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APPLICATION FOR TRANSACTION
PRIVILEGE (SALES) AND USE TAX
CITY OF PHOENIX LICENSE
Finance Department
Tel: (602)262-6785, ACCOUNT/REFERENCE NO.
option 4
TTY: (602)534-5500
Check one: Previous City License #: If consolidating account,
New Business New Owner of Existing Business provide Master #: OFFICE USE
Change in Business Location ONLY
Section I. Business Information Verify that your business is located in Phoenix at www.phoenix.gov/imap . NOV Date or
Business Name (Company, DBA, or Individual; first name, last name): Owning Entity Name (Corporation, LLC, etc.): DISV Ref.#
Physical Business Street Address, i.e., retail store, rental property (NOT a P.O. Box number, a PMB, or single-family home rental): ST Code
/
City, State, Country, Zip Code (+4): Business Phone # with Area Code: /
/
Tax Liability Start Date in Phoenix: E-Mail Address:
NAICS Code
State License #: Federal I.D. #:
Section II. Mailing Address & Phone Number Rental Units
Enter Name (if different from Section I above) or “Care of” Name:
Owner Type
Mailing Address:
Reporting
City, State, Country, Zip Code (+4): Phone # with Area Code: Method
C A
Section III. Business Ownership Liability Date
Ownership: Sole Husband/Wife LLC* Corp./Inc., State ______* General Partnership* Ltd. Partnership*
Revocable Trust* Irrevocable Trust* Other, explanation:______________________________ Entered by
*List of 1.) Name: Title:
officers I-Edited by
attached: Home Address: SSN #:
Yes No City, State, Country, Zip Code (+4): Phone #: Approved by
2.) Name: Title:
Home Address: SSN #:
City, State, Country, Zip Code (+4): Phone #:
Section IV. Business Type (Check all that apply and provide a detailed description of your business.)
Do you sell Liquor? Retail Restaurant/Bar Hotel/Motel Retail Food Sales NAICS Code (6 digits):
Yes No Advertising Job Printing Amusement Personal Property Rental
Telecommunications Short-Term Motor Vehicle Rental _ _ _ _ _ _
Reporting Method: Commercial Rental Property Residential Rental Property, # of Units_____ Principal business codes are
Cash Construction Contracting, AROC#_____________________ Home Builder/Spec. Sale available at
Accrual Use Tax (Phoenix business) Use Tax (out-of-state business with no AZ nexus) www.naics.com/search.htm
Describe Nature of Business:
Section V. Business Premises Status
Do you own your business location? Yes No If yes, is this your residence? Yes No If yes, skip to the Signature section.
Do you rent a portion of the business premises to another entity or business? Yes No If yes, see the instructions for more information.
Landlord/Property Manager: Mailing Address: Phone # with Area Code:
I certify that the statements made in this application are true and complete to the best of my knowledge. I accept the license
authorized and issued in response to this application with the condition that I report timely and pay any and all privilege taxes
due by me to the City of Phoenix. IF APPLICABLE, I UNDERSTAND THAT BY LAW, I MAY BE LIABLE FOR ANY UNPAID
TAX DUE BY THE FORMER OWNER(S) OF THIS BUSINESS.
FOR CITY USE ONLY BELOW
Applications received incomplete or without payment may not be processed. Postmarks are not accepted as proof of timely payment.
Printed Name: Title:
Signature: Date: Click here to PRINT APPLICATION
Checks are payable to Phoenix City Treasurer, P.O. Box 2005, Phoenix, AZ 85001-2005.
Revised 02/2015
