BUSINESS REGISTRATION LICENSE APPLICATION                                                                                                                 Business Services Office Location
                                                                                                                                                           7447 E. Indian School Road, Suite 110
                                                                                                                                                           Scottsdale, AZ 85251
If applicable, make checks payable to: City of Scottsdale
Mail to: PO BOX 1586                                                                                                                                      Telephone:  (480) 312-2400         Fax:  (480) 312-4806
Scottsdale, AZ 85252-1586                                                                                                                                 www.ScottsdaleAZ.gov

SECTION I.  Business Information   (separate licenses are required for each location)
Check any that apply:            New Business to Scottsdale                                                                                Update                          Merchant (Attach Copy of AZ State TPT License)
                                 Ownership Change, Date Changed  ________________                                                          Insurance Only                  Service
Date business started in Scottsdale             Former Owner (if applicable)                                                                      Current City License #                  Previous City License #            For Office Use Only
                                                                                                                                                                                                                             App. Fee
Doing Business As (DBA), Name on Signage, Name known to the public

Physical address  (Mail box, Mail Drop addresses are not acceptable)                                                                                                                                                         License #

City                                                                         State                                                          Zip Code + 4                 (Area Code) Business Telephone #                    NAICS Code

E-Mail Address                                                                                              Check to receive email updates  AZ State TPT #                        Federal ID #                               Date Received

SECTION II.  Additional Business Information, Mailing and Telephone Number
Legal Business Name of Entity or Individual Name
                                                                                                                                                                                                                                 Initials
Mailing Address (Including C/O)

City                                             State                       Zip Code + 4                                                   Fax #                         (Area Code) Other Business Telephone #             Comments

SECTION III.  Business Ownership & Record Location
 Ownership:        Individual        LLC        Corp. / S corp                             Partnership                                                                     Other __________________________
                      Name                                                                 Title                                                                         (Area Code) Telephone #
     Owners, 
  Partners, LLC       Home Address                                                                                                                                       Social Security #
  Members, or 
     Officers         City                                            State                ZIP Code + 4                                                                  Driver’s License #

                      Name                                                                 Title                                                                         (Area Code) Telephone #

                      Home Address                                                                                                                                       Social Security #
  (For Additional 
     Names,
Please Attach List)   City                                            State                ZIP Code + 4                                                                  Driver’s License #

     Corporate or LLC                 Name                                                                                                        Title                            Phone #
     Statutory Agent
                                      Address
  Location where business 
 records are kept, if different       City                                         State                                                          ZIP Code + 4                     (Area Code) Telephone #
  from business location

     SECTION IV. 
     Business Type                      Retail Sales         Wholesaler                     Service Only                                              Construction Contracting              Restaurant/Bar
                                        Manufacturer         Commercial Rental              Automotive                                                Hotel/Motel                           Other _______________________________
     Describe Nature                                                                                                                                                                                                      # of Employees
     of Business
SECTION V.  Physical Address Information
Is this your residence?       Yes      No                      Do you own your business location?                                            Yes      No
If yes, complete the Home Business Questionaire                If you do not own your business location, complete Landlord/Property Manager information below.
Landlord/Property Manager Name                             Address                                                                                       City                                   State            Zip Code + 4

(Area Code) Telephone #                                                                                                                    Do you rent a portion of the business premises to another entity?      Yes      No
I certify that the statements made in this application are true and complete to the best of my knowledge.   Incomplete applications may not be processed.
Print Name(s)                                                  Signature(s)                                                                                                       Title(s)                                   Date

IF YOU PURCHASE A BUSINESS, BE SURE ALL SALES TAX HAS BEEN PAID BY FORMER OWNER. BY LAW YOU MAY BE LIABLE FOR ANY UNPAID TAX.                                                                                                BS2017-843_BRLA

                 INSTRUCTIONSFORCOMPLETINGBUSINESSREGISTRATIONLICENSEAPPLICATION
                                    PleasecompleteallsectionsstartingwithSectionI.
 
        SectionI:BusinessInformation
        CheckBoxes
          Putacheckinanyoftheboxesthat applytoyourbusiness.
        General Information
                  Line 2 provide start date and any other applicable information.
        BusinessName
          ThebusinessnameshouldbetheDBA(DoingBusinessAs)orifyouarenotusingabusinessname,thenameofthe
          owner.
        BusinessLocationAddress
          Theaddresslistedisyourbusinesslocationaddress.Includesuite,unit,orapartmentnumbers.P.O.Boxnumbersor mail
          drop /PMB addresses arenot acceptedforbusinesslocation.
        Business Telephone
          Thetelephonenumberlistedhereshouldcorrespondtothebusinesslocation.
        FaxNumber
          Providethefaxnumberforthepersonwhoshouldreceiveinquiriesconcerningthisapplication.
        E-mailAddress
          ProvidetheE-mailaddressforthepersonwhoshouldreceiveinquiriesconcerningthisapplication.
        StateTaxLicense#
          ListyourArizonaStateprivilegetaxnumber,ifyouarerequiredtohaveone.
        SectionII:Additional Business Information, Mailing andTelephoneNumber
        Name
          ListbusinesslegalentitynameifdifferentfromSectionI,or"In-Care-Of"nameorinformation.
        MailingAddress
          Providethemailingaddress.Note:Businesslicenseandrenewalswillbesenttothisaddress.Pleaseinclude
          suite,unit,   apartment or mail drop/PMB numbers.
        Telephone Number
          Providethetelephonenumberto the person responsible for this application.
        SectionIII.BusinessOwnershipAndRecordLocation
        Ownership
          Please indicate the type of ownership. If you mark "other" please describe. A Limited LiabilityCorporation(LLC)must
          haveatleastonemember.Generalpartnershipsmustprovidethenameofthegeneralpartner(s).
        Owners/Partners/LLC/Members Or Officers
          Listcompleteowner/officer/partnerinformationasrequested.Includenames,titles and contact information.
        LocationWhereBusinessRecordsAreKept
          CompletethissectionifbusinessrecordsarenotkeptatthelocationlistedinSectionI.
        SectionIV:BusinessType
        Business Type
                 Check any boxes that apply to business activity.
        DescribeNatureOfBusiness
          Provideadetaileddescriptionofbusinessactivity.Forexample,ifretailsales,listtypeofitemstobesold;ifconstruction
          contracting,listtypeofcontracting,etc.
          # of Employees
          Employees at business location listed in Section I.  Does not include owners.
        SectionV:Physical Address Information
        OwnershipOfBusinessLocation
          Ifyourbusinesslocationisaresidence,check"Yes"andcompletetheenclosedHomeOccupationalForm.Ifyouanswer
          "No", please indicatewhetherornotyouownyourbusinesslocation.Ifyoudonotownyourbusinesslocation,please
          providethename of the legal owner or property manager along with their mailing address and telephone number.
        Application&LicenseFees
          EffectiveJuly 13, 2017, all applications for a City of Scottsdale Business Registration (Service) License must include a 
          $12 application fee and a $50 annual license fee.  Applications for a City of Scottsdale Business Registration (Merchant) 
          License must include acopy of the AZ State TPT License showing Scottsdale (SC) as a region code. 
 AllapplicationsMUSTbe signedbyeithertheSole Owner,AllPartners,OneCorporateOfficer,Trustee,orGeneral
 Partner.

 Applicationandannuallicensefeesarenon-refundable.

If your business is in a residential district (Home Based Business 

in Scottsdale), please complete the questionnaire below:

                                 Home Business Questionnaire

Home occupations, as defined in Scottsdale Revised Code, Appendix B, Article lll, Section 3-100, 
are uses permitted but must meet guidelines limiting the impact of uses in residential districts.  The 
following questionnaire will be used by the City of Scottsdale to determine if your request for a home 
occupation exception fits within the guidelines of a residential zoning district.

Please answer all the following questions in regard to your home based business with a check mark in 
the “yes” or “no” box supplied:

  1. Yes   No      Will this business be the main use to the residence? (people will not live 
                   here)

  2. Yes   No      Will employees come to the home? (other than people that live in the 
                   home)

  3.  Yes      No  Do you plan on using your garage or carport for storage? (may only use a 
                   bedroom or alternate room inside the home)

  4. Yes   No      Will a service or commodity be sold that invites customers to your home?

  5. Yes   No      Will commercial type vehicles be kept at this residence for business use?

  6. Yes   No      Are you operating any mechanical equipment at your residence that is 
                   not normally used for domestic, hobby, standard office or household 
                   purposes?  Such as; welding, metal working, wood assembling

  7. Yes   No      Will this business generate pedestrian or vehicular traffic?

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

                                                                                 Office Use Only
_____________________________________
                Owner / Applicant

_______________
     Date