City of Page | Business Registration Renewal

* Required field

It is time to renew your Business Registration. Please enter your business information in the required fields below, denoted with a red asterisk.

Date: *

Legal Business Name: *

DBA Business Name: *

Registration #:

If there have been any changes to your Business Registration information please fill them out in the necessary fields below.

*ONLY FILL FIELDS THAT NEED CHANGING*

*If there are no changes, scroll down to payment*

Business Information:

Legal Business Name:

DBA Business Name (if different):

Physical Address

City:

State:

Zip:

Phone

Email Address:

Business Type:

Sole Proprietorship

LLC

Corporation

S CORP

LLP

Other

Arizona Transaction Privilege Tax Number (TPT):

Employer Identification Number (EIN):

Mailing Address:

City:

State:

Zip:

Type of Business or Goods/Wares/Merchandise/Services to be Sold

Owner Information:

Full Name:

Mailing Address:

City:

State:

Zip:

Phone

Email Address:

On-Site Manager/Emergency Contact

Phone

Alternate Emergency Contact:

Phone

Do You Store Hazardous Materials?

Yes

If Yes, Please Describe

North American Industry Classification System Code (NAICS)

#	Item Description		Amount			Subtotal
1	Business Registration Fee		$25.00			$25.00

Total

$25.00

Payment Information

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

Email *

Please confirm your signature by typing your full name in the box below.

I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature.

Enter text below. *