Arizona Joint Tax Application Form – Fill Out and Use This PDF

Individual	Association
Partnership	Trust

Limited Liability Company

Other (Please Explain)

MAILING ADDRESS (Street, Route No., or P.O. Box)

IN CARE OF

CITY

STATE

ZIP CODE

BUSINESS PHONE (Include Area Code)

PRIMARY LOCATION OF BUSINESS (Must be Physical Address) STREET, CITY, STATE, ZIP CODE

ARIZONA COUNTY

Do you have or have you previously had an Arizona State Tax Number? Yes

No

If yes, fill in below and check here if you want to cancel the existing number

ENTER BUSINESS NAME

UNEMPLOYMENT NO.

WITHHOLDING NO.

TPT NO.

NAME OF COMPANY OR PERSON TO CONTACT

PHONE NUMBER (Include Area Code)

NEW	CHANGE	REVISE	REOPEN	SIC __________
ACCT NO ______________ CTY CD __________ LIAB __________ TLAPSE________
START ___________________________ LIAB EST _______________________________
REPORTS		S/E DATE		KP

TPT _______________________________________________________________

W H _______________________________________________________________

CITIES ____________ ___________ ___________ ___________ ___________

PREVIOUS OWNER'S CURRENT PHONE NO.

UNEMPLOYMENT NO.

WITHHOLDING NO.

TPT NO.

YEAR

19

19

1ST QUARTER

2ND QUARTER

3RD QUARTER

4TH QUARTER

SIGNATURE/TITLE	DATE

ADOR 50-4002 (4/96)

UC - 001

AGENCY USE ONLY

APPROVED/DATE

USE THIS APPLICATION TO:

·	License New Business:	A new business
	with no previous owners.
·	Change Ownership:	If purchasing an
	existing business or changing business
	entity (sole owner to corporation, etc.).
	If you need to update a license, add a
	business location, or make other
	changes: Request an update card or
	provide a written notification of the change
	(a form is not necessary). Please include

	Many of the larger cities in Arizona			IV. IDENTIFICATION OF OWNER(S)
	administer and collect their own privilege			Enter as many as applicable; attach a
	taxes. Please contact those cities directly to			separate sheet if additional space is needed.
	obtain	information	about licensing	V. LOCATION OF TAX RECORDS
	requirements.
	II. TYPE OF OWNERSHIP OR			Complete as indicated.
				VI. PREVIOUS OWNERS
	EMPLOYMENT UNIT
	Check	as applicable.	Corporation must	Complete this section if you acquired an
	provide the state and date of incorporation.			existing business.

fees of $12 per location plus applicable city

fee(s).

I.LICENSE TYPE

Transaction Privilege Tax (TPT): Anyone involved in an activity taxable under the TPT statutes must apply for a TPT License before engaging in business.

·For TPT, you are required to obtain a separate license for each business or rental location. This may be accomplished in one of the following ways:

·Each location may be licensed as a separate business with a separate license number for purpose of reporting sales and use taxes individually. Therefore a separate application is needed for each location.

Multiple locations may be licensed under a consolidated license number, provided the ownership is the same, to allow filing of a single tax return. If applying for a new license, list the various business locations as instructed below. If already licensed and you are adding locations, do not use this application to consolidate an existing license. Request on update form.

Please Note: Applicants in the construction contracting business may be required to submit bonds for TPT tax before a transaction privilege license is issued. The amount of bond required is based on the type of construction performed. Please see the Department of Revenue Taxpayer Bonds brochure for more information.

In addition, bonds are required for new license holders for construction contracts over $50,000, before building permits can be issued. TPT license holders who are delinquent in payment of tax or returns are also subject to bonding.

Withholding & Unemployment Taxes: Employers paying wages or salaries to employees for services performed in the State must apply for a Withholding number & Unemployment number.

Use Tax: Out-of-state vendors (that is, vendors with no Arizona location) making direct sales into Arizona must obtain a Use Tax Registration Certificate. In-state vendors making out-of-state purchases for their own use (and not for resale) must also obtain the Use Tax Registration Certificate.

TPT for cities only: This type of license is needed if your business activity is subject to city TPT that is collected by the state, but the activity is not taxed at the state level.

III.BUSINESS INFORMATION

·Enter the Legal Business Name of the Owner or Employing Unit (Name of corporation as listed in its articles of incorporation, or individual & spouse, or partners, or organization owning or controlling the business).

·Enter the name of the Business/DBA (doing business as) name, if same as above, enter "same."

·Enter mailing address where all correspondence is to be sent. You may use

your home address, corporate headquarters, or accounting firm's address, etc. If mailing addresses differ for licenses (for instance withholding and unemployment insurance), please use cover letter to explain.

·If you wish correspondence to be sent to a name other than the owner, enter the name of the department or accountancy firm in the "In care of" box to ensure delivery by the postal service.

·Enter the street address for the primary location(s) of the business. For additional

business location(s) complete the supplemental form on the reverse side of the instructions.

·Describe the major business activity:

principal product you manufacture, commodity sold, or services performed. Your description of the business is very important because it determines your transaction privilege tax rate and provides a basis for state economic forecasting.

·Enter the date the business started in Arizona.

·Enter the date sales began in Arizona.

·Enter the date employees were first hired in Arizona and the average number of employees.

·Cash/Accrual Methods: Cash method requires the payment of tax based on sales receipts actually received during the period covered on the tax return. When filing under the accrual method, the tax is calculated on the sales billed rather than receipts.

·Sellers of new motor vehicles and motor vehicle tires in the state, for on-road use, are required to report and pay waste tire fees to the Department of Revenue. By checking the box, you will be sent form TR-1 on a quarterly basis.

·Indicate whether you are liable for FUTA

and enter your Federal Employer Identification number.

·Taxpayers are required to provide their taxpayer identification number (TIN) on all returns and documents. A TIN is defined as the federal employer identification number (EIN), or social security number (SSN) depending upon how income tax is reported. Employers must provide their federal EIN. A penalty of $5 will be assessed for each document filed without a TIN.

VII. EMPLOYMENT INFORMATION

Enter total gross wages paid for each quarter the business has operated. Enter the number of persons performing services each week the business operated.

VIII. COMPLETE AS APPLICABLE

IX. FEES

There are no fees for Withholding, Unemployment, or Use Tax registrations. To calculate the fees for TPT ($12) licenses, calculate the State fees by multiplying the number of locations in the state by $12. To calculate the city(ies) fee, use the table on the reverse of instructions. First, indicate the number of businesses or physical locations for each of the cities for which the Department of Revenue licenses and collects. Then multiply by the city fee for each city in which you will do business. Add the columns to determine the total city fees. Fill in the totals for state fees and city fees on the application form and total to determine the amount due. Make checks payable to the Arizona Department of

Revenue. Be sure to return the instruction/fees sheet with your application.

To obtain licensing for cities not listed on the form, please contact the city directly.

X.SIGNATURES

The application must be signed only by individuals legally responsible for the business, not agents or representatives.

XI. VOLUNTARY ELECTION OF UN- EMPLOYMENT TAX COVERAGE

Complete and sign this portion of the application ONLY if you wish to provide unemployment coverage to your employees, and you believe you are not REQUIRED to provide coverage. Refer to "A Guide to Arizona Employment Tax Requirements" or "Employers' Handbook" for requirements.

TOTAL

TOTAL

TOTAL

FOR CITIES NOT LISTED, PLEASE CONTACT THE CITY DIRECTLY

PLEASE NOTE:

City fees are subject to change occasionally.

You will be billed for the difference.

Total of City Fees: State Fees $12.00 x No. Loc.:

TOTAL FEES:

Physical Location (not P.O. Box or Rte. No.)

Telephone No.