City of Chandler                                (480) 782-2280      Phone
                                  Tax and License Division                        (480) 782-2343      Fax
                                                                              salestax@chandleraz.gov e-Mail
                                175 S. Arizona Ave, Suite A                   www.chandleraz.gov/tax  Website
                                  Chandler, AZ  85225

   BUSINESS REGISTRATION APPLICATION SUPPLEMENT

According to the Legal Arizona Workers Act (A.R.S. 41-1080), specific documentation is required to
issue a registration if your business ownership type is identified as an Individual (Sole Proprietorship) or
General Partnership. Before your registration can be approved, you must provide a copy of one of the
following documents indicating your presence in the United States is authorized under federal law (if
applying as a General Partnership all partners must provide the required documentation). *Please note:
If you are providing one of the documents listed below that does not contain a photograph, you
must also provide a copy of a government issued document that contains a photograph.
 ü Check the box next to the documentation you are providing:
   An Arizona driver license issued after 1996 or an Arizona non-operating identification license.
   A driver license issued by a state that verifies lawful presence in the United States. (Driver
   licenses CANNOT be accepted if issued by: HI, ME, MD, MI, NM, UT, or WA).
   A birth certificate or delayed birth certificate issued in any state, territory or possession of the
   United States.  (*Photo also required – See above)
   A United States certificate of birth abroad.  (*Photo also required – See above)
   A United States passport.
   A foreign passport with a United States visa.
   An I-94 form with a photograph.
   A United States citizenship and immigration services employment authorization document or
   refugee travel document.  (*Photo also required – See above)
   A United States certificate of naturalization.  (*Photo also required – See above)
   A United States certificate of citizenship.  (*Photo also required – See above)
   A tribal certificate of Indian blood.  (*Photo also required – See above)
   A tribal or Bureau of Indian affairs affidavit of birth.  (*Photo also required – See above)
   Any other license that is issued by the Federal Government, any other state government, an
   agency of this State or a political subdivision of this State that requires proof of citizenship or
   lawful alien status before issuing the license.  (*Photo also required – See above)

This provision does not apply to an individual, if all of the following apply:

   The individual is a citizen of a foreign country, or, if at the time of application, the individual
   resides in a foreign country.
   The benefits that are related to the license do not require the individual to be present in the
   United States in order to receive those benefits.

You may mail a copy of the required document or bring the original into our office and we will make a
copy for you.  Please note, if the application and payment is not received in our office within 45 days of
the business start date, the delinquent Penalty will apply.

                                                                                                _______
Signature of Applicant(s)         Printed Name(s)                                               Date

                                  Mailing Address
                                  Mail Stop 701
                                  P.O. Box 4008
                                  Chandler, AZ  85244-4008