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 
     
                 LICENSE APPLICATION SUPPLEMENT 
 
    (For Ownership Type marked as Individual, Sole Proprietorship, or Husband and Wife) 
 
According to the Legal Arizona Workers Act (A.R.S. 41-1080), specific documentation is 
required to issue a license if your business ownership type is identified as an Individual, Sole 
Proprietorship, or Husband and Wife business. Before your license 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 Husband and Wife, both individuals must provide 
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.  

   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)  
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 start of business, the Delinquent License Penalty will apply.   
 
                                                                                        _______ 
Signature of Applicant(s)             Printed Name(s)                                   Date 
                                              
                                     Mailing Address 
                                      Mail Stop 701 
                                      P.O. Box 4008 
                              Chandler, AZ  85244-4008