Carbon County Clerk
             
Carbon County Clerk's Office
Business License
751 East 100 North, Suite 1100 - Price, UT 84501
VALYN.PEACOCK@CARBON.UTAH.GOV
435-636-3227


Contact the clerks office prior to payment for exact amount.


Amount:   $   Item Subtotal:  
$0.00
Business Account Number [1]
Business Name [1]

Business Account Number

[2]
Business Name [2]

Business Account Number

[3]
Business Name [3]

Business Account Number

[4]
Business Name [4]

Business Account Number

[5]
Business Name [5]

Business Account Number

[6]
Business Name [6]

Business Account Number

[7]
Business Name [7]

Business Account Number

[8]
Business Name [8]

Business Account Number

[9]
Business Name [9]

Business Account Number

[10]
Business Name [10]
Total:
$0.00
 
Payer's Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
Payment Information
Method of Payment:
Convenience Fees: Credit cards: 2.5% ($1.50 min)
                    (+1.5% convenience for foreign cards)
eChecks: $0.75
Update name from Payer's Information
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Credit Card Number: (Type number or swipe with cursor in this empty field)
Expiration Date: /
Cardholder Information (exactly as it appears on your statement)
  Update from Payer's Information
Cardholder's Name:
Billing ZIP/Postal Code:

Please be aware that credit card payments will reflect on your statement as
Carbon UT 800-764-0844 Price UT

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