Haysi, VA · Dickenson County
Business License Application
Businesses use this application to provide license information and report gross receipts to the Town of Haysi for its business license tax.
What this form is
This application provides the Town of Haysi with business details and information to calculate the business license tax. It asks for owner and contact information, business location, federal ID number, primary business purpose, and 2025 gross receipts. The form lists March 1 for business license renewal and includes tax rates, a due date calendar, and a certification for the applicant to sign.
Who needs it
A business applying for or renewing a Town of Haysi business license needs to complete and sign this application.
How to submit it
Mail the signed application to Town of Haysi, P.O. Box 278, Haysi, VA 24256. Make checks payable to the Town of Haysi; the form also lists phone and fax numbers.
About notarization
No notary is required; the form asks the applicant to sign and date the certification, and it lists no notarized or sworn attachment.
How to submit this form
- 1
Download The Application
Download the Business License Application PDF.
- 2
Complete The Application
Enter the business, owner, contact, location, federal ID, business purpose, and gross receipts information requested.
- 3
Review And Sign
Review the tax calculation and due date information, then sign and date the certification.
- 4
Mail The Application
Mail it to Town of Haysi, P.O. Box 278, Haysi, VA 24256. Make checks payable to the Town of Haysi.
Frequently asked questions
- Do I need a notary for the Business License Application?
- No. The form asks the applicant to sign and date the certification; it lists no notarized or sworn attachment.
- How do I submit the Business License Application?
- Mail the signed application to Town of Haysi, P.O. Box 278, Haysi, VA 24256. Make checks payable to the Town of Haysi.
- What information does the application ask for?
- It asks for business and owner details, contact information, location, federal ID number, primary business purpose, and gross receipts used to calculate the license tax.
- When does the form list business license renewal as due?
- The due date calendar on the application lists March 1 for business license renewal.