Form Ador 11186 - Transaction Privilege Tax City Only Application Page 2
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5Legal Business Name (as shown on page 1)
FEIN or SSN
SECTION C: City License Fee Worksheet
ALL FEES ARE SUBJECT TO CHANGE. Check for updates at
To calculate CITY FEE: Multiply No. of Locations by the License Fee and enter sum in License Subtotal.
No. of
License
License
No. of
License
License
No. of
License
License
City/Town
Code
Loc’s
Fee
Subtotal
City/Town
Code
Loc’s
Fee
Subtotal
City/Town
Code
Loc’s
Fee
Subtotal
Goodyear
GY
$5.00
Sahuarita
SA
$5.00
Guadalupe
GU
$2.00
San Luis
SU
$2.00
Benson
BS
$5.00
Hayden
HY
$5.00
Bisbee
BB
$1.00
Holbrook
HB
$1.00
Sedona
SE
$2.00
Buckeye
BE
$2.00
Huachuca City
HC
$2.00
Show Low
SL
$2.00
Bullhead City
BH
$2.00
Jerome
JO
$2.00
Sierra Vista
SR
$1.00
Camp Verde
CE
$2.00
Kearny
KN
$2.00
Snowflake
SN
$2.00
Carefree
CA
$10.00
Kingman
KM
$2.00
Somerton
SO
$2.00
Casa Grande
CG
$2.00
Lake Havasu
LH
$5.00
South Tucson
ST
$2.00
Cave Creek
CK
$20.00
Litchfield Park
LP
$2.00
Springerville
SV
$5.00
Mammoth
MH
$2.00
St. Johns
SJ
$2.00
Chino Valley
CV
$2.00
Marana
MA
$5.00
Star Valley
SY
$2.00
Clarkdale
CD
$2.00
Maricopa
MP
$2.00
Superior
SI
$2.00
Clifton
CF
$2.00
Surprise
SP
$10.00
Colorado City
CC
$2.00
Miami
MM
$2.00
Taylor
TL
$2.00
Coolidge
CL
$2.00
Cottonwood
CW
$2.00
Oro Valley
OR
$12.00
Thatcher
TC
$2.00
Dewey/Humboldt DH
$2.00
Page
PG
$2.00
Tolleson
TN
$2.00
Paradise Valley
PV
$2.00
Tombstone
TS
$1.00
Duncan
DC
$2.00
Parker
PK
$2.00
Eagar
EG
$10.00
Patagonia
PA
$0.00
Tusayan
TY
$2.00
El Mirage
EM
$15.00
Payson
PS
$2.00
Wellton
WT
$2.00
Eloy
EL
$10.00
Wickenburg
WB
$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
Winslow
WS
$10.00
Gila Bend
GI
$2.00
Prescott Valley
PL
$2.00
Youngtown
YT
$10.00
Gilbert
GB
$2.00
Quartzsite
QZ
$2.00
Yuma
YM
$2.00
Queen Creek
QC
$2.00
Globe
GL
$2.00
Safford
SF
$2.00
Subtotal City License Fees
Subtotal City License Fees
Subtotal City License Fees
$
$
$
(column 1)
(column 2)
(column 3)
$
AA TOTAL City License Fee(s) DUE(column 1 + 2 + 3) ..................................................................................................................
• Make check payable to Arizona Department of Revenue.
• Include FEIN or SSN on payment.
• Do not send cash.
• License will not be issued without full payment of fee.
ADOR 11186 (5/16)
TRANSACTION PRIVILEGE TAX CITY ONLY APPLICATION
Page 2 of 3
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