Application For Transaction Privilege (Sales) And Use Tax License - City Of Phoenix, Arizona Finance Department

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APPLICATION FOR TRANSACTION
PRIVILEGE (SALES) AND USE TAX
LICENSE
CITY OF PHOENIX
Finance Department
Tel: (602)262-6785,
ACCOUNT/REFERENCE NO.
option 4
TTY: (602)534-5500
Previous City License #:
If consolidating account,
Check one:
New Business
New Owner of Existing Business
provide Master #:
OFFICE USE
Change in Business Location
ONLY
Section I. Business Information
Verify that your business is located in Phoenix at
.
NOV Date or
Business Name (Company, DBA, or Individual; first name, last name):
Owning Entity Name (Corporation, LLC, etc.):
DISV Ref.#
Physical Business Street Address (i.e., retail store, rental property and NOT a P.O. Box number nor a PMB):
ST Code
/
City, State, Country, Zip Code (+4):
Business Phone # with Area Code:
/
/
Tax Liability Start Date in Phoenix:
E-Mail Address:
NAICS Code
State License #:
Federal I.D. #:
Section II. Mailing Address & Phone Number
Rental Units
Enter Name (if different from Section I above) or “Care of” Name:
Owner Type
Mailing Address:
Reporting
City, State, Country, Zip Code (+4):
Phone # with Area Code:
Method
C A
Section III. Business Ownership
Liability Date
Ownership:
Sole
LLC*
Corp./Inc., State ______*
General Partnership*
Ltd. Partnership*
Revocable Trust*
Irrevocable Trust*
Other, explanation:______________________________
Entered by
*List of
1.) Name:
Title:
officers
I-Edited by
Home Address:
SSN #:
attached:
Yes
No
City, State, Country, Zip Code (+4):
Phone #:
Approved by
2.) Name:
Title:
Home Address:
SSN #:
City, State, Country, Zip Code (+4):
Phone #:
Section IV. Business Type (Check all that apply and provide a detailed description of your business.)
Do you sell Liquor?
NAICS Code (6 digits):
Retail
Restaurant/Bar
Hotel/Motel
Retail Food Sales
Yes
No
Advertising
Job Printing
Amusement
Personal Property Rental
_ _ _ _ _ _
Telecommunications
Short-Term Motor Vehicle Rental
Reporting Method:
Commercial Rental Property
Residential Rental Property, # of Units_____
Principal business codes are
Cash
Construction Contracting, AROC#_____________________
Home Builder/Spec. Sale
available at
Accrual
Use Tax (Phoenix business)
Use Tax (out-of-state business with no AZ nexus)
Describe Nature of Business:
Section V. Business Premises Status
Do you own your business location?
Yes
No
If yes, is this your residence?
Yes
No
If yes, skip to the Signature section.
Do you rent a portion of the business premises to another entity or business?
Yes
No If yes, see the instructions for more information.
Landlord/Property Manager:
Mailing Address:
Phone # with Area Code:
I certify that the statements made in this application are true and complete to the best of my knowledge. I accept the license
authorized and issued in response to this application with the condition that I report timely and pay any and all privilege taxes
due by me to the City of Phoenix. I understand that the information I provide on this application can be used for collection
FOR CITY USE ONLY BELOW
purposes. I specifically understand and acknowledge that if I provide a cellular telephone number on this application, the city of
Phoenix or any collection agencies contracted by the City can use the cellular telephone number to contact me for collection
purposes on any unfiled or past due balances. IF APPLICABLE, I UNDERSTAND THAT BY LAW, I MAY BE LIABLE FOR ANY
UNPAID TAX DUE BY THE FORMER OWNER(S) OF THIS BUSINESS.
Applications received incomplete or without payment may not be processed. Postmarks are not accepted as proof of timely payment.
Printed Name:
Title:
Click here to PRINT APPLICATION
Signature:
Date:
Checks are payable to Phoenix City Treasurer, P.O. Box 2005, Phoenix, AZ 85001-2005.
Revised 03/2016

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