Arizona Additional Business Location(s) Addendum (TPT)

Additional Business Location(s) Addendum (TPT)
Additional Business Location(s) Addendum
Name (as shown on page 1)

FEIN or SSN (as shown on page 1)
Page

of

Additional Business Location(s) Addendum
For use with: Arizona Joint Tax Application (JT-1), City Only Application, or Arizona Business Account Update form.
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. Refer to the
publication, Taxpayer Bonds, available online at www.azdor.gov or in Arizona Department of Revenue offices.

Business Name, “Doing Business As” or Trade Name at this Physical Location

Phone Number (with area code)

Physical Location of Business or Commercial/Residential Rental

City

State

ZIP Code

County/Region

Country

|

|

Residential Rental Only – Number of Units

Reporting City (if different than the physical location city)

Number and street (Do not use PO Box, PMB or route numbers)

Additional County/Region Indian Reservation/City: County/Region Indian Reservation and City Codes available at www.azdor.gov
County/
Region
City
Business Codes (Include all codes that apply):	
See instructions. Complete list available at www.azdor.gov
State/
County
City
Description of Business: Describe merchandise sold or taxable activity.
NAICS Codes:

Available at www.azdor.gov

Business Name, “Doing Business As” or Trade Name at this Physical Location

Phone Number (with area code)

Physical Location of Business or Commercial/Residential Rental

City

State

ZIP Code

County/Region

Country

|

|

Residential Rental Only – Number of Units

Reporting City (if different than the physical location city)

Number and street (Do not use PO Box, PMB or route numbers)

Additional County/Region Indian Reservation/City: County/Region Indian Reservation and City Codes available at www.azdor.gov
County/
Region
City
Business Codes (Include all codes that apply):	
See instructions. Complete list available at www.azdor.gov
State/
County
City
Description of Business: Describe merchandise sold or taxable activity.
NAICS Codes:

Available at www.azdor.gov

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ADOR 11189 (11/15)	

Clear Form

Arizona Department of Revenue