Arizona Joint Tax Application

ARIZONA JOINT TAX APPLICATION

Important: Incomplete applications will not be processed. All required information is designated with an asterisk (*).

To complete this application, see attached instructions. Please return the complete application with appropriate license fee(s) to the Department of Revenue.

Section A: Taxpayer Information

1. License Type (Check all that apply) *
Transaction Privilege Tax (TPT) Withholding/Unemployment Tax (if hiring employees) Use Tax TPT For Cities ONLY

2. Type of Ownership *
Individual / Sole Proprietorship Partnership Professional Limited Liability Limited Liability Company Limited Liability Partnership Corporation Sub-Chapter S Corporation Association Trust Government Estate Joint Venture Receivership

State of Inc.    Date of Inc.

3. Federal Employer Identification Number (Required for Employers and entities other than Sole Proprietors) or Social Security Number *

4. Legal Business Name / Owner / Employing Unit *

5. Business or “Doing Business As” Name *

6. Business Phone Number *

7. Fax Number

8. Mailing Address (Street, City, State, ZIP code) *

9. Country

10. Email Address

11. Is your business located on an Indian Reservation?
Yes No

12. Physical Location of Business (Street, City, State, ZIP code) *

13. County

14. Are you a construction contractor? *
Yes No

15. Did you acquire, or change the legal form of business of, all or part of an existing business? *
Yes No

16. Description of Business *

17. NAICS Code

18. Identification of Owner, Partners, Corporate Officers, Members / Managing Members or Officials of this employing unit

Section B: Transaction Privilege Tax (TPT)

1. Date Business Started in Arizona *

2. Date Sales Began *

3. Anticipated annual income for first twelve months of business

4. Business Classes (Select at least one) *

5. TPT Filing Method
Cash Receipts Accrual

6. Does your business sell tobacco products?
Yes No

7. Does your business sell new motor vehicle tires or vehicles?
No Yes Retailer Distributor

8. Are you a seasonal filer?
Yes No
Months: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

9. Location of Tax Records *

10. Name of Company or Person to Contact

11. Phone Number

Section C: Program Cities / License Fees

If applicable, list number of locations, city/town code, and fees for licensed cities. Use the provided city fee schedule from the form.

Total of City Fees:

State Fees $12.00 X = Total Fees:

Section D: Withholding/Unemployment Tax Information

1. Date Employees First Hired in Arizona *

2. Are you liable for Federal Unemployment Tax?
Yes No

3. Are individuals performing services excluded from withholding or unemployment tax?
Yes No

4. Do you have an IRS ruling that grants an exclusion from Federal Unemployment Tax?
Yes No

5. Do you have or have you previously had an Arizona Unemployment Tax Number?
No Yes

6. Record of Arizona wages paid by calendar quarter for current and preceding calendar year

7. Weekly record of number of persons performing services in Arizona for current and preceding calendar year

8. Date Acquired or Date Legal Form of Business changed *

9. Acquired, or Changed Legal Form of Business of *
All Part

10. Acquired by *
Purchase Lease Other

11. Name(s) of Previous Owner(s) *

12. Business Name of Previous Owner(s) *

13. Current Mailing Address of Previous Owner(s)

14. Current Telephone Number of Previous Owner(s)

15. Unemployment Account Number of Previous Owner(s)

16. Voluntary Election of Unemployment Insurance Coverage

Section E: AZTaxes.gov Security Administrator (Authorized User)

1. Authorized Users Last Name

2. Authorized Users First Name

3. Authorized Users Title

4. Authorized Users Social Security Number

5. Authorized Users Email Address

6. Authorized Users Phone Number

Section F: Signature(s) by individuals legally responsible for the business

Under penalty of perjury, I/we declare that the information provided on this application is true and correct.

Section G: Indian Reservation Codes

Use the appropriate reservation code from the form if your business is located on an Indian Reservation.

Section H: Business Classes

Select appropriate business classes based on business activity.

I Elect to Register to use aztaxes.gov to file and pay online. I DO NOT Elect to Register to use aztaxes.gov to file and pay online.