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Form Ador 50-4013 - Transaction Privilege Tax License Application For Bond Exemption

Transaction Privilege Tax License

Application For Bond Exemption

The purpose of this form is to request exemption from bonding requirements under ARS § 42-5006 for construction

contracting businesses applying for a Transaction Privilege Tax License. Exemptions are granted based on the criteria

listed in item four below. For more information on bonding and tax requirements, please refer to the Department of

Revenue brochures, Taxpayer Bonds and Contracting Activities. You can also call the Department of Revenue Tax Tapes

at 542-1991 or contact the License and Registration Section at (602) 542-4576 or 800-634-6494 toll-free in state.

Name of applicant:

Name and title of contact person:

Address:

Telephone number:

Do you have employees employed full time in Arizona?

If so, how many?

List dates you have had full-time employees in Arizona.

Your Arizona Employer Withholding Number:

If you are requesting exemption from the bonding requirements in accordance with AAC R15-10-202, please check

the appropriate box and provide the requested documentation.

If you have a letter of good standing verifying timely payment of all sales and transaction privilege taxes from

another state in which you have been licensed for at least the two years immediately preceding the date of

this application, please attach. If there have been instances of late or insufficient payment, a letter of

explanation must be included.

If the business has no potential liability for transaction privilege tax, documentation verifying that there is no

potential for Arizona tax liability must be submitted with this application.

If you have a bond for a previously issued Arizona Transaction Privilege License which adequately covers

your previously issued license tax liability and the expected tax liability under this license, please indicate the

license number here:

If you have previous license(s) with the Arizona Department of Revenue for which taxes were paid timely and

in full, please indicate license number and type of license:

If you have engaged in business in Arizona, but the the business was not subject to transaction privilege tax,

please submit copies of your most recent individual or corporate income tax return showing that the income

was reported and tax paid.

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For Department Use Only

Expiration Date:

Bond Required $:

Bond Company:

Exemption Approval:

ADOR 50-4013 (1/99)

Form Ador 50-4013 - Transaction Privilege Tax License Application For Bond Exemption