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.Department of
Revenue(CA
Woshington State
Business Licensing Service
PO Box 9034
Olympia WA 98507-9034
360-705-6741
BLS@dor.wa.gov
Fax: 360-705-6699
UBI number: -.6. 05 196211
For Hire Addendum
For faster service - Apply online
Questions? Call 360-664-6466 or email forhire@doLwa.gov
For Hire Operator: This form indicates if your For Hire business will be locally regulated.
1. Complete Section A and read Section B.
2. Take this form to your local jurisdiction official and have them complete and sign Section C.Ybur local
jurisdication is the city or county (if outside city limits) in which your business is physically located. You
can find contact information for your local jurisdiction at
mrsc.org/Home/Research-Tools/Washington-City-and -Town-Profiles.aspx (cities) or
mrsc.org/Home/Research-Tools/Washington-County-Profiles.a (counties).
3. Submit this signed and completed form with your business license app . licatio-n , or a . For Hire - change ange - of
location form at: http://www.dol.wa.gov/forms/750206.pdf.
Applicant information
•essica:-1/vrrght-Whitney,'_ Business owner nameFirm/trade name:Jessica`s`5huttle
-
_LLC
Type of For Hire business (check one): ❑Taxi ❑ Cabulance 0 Other (For Hire)
3 For Hire Operator Permit Fee
If the local jurisdiction official answers "No"to the first question in Section C, you must submit a For Hire Per-
mit fee ($110), along with other required fees, with your business license application or your For Hire address
change form.
Continued..
To request this document in an alternate format, please complete the form dor.wa.gov/Accessibl*I,'ItvRequest
or call 360-705-6705. Teletype (TTY) users please dial 711
BLS 700 200 (7/26/21) Page 1
Department of
For Hire Addendum
Revenue %,
Washington State
Local jurisdiction authority
J Y
Local jurisdiction official:
Does your jurisdiction, either alone or by agreement with another jurisdiction (e.g., King County), license or
regulate the For Hire business type checked in Section A in accordance with RCW 81.72? ❑ Yes No
BLS 700 200 (7/26/21) Page 2