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Local Business Tax Account Application
Lee County Tax Collector
P.O. Box 1549
Ft. Myers, FL 33902-1549
239.533.6000
(Return application, fees, and corresponding documents to the Lee County Tax Collector for processing.)
1. Type of Business:
2. Business Name (DBA):

EIN/SSN:

NOTE: Indicate below why you are exempt from filing for a Fictitious Name Registration/DBA (Doing Business As)

Business name indicates my full legal name

Business name is a registered trademark

Business name is the corporate name

Business name is the limited liability partnership name

Business name is the general partnership name

Attorney, Dept. of Health, Dept. of Business & Professional Regulation

3.
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Business Tax Fee (Includes a $20.00 Hazardous Waste Surcharge per Resolution 94-07-14) Full Year Fee
½ Year Fee (April - June)
¼ Year Fee (July - Sept)
Business Tax Receipt Fee:
$50.00
$12.50
$25.00
(Payment required at time of application.)
To obtain fees for Flea Markets, Special Events, Transient Merchants or Going Out of Business/Fire Sales call 239.533.6000.

Signatures: Under penalties of perjury, I hereby declare the statements above are true and correct to the best of my knowledge.
Owner/Qualifier:

Date:

/

/

Owner:

Date:

/

/

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ZONING APPROVAL IS REQUIRED FOR BUSINESSES LOCATED IN UNINCORPORATED LEE COUNTY.
Lee County Zoning Department must complete this section prior to local business tax receipt issuance, or attach a copy of the LOCATION Certificate of Use or Certificate of Occupancy.

Strap Number:

HOL-USE or COM # :

Approved By:

Title:

Form# 151

REV 06/2010

Date:

Make checks payable to: Lee County Tax Collector, P.O. Box 1549, Fort Myers, FL 33902-1549

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Application Instructions

Line 1 Nature (type) of Business: Please describe the type of business that will be conducted.
Line 2

Business

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