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ARIZONA JOINT TAX APPLICATION
IMPORTANT: Incomplete applications WILL NOT BE PROCESSED. All required information is designated with asterisk * To complete this application see attached instructions. Please return Complete application with appropriate license fee(s) to: License & Registration Section, Department of Revenue, 1600 W Monroe, Phoenix AZ 85007.
To complete this online, go to www.aztaxes.gov
Section A: Taxpayer Information (Print legibly or type the information on this application.) 2. Type of Ownership * 1. License Type (Check all that apply) * Individual / Sole Proprietorship Transaction Privilege Tax (TPT) Partnership Withholding/Unemployment Tax (if hiring employees) Professional Limited Liability Use Tax Limited Liability Company TPT For Cities ONLY Limited Liability Partnership Corporation 3. Federal Employer Identiﬁcation Number (Required for Employers and State of Inc. Arizona Entities other than Sole Proprietors) or Social Security Number * Date of Inc. 12/21/2004
Sub-Chapter S Corporation Association Trust Government Estate Joint Venture Receivership
4. Legal Business Name / Owner / Employing Unit *
Tax exempt organizations must attach a copy of the Internal Revenue Service letter of determination.
Southwest Classical Dance Institute, Inc.
5. Business or “Doing Business As” Name * 6. Business Phone Number * 7. Fax Number
Southwest Classical Dance Institute
8. Mailing Address (Street, City, State, ZIP code) *
480-228-8097 AZ 85204
2444 East Javelina Avenue Mesa
10. Email Address
11. Is your business located on an Indian Reservation? Yes If yes, (See Section G for listing of Reservations) ArtDir@swcdi.com No 13. County 12. Physical Location of Business (Street, City, State, ZIP code) Do not use PO Box or Route No. *
2444 East Javelina Avenue Mesa
14. Are you a construction contractor? * Yes (See Bonding Requirements below) No
For additional business locations, complete Section B-12 15. Did you acquire, or change the legal form of business of, all or part of an existing business? * Yes If yes, you must complete the Unemployment Tax Information (Section D) No
Bonding Requirements: Prior to the issuance of a Transaction Privilege Tax license, new or out-of-state contractors are required to post a Taxpayer Bond for Contractors, unless the Contractor qualiﬁes for an exemption from the bonding requirement. The primary type of contracting being performed determines the amount of bond to be posted. Bonds may also be required from applicants who are delinquent in paying Arizona taxes or have a history of delinquencies. For more information on bonding, please see the “Taxpayer Bonds” publication, which is available online or at the Department of Revenue ofﬁces. 16. Description of Business (Must include type of merchandise sold or taxable activity; for employers, the type of employment) *
Classical Dance School
17. NAICS Code: (Select at least one. Go to www.aztaxes.gov for a listing of codes) *
611610, 611620, 711120
18. Identiﬁcation of Owner, Partners, Corporate Ofﬁcers, Members / Managing Members or Ofﬁcials of this employing unit A. Name (Last, First, MI) * B. Soc. Sec. No. * C. Title * D. % Owned * E. Complete Residence Address *
F. Phone Number *
2444 East Javelina 85204
2444 East Javelina 85204
If the owner, partners, corporate ofﬁcers or combination of partners or corporate ofﬁcers, members and/or managing members own more than 50% of or control another business in Arizona, attach a list of the businesses, percentages owned and unemployment insurance account numbers. THIS BOX FOR AGENCY USE ONLY New Change Revise Reopen
ADOR 74-4002 (5/07)
Acct. No. Start S/E Date
LIAB LIAB Est.
DLN TPT WH
00 2.00 2.00 2.) Sep Oct Nov Dec No Distributor If yes. State 25.00 1.00 2. please attach additional sheets) 12.00 1.00 2.00 2.00 2. City 19.00 2.00 2. Johns Star Valley Superior Surprise Taylor Thatcher Tolleson Tombstone Wellton Wickenburg Willcox Williams Winkelman Winslow Youngtown Yuma Code SA SU SE SL SR SN SO ST SV SJ SY SI SP TL TC TN TS WT WB WC WL WM WS YT YM Fee 5.00 10.00 2. please contact the cities State Fees $12. Phone Number 20. County 17.00 2.00 15.00 2.00 2.00 2.00 2.00 5.00 5. ZIP code 16.) 22. of Loc Total City/Town Goodyear Guadalupe Hayden Holbrook Huachuca City Jerome Kearny Kingman Lake Havasu Litchﬁeld Park Mammoth Marana Maricopa Miami Oro Valley Page Paradise Valley Parker Patagonia Payson Pima Pinetop/Lakeside Prescott Valley Quartzsite Queen Creek Safford Code GY GU HY HB HC JO KN KM LH LP MH MA MP MM OR PG PV PK PA PS PM PP PL QZ QC SF Fee 5.00 2.00 10.00 2. State 18.00 2. TPT Filing Method Cash Receipts Accrual 8.00 25.00 No.00 10. City/Town Benson Bisbee Buckeye Bullhead City Camp Verde Carefree Casa Grande Cave Creek Chino Valley Clarkdale Clifton Colorado City Coolidge Cottonwood Dewey/Humboldt Douglas Duncan Eagar El Mirage Eloy Florence Fountain Hills Fredonia Gila Bend Gilbert Globe Code BS BB BE BH CE CA CG CK CV CD CF CC CL CW DH DL DC EG EM EL FL FH FD GI GB GL Fee 5. Phone Number For additional locations. Your license will not be issued until all fees are paid.00 10.00 1. Physical Location Address (Do not use PO Box or Route No.) 15. Business Classes (Select at least one.00 2.00 5.00 12.00 2.00 1.00 2.00 10. of Loc Total City/Town Sahuarita San Luis Sedona Show Low Sierra Vista Snowﬂake Somerton South Tucson Springerville St. Phone Number Section C: Program Cities / License Fees Below is a list of cities and towns licensed by the Arizona Department of Revenue.00 2.00 2. City.00 10.00 2.00 2.00 2.00 5.00 2. What is your anticipated annual income for your ﬁrst twelve months of business? 4. “Doing Business As” Name for this Location 21. City 23.00 2. Does your business sell new motor vehicle tires or vehicles? No Yes Jul Aug (You will be required to ﬁle a TR-1.00 1.00 2.00 No.00 X _____ Number of Locations: directly.00 10. Location of Tax Records (Street Address.00 2. Name of Company or Person to Contact 11. Retailer OR 7. complete the following: (If more space is needed. * 10.00 2.00 2. See Section H for a listing of business classes on page 4) * 5.00 No. ZIP code 13.00 2.00 2.00 2.00 2.00 2.00 2. County 24.00 2. “Doing Business As” Name for this Location 14. of Total Loc 4 Please Note: City fees are subject to change (go to our website Total of City Fees: for updates). please check the months in which you intend to do business: Jan Feb Mar Apr May Jun 9.00 2.00 2. For cities not listed above.00 2.00 2.00 5. Date Business Started in Arizona * 2.00 2. TOTAL Fees: ADOR 74-4002 (5/07) .00 2. State and ZIP code) Do not use PO Box or Route No.00 20.00 2.00 2. Physical Location Address (Do not use PO Box or Route No.JT-1/UC-001 (5/07) Page 2 Section B: Transaction Privilege Tax (TPT) 1.00 2. Does your business sell tobacco products? Yes If yes.00 2. Are you a seasonal ﬁler? Yes No 6.00 2.00 2.00 2. Date Sales Began * 3.00 2.
attach a copy of the Ruling Letter. Record of Arizona wages paid by calendar quarter for current and preceding calendar year. Unemployment Number 60420908 3RD QUARTER 4TH QUARTER 6. or Changed Legal Form of Business of. YEAR 1ST QUARTER 2ND QUARTER 2008 2007 0 6153. Date Employees 2. Weekly record of number of persons performing services in Arizona for current and preceding calendar year. Arizona Revised Statutes. by having the services they perform be deemed to constitute. to obtain an unemployment tax rate based on the Lease business’s previous account you must request it no later than 180 days after the date entered in item 8 of this section. describe the services: 4.00 0 0 0 0 MAY JUNE 0 0 7. Do you have an IRS Ruling that grants an exclusion from Federal Unemployment Tax? Yes No If yes. Name(s) of Previous Owner(s) * 12. If other. A. 5. even though I have not met conditions requiring me to provide such coverage. In. 16. Be deemed an employer subject to Title 23. Are individuals performing services that are excluded from withholding or unemployment tax? Yes 08/01/2008 No Substitue and Guest Teachers for No Dance Lessons If yes. Do you have or have you previously had an Arizona Unemployment Tax Number? If yes. and continuing for not less than two calendar years. Current Telephone Number of Previous Owner(s) 15. Current Mailing Address of Previous Owner(s) (Street. Business Name of Previous Owner(s) * 13. * 10. Date Acquired or Date 9.) 11. Unemployment Account Number of Previous Owner(s) Voluntary Election of Unemployment Insurance Coverage (subject to Unemployment Tax Ofﬁce approval). Chapter 4. Are you liable for Federal Unemployment Tax? First Hired in Arizona. to the same extent as all other such employers and provide unemployment insurance coverage to my workers performing services deﬁned by law as employment. YEAR JANUARY FEBRUARY MARCH APRIL 2008 2007 YEAR 2 3 2 2 2 3 2 2 2 3 JULY 2 3 2 2 2 3 2 2 2 3 2 2 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER 2008 2007 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 Complete this section if you acquired. above. B. Business Name IBA Foundation. * Yes If yes.R. City. Chapter 4. The applicant.S. or changed the legal form of business of. what was the ﬁrst year of liability? Year No Yes 3.JT-1/UC-001 (5/07) Page 3 Section D: Withholding/Unemployment Tax Information 1. voluntarily elects beginning January 1 of the current calendar year or the date employment started. State. if later. Acquired. on behalf of the employing unit. Acquired by * Legal Form of Business All Purchase changed * Part If part. all or part of an existing Arizona business. Extend unemployment insurance coverage to workers referred to in item 2. See instructions. 8. employment by an employer subject to Title 23. to: A. ZIP code) 14. including change in legal form of business. explain: Other Previous Owner Information or Previous Legal Form of Busness Information (See instructions. ADOR 74-4002 (5/07) .
the trustee.Prime Code COJ NAJ COK MOK COL MOL APM COM NAM Code 013 014 015 017 019 021 022 023 025 Indian Reservation (County) Pascua-Yaqui (Maricopa) Pascua-Yaqui (Pima) Salt River Pima-Maricopa (Mar. I Elect to Register to use aztaxes. Authorized Users Title 4.Timbering 010 Other Recreational Vehicle 011 Surcharge 012 Transient Lodging .gov site for the business identiﬁed in Section A.Owner Builder Municipal Water Membership Camping Code MAN PMN MAO GLP GRP PNP COQ MAT PMT Code 026 028 029 030 033 036 037 041 047 Indian Reservation (County) Tohono O’dham (Pinal) Tonto Apache (Gila) White Mtn Apache (Apache) White Mtn Apache (Gila) White Mtn Apache (Graham) White Mtn Apache (Navajo) Yavapai Apache (Yavapai) Yavapai Prescott (Yavapai) Code PNT GLU APD GLD GRD NAD YAW YAX Code 002 004 005 006 Business Class Jet Fuel Tax Jet Fuel Use Tax Rental Car Surcharge Jet Fuel Tax > 10 million gallons Use Tax Direct Payments 911 Wireline Telecommunications Rental Car Surcharge Stadium Code 049 051 053/055 056 129 131 153 Retail Severance 007/008 Metalliferous Mining Severance .Nonmetal Utilities Communications Transporting Private Car . if one is listed in Section E. to access the AZTaxes.Utilities Rental Occupancy Tax Use Tax Purchases Use Tax from Inventory Telecommunications Devices 911 Wireless Telecommunications Contracting .gov Security Administrator (Authorized User) By electing to register for www. I (we) hereby authorize the security administrator. partners.) Tohono O’Odham (Maricopa) Tohono O’Odham (Pima) Business Class Use Tax . Type or Print Name Title Signature Date Joshua Brooksher Type or Print Name Artistic Director Title Signature 08/01/2008 Date THIS APPLICATION MUST BE COMPLETED. use. 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. 1.) MAE Fort Mohave (Mohave) MOF Fort Yuma-Quechan (Yuma) YMG Gila River (Maricopa) MAH Gila River (Pinal) PNH Havasupai (Coconino) COI Section H: Business Classes Business Class Mining . declare that the information provided on this application is true and correct.aztaxes. This authority is to remain in full force and effect until the Arizona Department of Revenue has received written termination notiﬁcation from an authorized ofﬁcer. managing member. and ﬁle and pay Arizona transaction. Authorized Users Phone Number Section F: Signature(s) by individuals legally responsible for the business (required) This application must be signed by either a sole owner. the applicant. receiver or personal representative of an estate. Authorized Users First Name 3. You also designate authorized users to access these services.JT-1/UC-001 (5/07) Print Reset form Page 4 Section E: AZTaxes. I DO NOT Elect to Register to use aztaxes. Authorized Users Social Security Number 5.Pipeline Publication Job Printing Restaurants and Bars Amusement ADOR 74-4002 (5/07) Indian Reservation (County) Hopi (Coconino) Hopi (Navajo) Hualapai (Coconino) Hualapai (Mohave) Kaibab-Paiute (Coconino) Kaibab-Paiute (Mohave) Navajo (Apache) Navajo (Coconino) Navajo (Navajo) Business Class Commercial Lease Personal Property Rental Contracting . Under penalty of perjury I (we).) San Carlos Apache (Gila) San Carlos Apache (Graham) San Carlos Apache (Pinal) San Juan Southern Paiute (Coco. Authorized Users Email Address 6.gov you can have online access to account information. Section G: Indian Reservation Codes Indian Reservation Code (County) Ak-Chin (Pinal) PNA Cocopah (Yuma) YMB Colorado River (La Paz) LAC Fort McDowell-Yavapai (Mar.gov to ﬁle and pay online. and withholding taxes. corporate ofﬁcer. Authorized Users Last Name 2.Timbering 009 Ponderosa Severance .gov to ﬁle and pay online.
corporate headquarters. commodity sold. If same as above. Enter the date the business started in Arizona. please use cover letter to explain. to allow ﬁling of a single tax return. You will be set up for monthly ﬁling unless your anticipated annual income will result in a tax liability of less than $1. etc. 3. 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. If you answered yes. Multiple locations may be licensed under a consolidated license number. For businesses applying for Transaction Privilege and/or Use Tax. Enter the amount of Transaction Privilege Tax income you can reasonably expect to generate in your ﬁrst twelve months of business. Enter the physical location of business including county. do not use this application to consolidate an existing license. Enter the fax number including area code. etc. or organization owning or controlling the business). or estimate when you plan to begin selling in Arizona. or accounting ﬁrm’s address. Withholding & Unemployment Taxes: Employers paying wages or salaries to employees for services performed in the State must apply for a Withholding number & Unemployment number. Withholding or Use Tax (Department of Revenue) call (602) 542-4576 or 1-800-634-6494 (from area codes 520 and 928). For TPT. If you need to update a license.” 6. read the bonding requirements carefully. • For Unemployment Tax (Department of Economic Security) call (602) 771-6602 or e-mail uit. Please submit update form. Enter date sales began in Arizona.gov USE THIS APPLICATION TO: • License New Business: A new business with no previous owners. You may use your home address. TYPE OF OWNERSHIP Check as applicable. you must complete Section D. 8. Section A: TAXPAYER INFORMATION 1. or social security number (SSN) depending upon how income tax is reported. Therefore a separate application is needed for each location. A TIN is deﬁned as the federal employer identiﬁcation number (EIN). which may qualify you for quarterly ﬁling.250. but the activity is not taxed at the state level. list the various business locations as instructed below. Section B: TRANSACTION PRIVILEGE TAX (TPT) 1. 3. 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. 2. 2. A penalty of $5 will be assessed ADOR 74-4002 (5/07) by the Department of Revenue for each document ﬁled without a TIN. . Your description of the business is very important because it determines your transaction privilege tax rate and provides a basis for state economic forecasting. Use Tax: Out-of-state vendors (that is. Identify the owners of the business. or individual & spouse. 17. and 9. provided the ownership is the same. and 13. enter “same. enter the applicable business classes based on your activity.status@azdes. Enter your Federal Employer Identiﬁcation number. • Change Ownership: If acquiring or succeeding to all or part of an existing business or changing the legal form of your business (sole proprietorship to corporation. If mailing address differs for licenses (for instance withholding and unemployment insurance). Enter the North American Industries Classiﬁcation System (NAICS) code identiﬁed for your business activity. If you are a construction contractor. See section G for listing of reservation codes if your business is located on an Indian Reservation. vendors with no Arizona location) making direct sales into Arizona must obtain a Use Tax Registration Certiﬁcate. 10. or services performed. Enter the name of the Business/DBA (doing business as) Name. Enter as many as applicable. attach a separate sheet if additional space is needed. Enter mailing address where all correspondence is to be sent. Enter the e-mail address (option) for the business or contact person. This can not be a PO Box or Route Number. Describe the major business activity: principal product you manufacture. get a copy of your license or make other changes: Complete a Transaction Privilege Tax License Update form and include fees of $12 per location. Enter the Legal Business Name of the Owner or Employing Unit (name of corporation as listed in its articles of incorporation.JT-1/UC-001 (5/07) Page 5 IMPORTANT: You must complete each of the following sections or your application will be returned INSTRUCTIONS FOR ARIZONA JOINT TAX APPLICATION • For licensing questions on Transaction Privilege. 14. or partners. • Taxpayers are required to provide their taxpayer identiﬁcation number (TIN) on all returns and documents. See Section H for listing of business classes. If applying for a new license. 7. A corporation must provide the state and date of incorporation. 11. 18. 4. If already licensed and you are adding locations.). Many of the larger cities in Arizona administer and collect their own privilege taxes. The EIN is required for all employers. 15. Please contact those cities directly to obtain information regarding licensing requirements. 12. In-state vendors making out-of-state purchases for their own use (and not for resale) must also obtain the Use Tax Registration Certiﬁcate. 16. 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 purposes of reporting transaction privilege and use taxes individually. Enter the business telephone number including area code. 5. 4. add a business location. you are required to obtain and display a separate license certiﬁcate for each business or rental location.
To calculate the city fees. Enter the date you acquired the previous owner’s business or changed the legal form of your existing business (sole proprietor to corporation.aztaxes. Section D: WITHHOLDING/UNEMPLOYMENT TAX INFORMATION 1. gov. 12. then your signature(s) in Section F conﬁrm(s) your voluntary election to assume liability for the extent of unemployment coverage your selection indicates for at least two calendar years.JT-1/UC-001 (5/07) Page 6 5. if you merely changed the legal form of your existing business. the contact person and their phone number. please contact the city directly.com. If you have additional business locations. or contact the Unemployment Tax Ofﬁce Employer Status Unit. 9. Complete as indicated. Check Box B if you voluntarily elect to cover your workers who perform services the law excludes from its deﬁnition of employment and who are excluded from coverage otherwise. 10. for on-road use. Then multiply by the city fee for each city in which you will do business. etc). are required to report and pay waste tire fees to the Department of Revenue. This can not be a PO Box or Route Number. check “Other” and explain. To calculate the fees for TPT licenses. Make checks payable to the Arizona Department of Revenue. 8. contact the Unemployment Tax Ofﬁce Experience Rating Unit for an Application & Agreement for Severable Portion Experience Rating Transfer (form UC-247. Indicate the physical location of your tax records. Please note: If you check one or both boxes. the tax is calculated on the sales billed rather than actual receipts. 11. If part. but only for services the law deﬁnes as employment. multiply the number of locations in the state by $12. To learn more. and you will not be permitted to challenge this election at a later date if it is approved. Leave boxes blank if neither choice applies. you will receive form TR-1 on a quarterly basis. Complete as indicated if you acquired an existing business or. through 15. use the listing of program cities in Section C. 7. Section E: AZTaxes. select the appropriate code from this table and indicate on Section A-11. through 12. Unemployment.gov AUTHORIZED USER INFORMATION 1. Indicate the manner in which you became the new owner or operator of this business or. Once certain conditions are met. Cash/Accrual Methods: Cash method requires the payment of tax based on sales receipts actually received during the period covered on the tax return. you must request it no later than 180 days after the date of acquisition or legal form of business change.com). When ﬁling under the accrual method. through 6. Complete this section if you would like to designate a security administrator for your online services at www. Fill in the totals for state fees and city fees on the application form and total to determine the amount due. if you merely changed the legal form of your existing business. or Use Tax registrations.azui. 16. please refer to the Employers’ Handbook or Guide to Arizona Employment Tax Requirements available online at www. provide information on your business under its previous legal form. First. Section C: PROGRAM CITIES / LICENSE FEES There are no fees for Withholding. Complete as indicated.azui. Be sure to return the city fees sheet with your application. and 11. if you merely changed the legal form of your existing business. You must indicate at least one business class on Section B-4. not agents or representatives. attach additional sheets. ADOR 74-4002 (5/07) . 9. Check Box A if you believe you have not met such conditions and you voluntarily elect to provide such coverage anyway. If more space is necessary. Sellers of new motor vehicles and motor vehicle tires in the state.”. to obtain an unemployment tax rate based on the business’s previous account. Section H: BUSINESS CLASSES Select appropriate business classes based on your business activities. 8. and remit tax payments on behalf of the business identiﬁed in Section A. through 25. the law requires employers to provide unemployment insurance coverage to their workers. indicate the months in which you intend to do business. 13. 10. Indicate whether you acquired or changed all or only part of the existing Arizona business. The name and e-mail address of the administrator are required for registration. for example. indicate the number of businesses or physical locations for each of the cities for which the Department of Revenue licenses and collects. printable version available online at www. “Changed sole proprietorship to corporation. 6. Section G: INDIAN RESERVATION CODES If your business is located on an Indian Reservation. By checking the box. Add the columns to determine the total city fees. provide information on your business under its previous legal form. To obtain licensing for cities not listed on the form. complete this section. ﬁle tax returns. Complete as indicated if you know the previous owner’s information or. The authorized individual will have full access to tax account information and will add or delete users and grant user privileges to view tax account information. Section F: SIGNATURES The application must be signed only by individuals legally responsible for the business. If your business is seasonal or a transient vendor. through 7.