BUSINESS LICENSE RENEWAL WAIVER APPEAL FORM

DO NOT COMPLETE THIS FORM IF YOUR BUSINESS IS NOT DUE FOR RENEWAL

Pursuant to Resolution No. 2021-26, the City of Newport Beach will waive the annual business license tax for businesses within the city that were deemed non-essential and forced to close to comply with Executive and Public Health orders during the COVID-19 pandemic. The waiver applies to business license tax renewals due between April 1, 2021 through March 31, 2022.

In order to qualify for the waiver, a business must meet the following requirements:

1. Be located at a commercial address (not residential);
2. Have been closed by Executive Order during the COVID-19 pandemic and could not offer services virtually; AND
3. Is not delinquent on its business license tax payments.

1

Business License Number (BT)

 *

Business License Number (BT)

2

Business Name as it appears on Business License

 *

Business Name as it appears on Business License

3

Business Address

 *

Business Address

4

Contact Name

 *

Contact Name

5

Contact Information

 *

Contact Information

Email

Phoneext.

6

Last 4 digits of ID number (FEIN, SSN, DL#, TIN) provided on business license tax application

 *

Last 4 digits of ID number (FEIN, SSN, DL#, TIN) provided on business license tax application

7

Business Category (included on your current business license certificate)

 *

Business Category (included on your current business license certificate)

8

Describe your business activity

 *

Describe your business activity

9

Total number of current full-time and part-time W-2 employees

 *

Total number of current full-time and part-time W-2 employees

10

Was your business required to close by Executive Order?

 *

Was your business required to close by Executive Order?

Yes

No

11

What were the dates of your business closure?

 *

What were the dates of your business closure?

Date Closed

Date Reopened

12

Did your business operate remotely or virtually during this time?                        

 *

Did your business operate remotely or virtually during this time?

Yes

No

13

Is your business current on its business license tax payments?

 *

Is your business current on its business license tax payments?

Yes

No

14

Certification

 *

Certification

I hereby certify under penalty of perjury that I am authorized to make this statement and the foregoing statements to be true and correct.

Your Name

Overview of Process

• Submit the form in the month your renewal is due. Forms received prior to your renewal month will not be processed and cannot be saved until your renewal month.
• Any past due business license account balance must be paid in full prior to requesting an appeal. Payments may be made using the online system at newportbeachca.gov/payments.
• Businesses will be notified of the City's final decision within 15 business days of their submittal.
• If your business qualifies for the waiver, the account will be automatically adjusted and no further invoice will be sent.
• If your business license expiration date is 15 or more days past due, you must renew and submit payment to avoid the imposition of penalties. Please note, if your business does not qualify for the waiver program and the appeal form was not received within 15 days after your expiration date, penalties will accrue and be due and payable. If you have made payment and qualify for the waiver a full refund will be issued within 30 days.

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