Form Ador 10193 - Business Account Update

Download a blank fillable Form Ador 10193 - Business Account Update in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Ador 10193 - Business Account Update with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Arizona Department of Revenue
License & Registration Section
PO Box 29032 • Phoenix AZ 85038-9032
Phoenix: (602) 542-4576 • Toll-free: (800) 634-6494 (from area codes 520 and 928)
BUSINESS ACCOUNT UPDATE
For Transaction Privilege Tax License and Withholding Registration: if ownership changes require a new
Employer Identification Number (EIN), a Joint Tax Application is required. Do not use this form to change the EIN.
Taxpayer or Legal Business Name on Current License Number (Please print)
License Number(s)
EIN
SECTION A.
ACCOUNT TYPE
Transaction Privilege Tax License (TPT)
Corporate (Including Partnership, Limited
Withholding/Unemployment Tax Registration (
Liability, and S Corporations)
)
if hiring employees
Use Tax Registration
SECTION B.
CHANGES REQUESTED / FEES
STATE FEE:
Please check boxes below to indicate the change in your account, and complete Sections C through
*
G to verify or correct all information. Asterisked (
) changes to Transaction Privilege Tax licenses are subject to a
CITY FEE(S):
(from back page)
fee of $12 per location for the state fee and any applicable city fees. City fees are listed on the back of this form. There are no
TOTAL FEE(S):
fees for changes to Corporate Account, Use Tax or Withholding Registrations.
*
*
Business name or DBA name change
Duplicate license
Mailing address change
*
Add city license (see other side)
*
Business location change
Reinstate Effective Date
*
Additional business or rental location(s) filing consolidated reports
Cancel effective date
Corporate Officers
SECTION C. BUSINESS NAME AND ADDRESS
Legal Business Name / Owner / Employing Unit
Business or “Doing Business As” Name
Mailing Address (Street Name or PO Box), City, State, Zip
Country
E-mail address
Business Phone Number
Fax Number
Physical Location Business or Rental (NOT a PO Box)
County
Check here if this is an added location
SECTION D. IDENTIFICATION OF OWNER Partners, Corporate Officers, Members (or Managing Members) or Officials
A. Name (Last, First, MI)
B. Soc. Sec. No.
C. Title
D. % Owned
E. Complete Residence Address
F. Phone Number
%
%
%
%
If the owner, partners, corporate officers or combination of partners or corporate officers, members and/or managing members own or control
more than 50% of another business in Arizona, attach a list of the businesses, percentages owned and unemployment insurance account numbers.
ADOR 10193 (1/15)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2