Form Ador 10193 PDF Details

For many businesses operating within Arizona, navigating the complexities of tax and licensure obligations is an essential part of maintaining compliance with state laws. At the heart of this process lies the ADOR 10193 form, a critical document provided by the Arizona Department of Revenue. This form serves multiple functions, primarily aimed at facilitating updates to a business's account for Transaction Privilege Tax License and Withholding Registration. Significantly, the form underscores the necessity of filing a Joint Tax Application if there are ownership changes that result in a new Employer Identification Number (EIN), explicitly advising against using the ADOR 10193 for EIN modifications. Through a series of sections, the form gathers comprehensive information about the business, including changes in business name or DBA (Doing Business As) name, mailing addresses, as well as alterations in business location or additional locations for consolidated reports. Moreover, it includes crucial details about corporate officers and the identification of the owner or partners, along with a detailed disclosure of tax records' location to keep the transactions transparent and under scrutiny if needed. Notably, the form also outlines the state and applicable city fees for changes to the Transaction Privilege Tax licenses, which vary based on the type of amendments required, and provides an extensive list of city fees for transaction privilege tax, signaling the financial implications of administrative changes. By meticulously outlining all necessary updates and consolidating them into a single document, the ADOR 10193 form thus plays a pivotal role in ensuring businesses can easily comply with Arizona’s regulatory requirements, thereby avoiding potential legal complications.

QuestionAnswer
Form NameForm Ador 10193
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesazdor form 10193, Maricopa, yavapai, Mtn

Form Preview Example

Arizona Department of Revenue

License & Registration Section

PO Box 29032 • Phoenix AZ 85038-9032

Phoenix: (602) 542-4576 • Toll-free: (800) 634-6494 (from area codes 520 and 928)

BUSINESS ACCOUNT UPDATE

For Transaction Privilege Tax License and Withholding Registration: if ownership changes require a new

Employer Identification Number (EIN), a Joint Tax Application is required. Do not use this form to change the EIN.

Taxpayer or Legal Business Name on Current License Number (Please print)

License Number(s)

 

 

EIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION A. ACCOUNT TYPE

 

 

 

 

 

 

 

 

 

 

 

Transaction Privilege Tax License (TPT)

 

 

Corporate (Including Partnership, Limited

Withholding/Unemployment Tax Registration (if hiring employees)

 

Liability, and S Corporations)

 

 

 

 

 

 

Use Tax Registration

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION B. CHANGES REQUESTED / FEES

 

 

 

 

 

 

 

 

 

 

 

Please check boxes below to indicate the change in your account, and complete Sections C through G to verify or correct

STATE FEE:

 

 

all information. Asterisked (*) changes to Transaction Privilege Tax licenses are subject to a fee of $12 per location for the

CITY FEE(S):

 

 

state fee and any applicable city fees. City fees are listed on the back of this form. There are no fees for changes to Corporate

 

 

 

(from back page)

Account, Use Tax or Withholding Registrations.

 

 

 

 

 

 

TOTAL FEE(S):

Business name or DBA name change *

 

 

Duplicate license *

 

 

 

 

 

 

Mailing address change

 

 

Add city license (see other side) *

 

 

 

 

 

Business location change *

 

 

Reinstate Effective Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional business or rental location(s) filing consolidated reports *

Cancel effective date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate Officers

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C. BUSINESS NAME AND ADDRESS

 

 

 

 

 

 

 

 

 

 

 

Legal Business Name / Owner / Employing Unit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business or “Doing Business As” Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (Street Name or PO Box), City, State, Zip

 

 

 

 

 

Country

 

 

 

 

 

 

 

 

 

 

 

 

E-mail address

 

Business Phone Number

Fax Number

 

 

 

 

 

 

 

 

 

 

 

 

Physical Location Business or Rental (NOT a PO Box)

†Check here if this is an added location

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION D. IDENTIFICATION OF OWNER Partners, Corporate Officers, Members (or Managing Members) or Officials

A. Name (Last, First, MI)B. Soc. Sec. No. C. Title D. % Owned E. Complete Residence Address F. Phone Number

If the owner, partners, corporate officers or combination of partners or corporate officers, members and/or managing members own or control more than 50% of another business in Arizona, attach a list of the businesses, percentages owned and unemployment insurance account numbers.

ADOR 10193 (7/11)

Business Account Update

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 2 of 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION E. LOCATION OF TAX RECORDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Location of Tax Records (Street Address, City, State and ZIP code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Company or Person to Contact

 

 

 

 

 

 

 

Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION F. PROGRAM CITY TPT LICENSE FEES (Indicate affected cities in “Total” column.)

Date you started business in cities

 

 

 

 

 

 

For Use Tax updates, indicate the city locations, but enter zero (0) in the “Total” column.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/Town

 

Code

 

Fee

 

No. of

Total

City/Town

Code

 

Fee

No. of

Total

City/Town

 

 

Code

Fee

 

No. of

Total

 

 

 

 

 

 

 

Loc

 

 

 

 

 

 

 

Loc

 

 

 

 

 

 

 

 

 

 

Loc

 

 

Benson

 

BS

 

5.00

 

 

 

 

Hayden

HY

 

5.00

 

 

Show Low

 

 

SL

2.00

 

 

 

 

 

Bisbee

 

BB

 

1.00

 

 

 

 

Holbrook

HB

 

1.00

 

 

Sierra Vista

 

 

SR

1.00

 

 

 

 

 

Buckeye

 

BE

 

2.00

 

 

 

 

Huachuca City

HC

 

2.00

 

 

Snowflake

 

 

SN

2.00

 

 

 

 

 

Camp Verde

 

CE

 

2.00

 

 

 

 

Jerome

JO

 

2.00

 

 

South Tucson

 

 

ST

2.00

 

 

 

 

 

Carefree

 

CA

 

10.00

 

 

 

 

Kearny

KN

 

2.00

 

 

Springerville

 

 

SV

5.00

 

 

 

 

 

Casa Grande

 

CG

 

2.00

 

 

 

 

Kingman

KM

 

2.00

 

 

St. Johns

 

 

SJ

2.00

 

 

 

 

 

Cave Creek

 

CK

 

20.00

 

 

 

 

Lake Havasu

LH

 

5.00

 

 

Star Valley

 

 

SY

2.00

 

 

 

 

 

Chino Valley

 

CV

 

2.00

 

 

 

 

Litchfield Park

LP

 

2.00

 

 

Superior

 

 

SI

2.00

 

 

 

 

 

Clarkdale

 

CD

 

2.00

 

 

 

 

Mammoth

MH

 

2.00

 

 

Surprise

 

 

SP

10.00

 

 

 

 

 

Clifton

 

CF

 

2.00

 

 

 

 

Marana

MA

 

5.00

 

 

Taylor

 

 

 

 

TL

2.00

 

 

 

 

 

Colorado City

 

CC

 

2.00

 

 

 

 

Maricopa

MP

 

2.00

 

 

Thatcher

 

 

TC

2.00

 

 

 

 

 

Coolidge

 

CL

 

2.00

 

 

 

 

Miami

MM

 

2.00

 

 

Tolleson

 

 

TN

2.00

 

 

 

 

 

Cottonwood

 

CW

 

2.00

 

 

 

 

Oro Valley

OR

 

12.00

 

 

Tombstone

 

 

TS

1.00

 

 

 

 

 

Dewey/Humboldt

 

DH

 

2.00

 

 

 

 

Page

PG

 

2.00

 

 

Tusayan

 

 

TY

2.00

 

 

 

 

 

Duncan

 

DC

 

2.00

 

 

 

 

Paradise Valley

PV

 

2.00

 

 

Wellton

 

 

WT

2.00

 

 

 

 

 

Eagar

 

EG

 

10.00

 

 

 

 

Parker

PK

 

2.00

 

 

Wickenburg

 

 

WB

2.00

 

 

 

 

 

El Mirage

 

EM

 

15.00

 

 

 

 

Patagonia

PA

 

25.00

 

 

Williams

 

 

WL

2.00

 

 

 

 

 

Eloy

 

EL

 

10.00

 

 

 

 

Payson

PS

 

2.00

 

 

Winkelman

 

 

WM

2.00

 

 

 

 

 

Florence

 

FL

 

2.00

 

 

 

 

Pima

PM

 

2.00

 

 

Winslow

 

 

WS

10.00

 

 

 

 

 

Fountain Hills

 

FH

 

2.00

 

 

 

 

Pinetop/Lakeside

PP

 

2.00

 

 

Youngtown

 

 

YT

10.00

 

 

 

 

 

Fredonia

 

FD

 

10.00

 

 

 

 

Prescott Valley

PL

 

2.00

 

 

Yuma

 

 

 

 

YM

2.00

 

 

 

 

 

Gila Bend

 

GI

 

2.00

 

 

 

 

Quartzsite

QZ

 

2.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gilbert

 

GB

 

2.00

 

 

 

 

Queen Creek

QC

 

2.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Globe

 

GL

 

2.00

 

 

 

 

Safford

SF

 

2.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Goodyear

 

GY

 

5.00

 

 

 

 

Sahuarita

SA

 

5.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Guadalupe

 

GU

 

2.00

 

 

 

 

San Luis

SU

 

2.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTE: City fees are subject to change occasionally. You will be billed for the difference.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Indian Reservation

 

 

 

Code

Indian Reservation

 

Code

Indian Reservation

 

 

Code

 

Indian Reservation

 

 

Code

(County)

 

 

 

(County)

 

 

(County)

 

 

 

 

 

(County)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ak-Chin (Pinal)

 

 

 

 

PNA

Hopi (Coconino)

 

COJ

Pascua-Yaqui (Maricopa)

 

 

MAN

 

Tohono O’Odham (Pinal)

 

PNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cocopah (Yuma)

 

 

 

 

YMB

Hopi (Navajo)

 

NAJ

Pascua-Yaqui (Pima)

 

 

PMN

 

Tonto Apache (Gila)

 

 

GLU

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Colorado River (La Paz)

 

 

LAC

Hualapai (Coconino)

 

COK

Salt River Pima-Maricopa (Mar.)

 

MAO

 

White Mtn Apache (Apache)

 

APD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fort McDowell-Yavapai (Mar.)

 

 

MAE

Hualapai (Mohave)

 

MOK

San Carlos (Apache (Gila)

 

 

GLP

 

White Mtn Apache (Gila)

 

 

GLD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fort Mohave (Mohave)

 

 

MOF

Kaibab-Paiute (Coconino)

 

COL

San Carlos Apache (Graham)

 

GRP

 

White Mtn Apache (Graham)

 

GRD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fort Yuma-Quechan (Yuma)

 

 

YMG

Kaibab-Paiute (Mohave)

 

MOL

San Carlos Apache (Pinal)

 

 

PNP

 

White Mtn Apache (Navajo)

 

NAD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gila River (Maricopa)

 

 

MAH

Navajo (Apache)

 

APM

San Juan Southern Paiute

 

 

COQ

 

Yavapai Apache (Yavapai)

 

YAW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gila River (Pinal)

 

 

 

 

PNH

Navajo (Coconino)

 

COM

Tohono O’Odham (Maricopa)

 

MAT

 

Yavapai Prescott (Yavapai)

 

YAX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Havasupai (Coconino)

 

 

COI

Navajo (Navajo)

 

NAM

Tohono O’Odham (Pima)

 

 

PMT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION G. SIGNATURE of Individual legally responsible for the business (required)

UNDER PENALTY OF PERJURY I DECLARE THAT THE INFORMATION ON THIS DOCUMENT IS TRUE AND CORRECT.

Type or Print Name

 

Title

 

Signature

Date

 

 

 

 

 

 

THIS APPLICATION MUST BE COMPLETED, SIGNED AND RETURNED AS PROVIDED BY ARS § 23-722

 

Equal Opportunity Employer/Program

This document available in alternative formats by contacting the UI Tax Office.

ADOR 10193 (7/11)

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Stage # 1 in filling in Yuma

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Yuma writing process described (stage 2)

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4. Now complete this next segment! In this case you have all these Benson Bisbee Buckeye Camp Verde, BS BB BE CE CA CG CK CV CD CF CC, Hayden Holbrook Huachuca City, HY HB HC JO KN KM LH LP MH MA MP, NOTE City fees are subject to, Show Low Sierra Vista Snowfl ake, SL SR SN ST SV SJ SY SI SP TL TC, Indian Reservation County AkChin, Code, Indian Reservation County, Code, Indian Reservation County, Code, Indian Reservation County, and PNA Hopi Coconino YMB Hopi Navajo empty form fields to do.

Yuma writing process described (stage 4)

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