Arizona Department Of Revenue City Of Phoenix - Report Transaction Privilege Tax

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Finance Department
Tax Division
File and Report Transaction Privilege Tax (TPT) with the Arizona Department of Revenue (ADOR)
Please complete this form to request to file and report TPT with ADOR (one form per City license number).
All boxes must be completed. Incomplete forms will NOT be processed.
Phoenix TPT License Number (
):
Business Name:
8 digits
Arizona TPT Number (
):
*Location Number (
):
8 digits, no alpha
3 digits
Beginning Tax Period TPT Reported and Remitted to ADOR:
/2016
Contact Phone Number:
Email Address:
I understand that the city of Phoenix will no longer provide me with a TPT return form for future tax
periods and I am to file and report all tax owed to the City with the Arizona Department of Revenue.
I am listed on the City account as an authorized owner or principal of the above-named business to
complete this form.
____________________________
___________________________
Signature
Printed Name
*Instructions on how to find your ADOR Location Number on the ADOR TPT license form:
and type “Form 2111” in the subject line, or fax it to the Tax
Email this form to
tax@phoenix.gov
Division at fax number (602) 732-2769.
Form 2111 08/2016

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