Business License Application - City Of Douglas
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1
2BUSINESS LICENSE APPLICATION
LICENSE NO._________________
CITY OF DOUGLAS
Location: 425 10TH STREET
Mail to: 425 10TH STREET
Douglas, AZ 85607
(520) 417-7333 - Fax (520) 417-7162
For Office Use Only
EACH SECTION OF THIS APPLICATION MUST BE COMPLETED BEFORE A LICENSE WILL BE ISSUED.
Application Date:
Check One:
New Business
Former Owner (If Applicable):
License Type:
TPT
OBL
Start Date:
Application & License Fee
New Owner of Existing Business
Current City License#:
For Changes
Name Change Only
Date of Change:
To Existing
Location Change
License #
Licenses:
Change Corporate Officers
SECTION I. BUSINESS LOCATION INFORMATION
Business Name:
Approvals
Street Address:
Suite or Apt. #
Finance Department
A
D
City:
State:
Zip
Business Telephone#:
Planning/Zoning Department
A
D
E-Mail Address:
Business Fax #
Fire Department
A
D
SECTION II MAILING ADDRESS
Health Department
Enter name if Different From Section I (above) or Enter "In-Care-of" Name:
A
D
Address
City
State
Zip
SECTION III. BUSINESS OWNERSHIP & RECORD LOCATION
Ownership:
Individual
LLC
Corp.
Gen Partnership
S Corp.
Other/Non-Profit
If LLC do you file with IRS as:
Sole Proprietor
Corporation
If Corporation or LLC, it must be registered with the Arizona Corporation Commission.
Contact person or
Name:
Day Time Phone #:
Night Phone #:
owner
Corporation or LLC
if different than DBA
Name and Address:
Phone #:
Corporate or LLC
Statutory Agent
SECTION IV. BUSINESS TYPE
Business
Retail
Amusements
Other/Services
Rental of Real Property
Type
Restaurants/Bars
Taxi/Shuttle
Wholesaler
Construction Contracting
Roc#
Rental of Tangible Personal Property
Hotel/Motel
Home Occupation
Describe in detail
NAICS Code:
business activity:
SECTION V. BUSINESS PREMISES STATUS
CHECK ONE:
Is your business location your residence?
Yes
No
Do you rent/lease commercial property from another?
Yes
No
In City
If yes to either of these, please complete the Landlord/Property Information.
Landlord/Property Manager Name:
Address:
Phone #:
Out of City
Do you rent a portion of the business premises to another entity?
Yes
No
If YES, please list the name and telephone of the other entity:
Check method you will use in submitting reports:
Cash Receipts
Accrual
PLEASE LIST ALL VEHICLES TO BE USED BY YOUR BUSINESS (IF ANY):
LIC PLATE NO.
MAKE
MODEL
YEAR
Number of employees:
********For a Listing of NAICS Codes visit and click on "Business Tax Description Codes"
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Parent category: Business