Form Ador 74-4002 - Arizona Joint Tax Application Page 4
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4UC-001-I (3/03) (Page 4)
CITIES OR TOWNS LICENSED BY THE STATE
FOR CITIES NOT LISTED, PLEASE CONTACT THE CITY
F
F
F
TOTAL
TOTAL
TOTAL
CITY/TOWN
CODE
E
CITY/TOWN
CODE
E
CITY/TOWN
CODE
E
FEES
FEES
FEES
E
E
E
Apache Junction
AJ
2.00
Globe
GL
2.00
Safford
SF
2.00
Benson
BS
5.00
Goodyear
GY
5.00
Sahuarita
SA
5.00
Bisbee
BB
1.00
Guadalupe
GU
2.00
San Luis
SU
2.00
Buckeye
BE
2.00
Hayden
HY
5.00
Sedona
SE
2.00
Bullhead City
BH
2.00
Holbrook
HB
1.00
Show Low
SL
2.00
Camp Verde
CE
2.00
Huachuca City
HC
2.00
Sierra Vista
SR
1.00
Carefree
CA
10.00
Jerome
JO
2.00
Snowfl ake
SN
2.00
Casa Grande
CG
2.00
Kearny
KN
2.00
Somerton
SO
2.00
Cave Creek
CK
20.00
Kingman
KM
2.00
South Tucson
ST
2.00
Chino Valley
CV
2.00
Lake Havasu
LH
5.00
Springerville
SV
5.00
Clarkdale
CD
2.00
Litchfi eld Park
LP
2.00
St. Johns
SJ
2.00
Clifton
CF
2.00
Mammoth
MH
2.00
Superior
SI
2.00
Colorado City
CC
2.00
Marana
MA
5.00
Surprise
SP
10.00
Coolidge
CL
2.00
Miami
MM
2.00
Taylor
TL
2.00
Cottonwood
CW
2.00
Oro Valley
OR
12.00
Thatcher
TC
2.00
Douglas
DL
5.00
Page
PG
2.00
Tolleson
TN
2.00
Duncan
DC
2.00
Paradise Valley
PV
2.00
Tombstone
TS
1.00
Eagar
EG
10.00
Parker
PK
2.00
Wellton
WT
2.00
El Mirage
EM
2.00
Patagonia
PA
25.00
Wickenburg
WB
2.00
Eloy
EL
10.00
Payson
PS
2.00
Willcox
WC
1.00
Florence
FL
2.00
Pima
PM
2.00
Williams
WL
2.00
Fountain Hills
FH
2.00
Pinetop/Lakeside
PP
2.00
Winkelman
WM
2.00
Fredonia
FD
10.00
Prescott Valley
PL
2.00
Winslow
WS 10.00
Gila Bend
GI
2.00
Quartzsite
QZ
2.00
Youngtown
YT
10.00
Gilbert
GB
2.00
Queen Creek
QC
2.00
Yuma
YM
2.00
TOTAL
TOTAL
TOTAL
Indian Reservation (County) CODE Indian Reservation (County) CODE Indian Reservation (County)
CODE Indian Reservation (County) CODE
Ak-Chin (Pinal)
PNA Hopi (Coconino)
COJ Pascua-Yaqui (Maricopa)
MAN Tohono O’Odham (Pinal)
PNT
Cocopah
YMB Hopi (Navajo)
NAJ Pascua-Yaqui (Pima)
PMN Tonto Apache (Gila)
GLU
Colorado River (La Paz)
LAC Hualapai (Coconino)
COK Salt River Pima-Maricopa (Mar.)
MAO White Mtn Apache (Apache)
APD
Fort McDowell-Yavapai (Mar.)
MAE Hualapai (Mohave)
MOK San Carlos (Apache (Gila)
GLP White Mtn Apache (Gila)
GLD
Fort Mohave (Mohave)
MOF Kaibab-Paiute (Coconino)
COL San Carlos Apache (Graham)
GRP White Mtn Apache (Graham)
GRD
Fort Yuma-Quechan (Yuma)
YMG Kaibab-Paiute (Mohave)
MOL San Carlos Apache (Pinal)
PNP White Mtn Apache (Navajo)
NAD
Gila River (Maricopa)
MAH Navajo (Apache)
APM San Juan Southern Paiute
COQ Yavapai Apache (Yavapai)
YAW
Gila River (Pinal)
PNH Navajo (Coconino)
COM Tohono O’Odham (Maricopa)
MAT Yavapai Prescott (Yavapai)
YAX
Havasupai (Coconino)
COI
Navajo (Navajo)
NAM Tohono O’Odham (Pima)
PMT
PLEASE NOTE:
Total of City Fees:
_______________
City fees are subject to change occasionally.
State Fees $12.00 x No. Loc.:
_______________
You will be billed for the difference.
TOTAL FEES:
_______________
FOR ADDITIONAL LOCATIONS, COMPLETE THE FOLLOWING:
NAME DOING BUSINESS AS AT THIS LOCATION
PHYSICAL LOCATION (not PO Box or Rte. No.)
PHONE NUMBER
(
)
CITY
COUNTY
STATE
ZIP CODE
AVG. NO. OF EMPLOYEES
NAME DOING BUSINESS AS AT THIS LOCATION
PHYSICAL LOCATION (not PO Box or Rte. No.)
PHONE NUMBER
(
)
CITY
COUNTY
STATE
ZIP CODE
AVG. NO. OF EMPLOYEES
If more space is needed, please attach additional sheet.
ADOR 74-4002 (3/03)
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