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                                                                                    BUSINESS LICENSE APPLICATION 
                                                                                         CITY OF BULLHEAD  CITY 
                                                                                         Business License Office 
                                                                                                    PO Box 23189                                                                            
                                                                                         Bullhead City, AZ  86439-3189 
                                                          Office: (928) 763-0110 -  Fax: (928) 763-0131 - E-mail: bhcbusinesslicense     @bullheadcityaz.gov                                        
                                                                        Location: 2355 Trane Rd, Bullhead City, AZ  86442 
                               EACH  SECTION  OF THIS  APPLICATION  MUST  BE COMPLETED  BEFORE  A LICENSE  WILL  BE ISSUED.                                                                 For Office Use Only 
 
 Check One:         New Business                                        Former Owner (If Applicable):             Application  Date:                                                        License Type: 
                                                                                                                                                                                                   TPT               OBL 
                    New Owner of Existing  Business                                                               Start Date:                                                               Application & License Fee 
 
 For Changes        Name Change Only                                    Current City License#:                    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. #                                                                               Business License Office 
                                                                                                                                                                                              A      D
 City:                                                                  State:                 Zip                Business Telephone #:                                                      Building Department 
                                                                                                                                                                                              A      D
 E-Mail Address:                                                                                                  Business Fax #                                                             Planning/Zoning Department 
                                                                                                                                                                                             A     D 
 SECTION  II:  MAILING ADDRESS                                                                                                                                                                Fire Department 
 Enter name if Different From Section I (above) or Enter "In-Care-of" Name:                                                                                                                  A      D
                                                                                                                                                                                              Health  Department 
 Address                                                                                                                                                                                     A      D
                                                                                                                                                                                              Police  Department 
 City                                                                   State                  Zip                                                                                           A      D
 
 SECTION  III:  BUSINESS OW NERSHIP  & 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  unless  exempt. 
 Contact person or             Name:                                                                              Day Time Phone #:                                                         Night Phone #: 
 owner 
 Corporation or LLC 
 if different than DBA 
 Corporate  or LLC  Name and Address:                                                                                                         Phone #: 
 Statutory Agent 
 SECTION  IV:  BUSINESS  TYPE 
 Business           Retail-New Products Only                                                   Amusements                     Other/Services                                                Construction  Contracting 
 Type               Restaurants/Bars                                                           Taxi                           W holesaler                                                   ROC# 
                    Rental of Tangible Personal Property                                       Hotel/Motel                    Home Occupation 
 Describe in detail 
 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: 
 
 Indicate reporting status for filing S t a t e  a n d  City Transaction Privilege  (Sales) T ax Returns: 
 Monthly                                                      Quarterly                        Annually 
 
 Number of employees: 
 
 Give a listing of all locations  where the business  has operated  or where the applicant  has operated a business  during the 
 last five years: (If not applicable,  please write N/A.) 

Revised 10/2022 



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   The following information  is confidential: 
 
    State TPT #                                                                         Federal ID#/EIN# or SS# (last 4 digits) 
 
                (COPY  OF STATE   TPT  LICENSE  REQUIRED)                       
 
  Owners,               Name:                                                                        Title                      Date of Birth: 
  Partners, LLC 
  Members, or           Home Address:                                                                                           Driver’s License – State and # 
  Officers 
  (For  Additional  City:                                                              State:        Zip Code:                  Phone #: 
  Names  Please 
  Attach List)          Name:                                                                        Title                      Date of Birth: 

                        Home Address:                                                                                           Driver’s License – State and # 

                        City:                                                          State:        Zip Code:                  Phone #: 
 
    IMPORTANT NOTICES: 
   ISSUANCE  OF A CITY BUSINESS  LICENSE  DOES NOT RELIEVE  THE APPLICANT  OF THE RESPONSIBILITY OF COMPLYING  WITH THE VARIOUS CITY CODES.   IF YOU 
   ARE UNSURE  OF SPECIFIC  CODE REQUIREMENTS; PLEASE  CONTACT  THE PLANNING,  BUILDING,  UTILITY,  AND FIRE DEPARTMENTS.   ALSO BE SURE THAT ALL 
   CITY TRANSACTION PRIVILEGE  (SALES) TAX AND TRANSIENT  OCCUPANCY  TAX HAS BEEN PAID BY THE FORMER  BUSINESS  OWNERS.   UNDER  THE CITY CODE 
   YOU ARE LIABLE  FOR ANY UNPAID  TAXES. 
    
    Per A.R.S.  §9-495. Employees providing assistance; identification; communication: 
    A. In any written communication between a city or town and a person, the city or town shall provide the name, telephone number and email address of the employee who is authorized and able to provide 
    information about the communication if the communication does any of the following: 
                1. Demands payment of a tax, fee, penalty, fine or assessment. 
                2. Denies an application for a permit or license that is issued by the city or town. 
             3. Requests corrections, revisions or additional information or materials needed for approval of any application for a permit, license or other authorization that is issued by the city or town. 
    B. An employee who is authorized and able to provide information about any communication that is described in subsection A of this section shall reply within five business days after the city or town 
    receives that communication. 
              
   Applicant's Signature                                                                Title                                            Date 
 
   Applicant's Signature                                                                Title                                            Date 
  
                                                                                        Additional Requirements 
   New                            Type of Ownership 
   Business 
                                  Individual             Copy of owners U.S. issued picture identification. 
 
                                  Partnership             A Partnership  Agreement  & copy of all partner  picture identifications. (US issued) 
                                  LLC                    Copy of Arizona  Articles  of Organization and/or Foreign LLC if applicable. 
                                  Corporation            Copy of Arizona  Articles  of Incorporation. (Foreign  L L C s  a n d  Corporations  must be 
                                                          registered with the Arizona Corporation  Commission  unless exempt.) 
 
   New Owner of Existing Business 
 
                                  Individual            Letter or Bill of Sale from prior owner and copy of new owners US issued picture ID. 
                                  Partnership            Letter or Bill of Sale from prior owner, partnership  agreement  and copy of new owners'  ID. 

                                  LLC                   Letter or Bill of Sale from prior owner and copy of the Articles of Organization. 
                                  Corporation           Letter or Bill of Sale from prior owner and copy of the Articles  of Incorporation. 
 
                                                        TOTAL FEES INCLUDE APP FEE PLUS LICENSE FEE 
 
   Initial general business license application  fee is $60.00 (non-refundable).   Non-profit,  Insurance  & Title companies  have no fee.            
                                                                                                     AND 
   The annual renewal license fee is $60.00; Secondhand  Dealer renewal fee is $160.00 (see separate application);  Non-profit,  Insurance 
   Companies,  and Title Companies  renewal fee is $0.00. Change of officers or business name is $20.00.  
   Change of location inside the City limits is $20.00.  Change of location outside the City limits is $5.00.  Duplicate printed license is $5.00. 

Revised 10/2022 






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