Form Ador 74-4001 - Transaction Privilege And Use Tax License Update - Arizona Department Of Revenue Page 2
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2Transaction Privilege & Use Tax License Update Form
Page 2 of 2
SECTION VI. OTHER LICENSES
Contractor No.
Class
State Withholding No.
State Liquor License No.
Do you sell new motor vehicles or tires?
Yes
No
To apply for registration as a solar energy device retailer or contractor, call the License & Registration section at (602) 542-4576.
SECTION VII. CITY LICENSES (Indicate affected cities in “Total Fees” column.)
Date you started business in cities ________________________
TOTAL
TOTAL
TOTAL
CITY / TOWN
CODE
FEE
FEE
CITY / TOWN
CODE
FEE
FEE
CITY / TOWN
CODE
FEE
FEE
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 FEES $
TOTAL FEES $
TOTAL FEES $
INDIAN
INDIAN
INDIAN
INDIAN
RESERVATION
COUNTY CODE
RESERVATION
COUNTY CODE
RESERVATION
COUNTY CODE
RESERVATION
COUNTY CODE
Ak Chin ..............................Pinal
PNA Hopi....................................Coconino
COJ Pascua-Yaqui ........................ Maricopa
MAN Tohono O’Odham...............Pinal
PNT
Cocopah.............................Yuma
YMB Hopi....................................Navajo
NAJ Pascua-Yaqui ........................ Pima
PMN Tonto Apache .....................Gila
GLU
Colorado River ...................La Paz
LAC Hualapai.............................Coconino
COK Salt River Pima-Maricopa ..... Maricopa
MAO White Mountain Apache .....Apache
APD
Fort McDowell-Yavapai ......Maricopa
MAE Hualapai.............................Mohave
MOK San Carlos Apache ............... Gila
GLP White Mountain Apache .....Gila
GLD
Fort Mohave.......................Mohave
MOF Kaibab-Paiute ....................Coconino
COL San Carlos Apache ............... Graham
GRP White Mountain Apache .....Graham
GRD
Fort Yuma-Quechan...........Yuma
YMG Kaibab-Paiute ....................Mohave
MOL San Carlos Apache ............... Pinal
PNP White Mountain Apache .....Navajo
NAD
Gila River ...........................Maricopa
MAH Navajo................................Apache
APM San Juan Southern Paiute .... Coconino
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
NOTE: City fees are subject to change. You will be billed for the difference.
SECTION VIII. SIGNATURE
I hereby certify that the statements herein are true and correct.
____________________________________________________
____________________________________________________
___________________
TAXPAYER
TITLE
DATE
OFFICIAL USE ONLY
__________________________________________
CITY START DATE
ADOR 74-4001 (9/03)
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