Location Administrator Request Form
Please Select:
User Information
Please enter the user account information in the fields provided below. Phone and email information must be accurate and complete in order to process your request. A Tax & License Representative will contact you to confirm the information submitted and will request your social security number prior to creating your account.
* First Name:   Middle Name:
* Last Name:
*   *
* Phone:   Mobile:
* Position:
* Required Fields
Add Locations
Please search for the location information you will be filing for below and add it to the list below. You must provide at least one location.


Location IDPrimary NameTypeAction
No Location Added.
  • Location Search
Select the desired location from the available list. Click the OK button after you have selected your location. Click the X button to return to previous page.