, but not more than 35 $15.00 450,000 500,000 $1,800.00 Bingo & Pull Tabs $ 250.00 (3) More than 35, but not more than 50 $20.00 500,000 550,000 $2,000.00 Electrician - License / Renewal $ 100.00 (4) More than 50, but not more than 75 $25.00 550,000 600,000 $2,200.00 Master Plumber's License $ 180.00 (5) More than 75, but not more than 100 $30.00 600,000 650,000 $2,400.00 Master Plumber's Renewal $ 100.00 (6) More than 100, but not more than 125 $50.00 650,000 700,000 $2,600.00 Master Plumber - Inactive Fee $ 30.00 (7) More than 125, but not more than 150 $100.00 700,000 750,000 $2,800.00 Mechanical License $ 180.00 (8) More than 150, but not more than 175 $150.00 750,000 800,000 $3,000.00 Mechanical Renewal $ 100.00 (9) More than 175, but not more than 200 $200.00 800,000 850,000 $3,200.00 Mechanical - Inactive Fee $ 30.00 (10) More than 200, but not more than 225 $250.00 850,000 900,000 $3,400.00 Juke Box $ 10.00 (11) More than 225, but not more than 250 $300.00 900,000 950,000 $3,600.00 Video Games, Pool & Foos Ball Tables $ 15.00 (12) More than 250, but not more than 275 $350.00 950,000... $3,700.00 Class A Retail Beer $ 35.00 (13) More than 275, but not more than 300 $400.00 Class B Retail Beer $ 25.00 (14) More than 300, but not more than 400 $450.00 Class A Retail Liquor $ 125.00 (15) More than 400, but not more than 500 $500.00 Class B Retail Liquor $ 125.00 (16) More than 500 stores $550.00 Video Poker Machine $ 50.00 Wholesale Beer $ 75.00