Business License Application Please enable JavaScript in your browser to complete this form. – Step 1 of 4 Planning Department 420 Howanut Road P.O. Box 536 Oakville WA 98568 PHONE: (360) 273-5911 EMAIL: mmedina@chehalistribe.org Non Refundable fee is due upon submitting application Make checks payable to Chehalis Tribe or pay via PayPal at https://www.chehalistribe.org/products/business-license Business Information Name of Business: * Contact Name: * Mailing Address: * Physical Address: * Address Line 1 Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState Zip Code Phone: * Cell Phone: Fax: Email * Have you previously had a Chehalis Tribal Business License? * Yes No If yes, please give us the year and name your most recent permit was issued under Next Description of Business Please check all boxes that apply: * Retail Food Service Wholesale Construction Professional Services Entertainment Hospitality Service Other Other Description: 1. List your business activities, including products and/or services being provided. * 2. If you are selling goods from your vehicle, please provide the year, make, model and license plate number of your vehicle. 3. Does your business provide construction services (general, electrical, mechanical, plumbing, other)? * Yes No If yes, please provide your contractor’s license # Are you bonded? *N/AYesNo Insured? *N/AYesNo Federal Employer ID Number * State Business Number * PreviousNext Location Where Business Activities Are Conducted Please tell us where on the Chehalis Reservation you will be conducting business activities. Check all that apply. * Chehalis Tribal Government Great Wolf Lodge Lucky Eagle Casino & Hotel Chehalis Tribal Enterprises End of the Trail stores Fireworks wholesaler Grand Mound Businesses Bazaar vendor Other Please provide address, location, or department: * Comment or Message PreviousNext ACKNOWLEDGEMENT TO BE COMPLETED BY SOLE OWNER OR PRINCIPLE OFFICER I certify that the statements made in this application are true. I understand that my business, including employees representing my business, must comply with the Chehalis Tribal Code and any applicable Federal laws while working within the boundaries of the Chehalis Reservation. Any license granted hereunder may be revoked with notice or formal hearing by the Planning Department or Business Committee upon their finding that an application has provided false information for a permit application or has violated any regulation of this ordinance. Revocation of a business license upon order of the Business Committee is final and conclusive. I understand that this license expires at the end of the calendar year and it is my responsibility to renew it prior to conducting any further business on the Chehalis Reservation. Printed Name: * Date: * Submit
