Enter the number of employees on payroll at this business location, including the owner(s).
If different from the address entered above, please enter the mailing address below.
This name will appear on the business license. To list a business as the owner, input the name in both the First and Last Name slots.
Is your business involved in any of the following activities?
Required if changed since last renewal.
Required if regulated by the Utah Dept. of Health & Human Services.
Upload any other documentation here.
This field is not part of the form submission.
* indicates a required field