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TOWN OF HUACHUCA CITY 500 N. Gonzales Blvd.

, Huachuca City, Arizona 85616 Phone: (520) 456-1354 Fax: (520) 456-2230 Application for Business and Occupational License
Name of Business: Location of Business: Mailing Address: Person to Contact: Type of Business: Name of Owner/Operator: Number of Employees (Exclusive of Owner): Business is: Sole Proprietorship Partnership Corporation Phone No.

Date Business established or incorporated: State of Incorporation: Name and Location of Statutory Agent: AZ Sales Tax Number: Federal Employer ID:

Note: Huachuca City charges a 1% sales tax including residential rentals. This tax must be reported to the Arizona Department of Revenue as Sales Tax. Number of Coin Machines Used: Amusement: Juke Box: Pinball: Pool Table: Other:

Apartments Trailer Courts Mobile Home Park: Number of Total Spaces: Number of Spaces Occupied:

List all State or County Licenses or Permits required for this business: State: State: County: County: Signature of Applicant/Owner: For Huachuca City Town Hall Use Only Category: Date Issued: Fees Per Year: Remarks: License No.: Type: Type: Type: Type: Number: Number: Number: Number: Exp. Date Exp. Date Exp. Date Exp. Date Date:

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