Business License Tax Rebate

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Business Information
Applicant Information
Mailing Address (if different from Business Address)
Program Questions
Submittal / Certification
By submitting this form I certify the aforementioned business applying for a rebate is not subject to any active investigations for violations of the City of Emeryville codes including, but not limited to Planning, Building and Fire codes, the Minimum Wage and Paid Sick Leave Ordinance, or any other City code, ordinance or regulation. By submitting this form, I also certify that I am authorized to submit this application for rebate of Business License Tax and / or Fire Inspection Fees on behalf of the aforementioned business.
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