City Of Tempe Tax License Form – Fill Out and Use This PDF

Have you previously performed retail sales, food sales, or

Current Privilege (Sales) Tax

Previous Privilege (Sales) Tax

License #

other activities for a fee at a Tempe Special Event?

License #

License #

Yes

No

If so, when

Vending Fee

SECTION I. BUSINESS INFORMATION

$25.00

NON-

REFUNDABLE

Business Name (Individual, Company or "DBA", first name first)

Street No.

(N,E,S,W)

Street Name

Type

Ste/Apt #

-

City

State

ZIP Code

Area Code

Business Telephone #

Start Date

E-mail address

-

For Office Use

State License #

Federal ID #

Only

SECTION II. MAILING ADDRESS & PHONE NUMBER

Status Code

(

)

Enter Name if Different from Section I (above) or Enter 'In-Care-Of' Name

Telephone #

Street No.

(N,E,S,W)

Street Name

(

) Type

Ste/Apt #

-

SIC Codes

City

State

ZIP Code + 4

Fax #

SECTION III. BUSINESS OWNERSHIP & RECORD LOCATION-

Individual

LLC

Corp. - State Inc.______

Gen. Partnership

Ltd. Partnership

Other _____________

Owners, Partners, 1)

Name

Social Security #

LLC Members, or

Officers

Home Address

Title

(For Additional Names,

Please Attach List)

City

State

ZIP Code

Phone No.

(

)

2)

Name

Social Security #

Geo Code

Home Address

Title

City

State

ZIP Code

Phone No.

(

)

Corporate or LLC

Name

Phone No.

Statutory Agent

(

)

Location Where

Name

Phone No.

(

)

Business Records

Address

City

State

ZIP Code

Are Kept

SECTION IV. BUSINESS TYPE

Retail Sales

Amusement

Food Sales

Other ___________________

Special Event Name

& Dates & Location