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Business Registration Renewal Application

  2. EMERGENCY CONTACT INFORMATION (Property/Building Owner)
  3. Property *
  4. STATE LICENSES/PERMITS REQUIRED (If applicable, must provide copy)
  5. Are you required to have a State of Michigan License or Permit for this type of business?*

    if yes, please describe below

  7. Does it Reset Automatically?
  8. Dog on Premise?

    (All Owners/Applicants listed must sign this Application)

  10. Electronic Signature Agreement*

    I (We) and/are the OWNER/AGENT of said business making application for this Business Registration Certificate and/or am otherwise an authorized representative of said business. I(We) authorize the verification of the information provided on this application. I (We) am a citizen of the United States of America and otherwise authorized to do business under the laws of the State of Michigan and the United States of America. I (We) depose and state that all of the information provided in the foregoing application is true to the best of my knowledge, information, and belief.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.


    Please include the following with this application:

    Copy of State of Michigan License or Permit (if applicable)

    Copy of Driver's License

  12. Leave This Blank:

  13. This field is not part of the form submission.