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BUSINESS LICENSE APPLICATION
CITY OF BULLHEAD CITY
Business License Office
PO Box 23189
Bullhead City, AZ 86439-3189
(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.)
7.2022
