Haysi, VA · Dickenson County
Business License Application (BPOL)
Businesses use this application to provide ownership, contact, location, and gross-receipts information when applying for a Town of Haysi business license.
What this form is
The Town of Haysi Business License Application collects business and owner details, the business location and mailing address, and information used to calculate the license tax. Businesses provide gross receipts and applicable deductions, identify their business purpose, and sign the certification. The form includes license tax rates and a due date calendar; it also asks applicants to report changes to business information.
Who needs it
A business seeking a Town of Haysi license should complete the application with its owner, contact, location, business-purpose, and gross-receipts information.
How to submit it
Mail the signed application and check payable to the Town of Haysi, P.O. Box 278, Haysi, VA 24256. The form also lists phone (276) 865-5187 and fax (276) 865-9808.
About notarization
This application is signed and dated without a notary; the document does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Application
Download the Town of Haysi Business License Application (BPOL) PDF.
- 2
Complete The Application
Fill in the business and owner details, business purpose, and gross-receipts information requested on the form.
- 3
Review The Tax Information
Use the application’s tax-rate information and due date calendar to review the license tax details.
- 4
Sign And Submit
Sign and date the application, make the check payable to the Town of Haysi, and mail it to the listed P.O. Box.
Frequently asked questions
- Who uses the Haysi business license application?
- Businesses applying for a Town of Haysi business license use the application to report owner and business contact details, location, business purpose, and gross receipts.
- What information does the application ask for?
- It requests business and owner names, contact information, street and mailing addresses, federal ID number, business purpose, and gross receipts and deductions for the tax calculation.
- Do I need a notary for the Haysi business license application?
- No. The application is signed and dated without a notary, and it does not identify any attachment or related step that must be notarized or sworn.
- How do I submit the Haysi business license application?
- Sign the application and mail it with a check payable to the Town of Haysi, P.O. Box 278, Haysi, VA 24256, as stated on the form.