Privilege (Sales) License Application Form - City Of Phoenix, Arizona Page 3
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3City of Phoenix, Arizona
Date:
CITY TREASURER
P.O. BOX 2005
PAYMENT TRANSMITTAL
Page 4
Phoenix, AZ 85001-2005
FOR CITY USE ONLY
Initiator: _____________________
Master / Single License #
Current Month
/
- 0 0
/
/ /
Business Name:
Reference Number
Amount Due
Amount Paid
Y E A R
(Single/Cons. Lic. #)
L
L
L
L
L
L
L
Total Amount Due $
Total Remittance $
CASHIER VALIDATION ONLY BELOW THIS LINE
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