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Transaction Privilege (Sales) And Use Tax Application - City Of Mesa Revenue Collections Operations - 2009 Page 3

RESIDENTIAL BUSINESS LOCATIONS

COMPLETE THIS FORM IF YOUR BUSINESS ADDRESS IS IN A MESA RESIDENTIAL

AREA. DO NOT COMPLETE THE COMMERCIAL BUSINESS LOCATION FORM

(REVERSE SIDE) IF YOU ARE IN A RESIDENTIAL AREA.

You have applied for a Transaction Privilege (Sales) & Use Tax License for your business which is

located in a residential zoning district within the City of Mesa. Businesses located in a residential

district must meet guidelines limiting the impact of uses in residential districts. Please complete the

following questionnaire. It will be used to determine if your request for a license in a residential

district fits within the guidelines of a residential zoning district.

Business Name __________________________________________________________________

Business Address ________________________________________________________________

Please answer all the follow questions in regard to your home based business with a check mark in

the ‘yes’ or ‘no’ box supplies.

Yes

Will this business be the main use of the residence?

Yes

Will employees come to the home? (other than people that live in the

home)

3. Yes

Will there be any storage of business materials or supplies outside of

the main residence?

4. Yes

Will you be having customers of the business coming to the residence?

5. Yes

Will commercial type vehicles be kept at this residence for business

use?

6. Yes

Will any work be performed outside of the residential structure in either

the front or back yards?

I certify that the statements made on this questionnaire are true and complete to the best of my

knowledge.

_________________________________________

Signature of Applicant (REQUIRED)

May 2009

Transaction Privilege (Sales) And Use Tax Application - City Of Mesa Revenue Collections Operations - 2009 Page 3