Form Jt-1/uc-00 - Arizona Joint Tax Application Page 2
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6JT-1/UC-001 (7/11)
Page 2
Section B: Transaction Privilege Tax (TPT)
1. Date Business Started in Arizona
2. Date Sales Began
3. What is your anticipated annual income for your fi rst twelve months of business?
*
*
4. Business Classes (Select at least one. See Section H for a listing of business classes on page 4)
*
5. TPT Filing Method
6. Does your business sell tobacco products?
7. Does your business sell new motor vehicle tires or
vehicles?
Yes
If yes,
Retailer
Cash Receipts
No
OR
Accrual
No
Distributor
Yes
(You will be required to fi le a TR-1.)
If yes, please check the months in which you intend to do business:
8. Are you a seasonal fi ler?
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Yes
No
9. Location of Tax Records (Street Address, City, State and ZIP code) Do not use PO Box or Route No.
*
10. Name of Company or Person to Contact
11. Phone Number
For additional locations, complete the following: (If more space is needed, please attach additional sheets)
12. “Doing Business As” Name for this Location
13. Phone Number
14. Physical Location Address (Do not use PO Box or Route No.)
15. City
16. County
17. State
18. ZIP code
19. “Doing Business As” Name for this Location
20. Phone Number
21. Physical Location Address (Do not use PO Box or Route No.)
22. City
23. County
24. State
25. ZIP code
Section C: Program Cities / License Fees Below is a list of cities and towns licensed by the Arizona Department of Revenue.
City/Town
Code
Fee
No. of
Total
City/Town
Code
Fee
No. of
Total
City/Town
Code
Fee
No. of
Total
Loc
Loc
Loc
Benson
BS
5.00
Hayden
HY
5.00
Show Low
SL
2.00
Bisbee
BB
1.00
Holbrook
HB
1.00
Sierra Vista
SR
1.00
Buckeye
BE
2.00
Huachuca City
HC
2.00
Snowfl ake
SN
2.00
Jerome
JO
2.00
South Tucson
ST
2.00
Camp Verde
CE
2.00
Kearny
KN
2.00
Springerville
SV
5.00
Carefree
CA
10.00
Kingman
KM
2.00
St. Johns
SJ
2.00
Casa Grande
CG
2.00
Lake Havasu
LH
5.00
Star Valley
SY
2.00
Cave Creek
CK
20.00
Litchfi eld Park
LP
2.00
Superior
SI
2.00
Chino Valley
CV
2.00
Mammoth
MH
2.00
Surprise
SP
10.00
Clarkdale
CD
2.00
Clifton
CF
2.00
Marana
MA
5.00
Taylor
TL
2.00
Colorado City
CC
2.00
Maricopa
MP
2.00
Thatcher
TC
2.00
Coolidge
CL
2.00
Miami
MM
2.00
Tolleson
TN
2.00
Cottonwood
CW
2.00
Oro Valley
OR
12.00
Tombstone
TS
1.00
Dewey/Humboldt
DH
2.00
Page
PG
2.00
Tusayan
TY
2.00
Duncan
DC
2.00
Paradise Valley
PV
2.00
Wellton
WT
2.00
Eagar
EG
10.00
Parker
PK
2.00
Wickenburg
WB
2.00
El Mirage
EM
15.00
Patagonia
PA
25.00
Williams
WL
2.00
Eloy
EL
10.00
Payson
PS
2.00
Winkelman
WM
2.00
Florence
FL
2.00
Pima
PM
2.00
Winslow
WS
10.00
Fountain Hills
FH
2.00
Pinetop/Lakeside
PP
2.00
Youngtown
YT
10.00
Fredonia
FD
10.00
Prescott Valley
PL
2.00
Yuma
YM
2.00
Gila Bend
GI
2.00
Quartzsite
QZ
2.00
Gilbert
GB
2.00
Queen Creek
QC
2.00
Globe
GL
2.00
Safford
SF
2.00
Goodyear
GY
5.00
Sahuarita
SA
5.00
Guadalupe
GU
2.00
San Luis
SU
2.00
4
Total of City Fees:
Please Note: City fees are subject to change (go to our website
for updates). For cities not listed above, please contact the cities
State Fees $12.00 X _____ Number of Locations:
directly. Your license will not be issued until all fees are paid.
TOTAL Fees:
ADOR 10194 (7/11)
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