Phone #
ZIP
Penalty Fee
Business Hours
Block
City
Gross Receipt
Business Information
Registration Type
Application Fee
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Home Office?
Business Address 2
Number of Spaces
Mandated Fee
Please Note: If you are not able to find your address using the below search, please choose the Address Not Found option to proceed.
Penalty Days
Business Name
Lot
Employer Identification Tax ID #
Business Type Code
Business Type
Please ensure you've completed all the required information in each of the tabs below.
Are You Selling Tobacco?
Total License Fees
Business Address
State
Describe the Business
Is Your Business Outside City Limits?
Business Details
Fee Other
{[PNAME]}
State Sales Tax ID (If applicable)
Begin search by typing the address number and part of the street name and press Enter.
Total No of Units
  • Contacts
  • Emergency Information
  • Theaters
  • Professional/Semi-Professional and Trade Business
  • Contractors
  • Retail, Service, Wholesale, Manufacturing, Hotels
  • Multiple Housing/Apartments
  • Delivery Vehicles
  • Real Estate Broker
  • Taxicabs/ Auto or Buses for Hire
  • Home Business
  • Canvassers/Peddlers/Solicitors
  • Attachments + Certification
Email (used for renewal notices)
Type of Ownership
First Name
State
Phone #
Last Name
Mailing Address Same as Business Address?
Additional Owner(s) Details
Business Owner Details
Title (if applicable)
Mailing Address
City
ZIP
# of Doors - Other
Name
State
City
Will Respond?
City
Panic Button
City
Alarm
Video Surveillance
Email
Emergency Contact 3
Phone #
Has Key?
State
Address
# of Doors - Front
Address
Phone #
Has Key?
Will Respond?
Email
Audible
Alarm Company Name
State
Name
Address
Emergency Contact 1 (After Hours)
Emergency Contact 2 (General Contact)
Will Respond?
Roof Access
# of Doors - Back
ZIP
Has Key?
Reset Time
Phone #
ZIP
Phone #
Email
This essential emergency information is provided to Fairfax Police Department in the event of an emergency, especially after-hours and can help provide urgent support.
Miscellaneous Information: (Lights, additional phone #'s, pager #'s, panel location, etc.)
Other Details
Name
Address
Please explain
Is there anything stored in your building that the officers need to be aware of for personal safety reasons? (ex: firearms, flammable materials or caustic materials)
ZIP

- Base Fee: $250, plus a Gross Receipts Fee on Gross Receipts over $37,500 (i.e. if gross receipts are $100,000, the fee is calculated on $62,500, which amounts to a $47 Gross Receipts Fee).

A) Theaters
# of Employees
# of Practicing Professionals
Number of practicing professionals: ____ x $135 = $_______
Number of Employees: ____ x $30 =$ _______
B) Professional/Semi-Professional and Trade Businesses
Business Address in Fairfax Business Address Outside of Fairfax
Annual Base Fee: $100 Annual Base Fee: $75
Contractors pay base fee only based on office location -- no gross receipts fee required.
C) Contractors
Has the tobacco retailer license/business operation license identified above ever been suspended or revoked?
Tobacco Retailer License
If you checked 'Yes', please give the licensee name(s), reason for suspension or revocation, and date(s) of suspension period or revocation
Board of Equalization Tobacco Retailer License #
D) Retail, Service, Wholesale, Manufacturing, Hotels

- Base Fee: $100

The Business License Fee is comprised of a Base Fee and Gross Receipts Fee.

Calculate your fee from the Gross Receipts table below and add to the Base Fee. The Gross Receipts Fee must be paid on the total combination of any and all of the above titled businesses in this category.

Gross Receipts Fee   Gross Receipts  Fee   Gross Receipts Fee
$0 - $10,000 $6   $50,000 - $75,000 $47   $200,001 - $250,000 $156
$10,001 - $25,000 $16   $75,001 - $100,000 $63   $250,001 - $300,000 $188
$25,001 - $37,500 $23   $100,001 - $150,000 $94   $300,001 - $350,000 $219
$37,501 - $50,000 $31   $150,001 - $200,000 $125   $350,001 - $400,000 $250

Add $31.00 for each additional $50,000 gross receipts, or fraction thereof, above $400,000

Multiple Housing/Apartments
# of Owner Occupied Units
# of Non-Owner Occupied Units
Number of Units ___ x $25= $______
Unit occupied by owner in multiple residential units with less than five (5) units is exempt.
# of Vehicles (weight up to 2 tons)
# of Vehicles (weight over 3 tons)
Delivery Vehicles
# of Vehicles (weight up to 3 tons)
# of Vehicles (weight up to 1 ton)
Fee for each Broker conducting business with no office in Fairfax: $200
# of Brokers
Fixed place of business in Fairfax: $175
Real Estate Broker
Place of Business

- 1 to 7 Passengers: $100     - 8 to 15 Passengers: $120      - Over 15 Passengers: $125

Taxicabs/Auto or Buses for Hire
# of Passengers
Home Business

- Annual Fee: $100 - FLAT FEE ONLY - No gross receipts required.

Canvasser Annual or Per Day?

- Annual Fee: $120      - Fee per day: $40

How Many Days?
Canvassers/Peddlers/Solicitors
Type Full Name :
Sign With Hand
- I understand that operating without a valid Town of Fairfax business license is prohibited.
If you are a Non-Profit Business, please attach the 501(c)(3) document.
- All information provided is true and correct to the best of my knowledge.
By signing below, I certify that:
- I am authorized to submit this renewal.
Certification
Attachments
Applicant Signature
- I agree to comply with all applicable Town ordinances and regulations.