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RICHLANDS BUSINESS INCUBATOR
TENANT APPLICATION CONFIDENTIAL |
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Assistance with any portion of this application is available by calling Dreama Shreve at 276-963-2660. |
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| 1. GENERAL INFORMATION | |
| Name of Applicant: _______________________________________________________________ | |
| Current Address: _________________________________________________________________ | |
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______________________________________________________________________________ |
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| Former address (if less than 2 years at current address): ____________________________________ | |
| ______________________________________________________________________________ | |
| Home Phone: _________________________ | Work Phone: _________________________ |
| Social Security #: ______________________ | Federal Tax ID #: _____________________ |
| Business Name: __________________________________________________________________ | |
| Contact Person (if different) _________________________________________________________ | |
| Type of Company: | ____Sole proprietorship | ____ Corporation | ____ LLC |
| ____ Parnership | ____ Subchapter S | ||
| Is the business currently in operation? | ____ Yes | ____ No | |
| If yes, the year founded: | __________________ | ||
| If no, where are you employed? ______________________________________________________ | |||
| Do you currently have a business license? | ____ Yes | ____ No | |
| If so, where? ____________________________________________________________________ | |||
| (Note: A business plan is required. Assistance is available upon request.) | |||