Business Account Update Form - Arizona Department Of Revenue Page 2

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Business Account Update
Page 2 of 2
SECTION E. LOCATION OF TAX RECORDS
Location of Tax Records (Street Address, City, State and ZIP code)
Name of Company or Person to Contact
Phone Number
SECTION F. PROGRAM CITY TPT LICENSE FEES (Indicate affected cities in “Total” column.)
Date you started business in cities
For Use Tax updates, indicate the city locations, but enter zero (0) in the “Total” column.
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
Snowfl ake
SN
2.00
Buckeye
BE
2.00
Huachuca City
HC
2.00
Camp Verde
CE
2.00
Jerome
JO
2.00
South Tucson
ST
2.00
Carefree
CA
10.00
Kearny
KN
2.00
Springerville
SV
5.00
Casa Grande
CG
2.00
Kingman
KM
2.00
St. Johns
SJ
2.00
Cave Creek
CK
20.00
Lake Havasu
LH
5.00
Star Valley
SY
2.00
Superior
SI
2.00
Chino Valley
CV
2.00
Litchfi eld Park
LP
2.00
Clarkdale
CD
2.00
Mammoth
MH
2.00
Surprise
SP
10.00
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
Tombstone
TS
1.00
Cottonwood
CW
2.00
Oro Valley
OR
12.00
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
Payson
PS
2.00
Winkelman
WM
2.00
Eloy
EL
10.00
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
Queen Creek
QC
2.00
Gilbert
GB
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
NOTE: City fees are subject to change occasionally. You will be billed for the difference.
Indian Reservation
Indian Reservation
Indian Reservation
Indian Reservation
Code
Code
Code
Code
(County)
(County)
(County)
(County)
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 (Mar.)
MAO White Mtn Apache (Apache)
APD
Fort McDowell-Yavapai (Mar.)
MAE
Hualapai (Mohave)
MOK San Carlos (Apache (Gila)
GLP
White Mtn Apache (Gila)
GLD
Fort Mohave (Mohave)
MOF
Kaibab-Paiute (Coconino)
COL
San Carlos Apache (Graham)
GRP
White Mtn Apache (Graham)
GRD
Fort Yuma-Quechan (Yuma)
YMG Kaibab-Paiute (Mohave)
MOL San Carlos Apache (Pinal)
PNP
White Mtn Apache (Navajo)
NAD
Gila River (Maricopa)
MAH
Navajo (Apache)
APM San Juan Southern Paiute
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
SECTION G. SIGNATURE of Individual legally responsible for the business (required)
UNDER PENALTY OF PERJURY I DECLARE THAT THE INFORMATION ON THIS DOCUMENT IS TRUE AND CORRECT.
Type or Print Name
Title
Signature
Date
THIS APPLICATION MUST BE COMPLETED, SIGNED AND RETURNED AS PROVIDED BY ARS § 23-722
Equal Opportunity Employer/Program This document available in alternative formats by contacting the UI Tax Offi ce.
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ADOR 10193 (7/11)

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