"Business License Application Form" - Douglas, Arizona

Business License Application Form is a legal document that was released by the Arizona Department of Financial Institutions - a government authority operating within Arizona. The form may be used strictly within Douglas.

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Download "Business License Application Form" - Douglas, Arizona

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BUSINESS LICENSE APPLICATION
LICENSE NO._________________
CITY OF DOUGLAS
Location: 425 10TH STREET
Mail to: 425 10TH STREET
Douglas, AZ 85607
(520) 417-7333 - Fax (520) 417-7162
For Office Use Only
EACH SECTION OF THIS APPLICATION MUST BE COMPLETED BEFORE A LICENSE WILL BE ISSUED.
Application Date:
Check One:
New Business
Former Owner (If Applicable):
License Type:
TPT
OBL
Start Date:
Application & License Fee
New Owner of Existing Business
Current City License#:
For Changes
Name Change Only
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. #
Finance Department
A
D
City:
State:
Zip
Business Telephone#:
Planning/Zoning Department
A
D
E-Mail Address:
Business Fax #
Fire Department
A
D
SECTION II MAILING ADDRESS
Health Department
Enter name if Different From Section I (above) or Enter "In-Care-of" Name:
A
D
Address
City
State
Zip
SECTION III. BUSINESS OWNERSHIP & 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.
Contact person or
Name:
Day Time Phone #:
Night Phone #:
owner
Corporation or LLC
if different than DBA
Name and Address:
Phone #:
Corporate or LLC
Statutory Agent
SECTION IV. BUSINESS TYPE
Business
Retail
Amusements
Other/Services
Rental of Real Property
Type
Restaurants/Bars
Taxi/Shuttle
Wholesaler
Construction Contracting
Roc#
Rental of Tangible Personal Property
Hotel/Motel
Home Occupation
Describe in detail
NAICS Code:
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:
Check method you will use in submitting reports:
Cash Receipts
Accrual
PLEASE LIST ALL VEHICLES TO BE USED BY YOUR BUSINESS (IF ANY):
LIC PLATE NO.
MAKE
MODEL
YEAR
Number of employees:
********For a Listing of NAICS Codes visit www.aztaxes.gov and click on "Business Tax Description Codes"
BUSINESS LICENSE APPLICATION
LICENSE NO._________________
CITY OF DOUGLAS
Location: 425 10TH STREET
Mail to: 425 10TH STREET
Douglas, AZ 85607
(520) 417-7333 - Fax (520) 417-7162
For Office Use Only
EACH SECTION OF THIS APPLICATION MUST BE COMPLETED BEFORE A LICENSE WILL BE ISSUED.
Application Date:
Check One:
New Business
Former Owner (If Applicable):
License Type:
TPT
OBL
Start Date:
Application & License Fee
New Owner of Existing Business
Current City License#:
For Changes
Name Change Only
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. #
Finance Department
A
D
City:
State:
Zip
Business Telephone#:
Planning/Zoning Department
A
D
E-Mail Address:
Business Fax #
Fire Department
A
D
SECTION II MAILING ADDRESS
Health Department
Enter name if Different From Section I (above) or Enter "In-Care-of" Name:
A
D
Address
City
State
Zip
SECTION III. BUSINESS OWNERSHIP & 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.
Contact person or
Name:
Day Time Phone #:
Night Phone #:
owner
Corporation or LLC
if different than DBA
Name and Address:
Phone #:
Corporate or LLC
Statutory Agent
SECTION IV. BUSINESS TYPE
Business
Retail
Amusements
Other/Services
Rental of Real Property
Type
Restaurants/Bars
Taxi/Shuttle
Wholesaler
Construction Contracting
Roc#
Rental of Tangible Personal Property
Hotel/Motel
Home Occupation
Describe in detail
NAICS Code:
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:
Check method you will use in submitting reports:
Cash Receipts
Accrual
PLEASE LIST ALL VEHICLES TO BE USED BY YOUR BUSINESS (IF ANY):
LIC PLATE NO.
MAKE
MODEL
YEAR
Number of employees:
********For a Listing of NAICS Codes visit www.aztaxes.gov and click on "Business Tax Description Codes"
The following information is confidential:
Az State Transaction Privilege Tax License #
Federal ID# or SS#
Health Permit #
******(COPY OF STATE LICENSE REQUIRED)*******
Owners,
Name:
Title
Date of Birth:
Partners, LLC
Members, or
Home Address:
Drivers License#:
Officers
(For Additional
City:
State:
Zip Code:
Phone #:
Names Please
Attach List)
Name:
Title
Date of Birth:
Home Address:
Drivers License#:
City:
State:
Zip Code:
Phone #:
Give a description of any and all traffic violations, misdemeanors, and felonies whether convicted or not in the last five (5) years:
(If not applicable, please write " None".)
Additional signed statement may be applicable.
IMPORTANT NOTICE:
COMPLETION OF THIS FORM DOES NOT CONSTITUTE APPROVAL OF LICENSE. BUSINESS CANNOT START UNTIL BUSINESS LICENSE IS ISSUED
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 PLANNING & ZONING 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.
Applicant's Signature
Title
Date
Applicant's Signature
Title
Date
PLEASE NOTE: Additional Information Required.
Additional Requirements
Type of Ownership
New Business
Individual
Copy of owners U.S. issued picture identification.
Partnership
Partnership Agreement & copy of partners picture I.D.(US issued)
LLC
Copy of Arizona Articles of Organization. (Foreign LLC must be registered with the ACC)
Corporation
Copy of Arizona Articles of Incorporation. (Foreign Corporations must be registered with
New Owner of Existing Business
the Arizona Corporation Commission)
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' picture 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.
Fees
$20.00
plus
A
(non-refundable) initial application fee for all general businesses
applicable license fees based on the number of employees
working inside the city limits as listed below.
Fee Type
Amount
Application Fee
$20.00
Transaction Privilege Tax License
$5.00
Business License
$75.00/ year, up to 3 Employees
Additional Full Time Equivalent (FTE) Employees
$20.00
Change of Business Name
$10.00
Change of Location
$25.00
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