
ADOR 74-4002 (12/03)
18. Enter the applicable business classes based on your activity. See
Section I for listing of business classes.
19. Identify the owners of the business. Enter as many as applicable;
attach a separate sheet if additional space is needed.
Section B: TRANSACTION PRIVILEGE TAX (TPT)
1. Enter the date the business started in arizona.
2. Enter date sales began in Arizona, or estimate when you plan to begin
selling in Arizona.
3. Enter the amount of Transaction Privilege Tax income you can reasonable
expect to generate in your fi rst twelve months of business. You will be set
up for monthly fi ling unless your anticipated annual income will result in a
tax liability of less than $1,250 which may qualify for a quarterly fi ler.
4. Cash/Accrual Methods: Cash method requires the payment of tax based
on sales receipts actually received during the period covered on the tax
return. When fi ling under the accrual method, the tax is calculated on the
sales billed rather than receipts.
5. Complete as indicated.
6. Sellers of new motor vehicles and motor vehicle tires in the state, for on-
road use, are required to report and pay waste tire fees to the Department
of Revenue. By checking the box, you will receive form TR-1 on a
quarterly basis.
7. If your business is seasonal or a transient vendor, indicate the months in
which you intend to do business.
8. 9. and 10.
Indicate the physical location of your tax records, the contact person and
their phone number.
11. through 24.
If you have additional business locations, complete this section. If more
space is necessary, attach additional sheets.
Section C: WITHHOLDING INFORMATION
1. Indicate whether you are liable for Federal Unemployment Tax and the fi rst
year of your liability
2. If you have individuals excluded from withholding or unemployment tax,
please explain why.
3. Indicate whether you have an IRS writing for exclusion from federal
unemployment tax..
4. Enter the date employees were fi rst hired in Arizona.
5. If you have or had an Arizona state tax number, provide requested
information.
6. Enter the average number of employees and total gross wages paid for
each quarter the business operated.
7. Enter the number of persons performing services each week the business
operated.
Section D: UNEMPLOYMENT TAX INFORMATION
WHAT IS A SUCCESSOR EMPLOYER?
When you acquire all or part of a business, which required to pay
unemployment taxes in Arizona, you are a “successor” for unemployment
tax purposes. As a successor, you are immediately liable for unemployment
taxes regardless of the amount of wages you pay or the number of workers
you employ.
As a successor, you may also take into account wages paid by the former
owner in determining the amount of wages on which you must pay taxes
during the year in which you acquired the business. For example, if the
former owner has paid wages in excess of $7,000 to a worker you continue
to employ, you will not have to pay taxes on any additional wages you pay
this worker in the year you acquire the business.
ACQUISITION OF ALL OF AN EXISTING ARIZONA BUSINESS
When you acquire an entire business and continue its operation, you are
assigned the tax rate and experience rating account of the former owner.
The experience rating account includes the record of wages and taxes
previously paid. Therefore, any unemployment benefi ts awarded based
on wages paid by the former owner, may be charged to your account.
Additionally, you may be liable for taxes unpaid by the former owner.
When acquiring a business, consider whether any unemployment taxes
remain unpaid by the seller.
ACQUISITION OF A PART OF AN EXISTING ARIZONA BUSINESS
If you acquire a PART of a business and continue to operate it, you are not
automatically assigned the tax rate and experience rating account of the
former owner. To apply for a portion of the account and its corresponding
tax rate, you must fi le an “Application & Agreement for Severable Portion
Experience Rating Transfer” (UC-247) within 180 days of acquiring the
business. The former owner must agree and provide payroll information
for the portions of the business acquired and retained. Your account may
then be charged for a portion of the unemployment benefi ts paid to the
former owners’ employees. The application form is available online at:
www.de.state.az.us/esa/uitax/taxform.asp.
or you may call (602) 248-9101
to obtain an application.
1. through 3.
Enter the date acquired, whether all or part, and how you acquired.
4. through 11.
Enter the previous owner’s information, name, business name, current
street address, telephone number, and unemployment number of previous
owner.
12. Voluntary Election of Unemployment Tax Coverage
Complete and sign this portion of the application ONLY if you wish to
provide unemployment coverage to your employees, and you believe
you are not REQUIRED to provide coverage. Refer to the “Employers
Handbook” (available online at www.de.state.az.us/esa/uitax/emp.asp.
or
“Guide to Arizona Employment Tax Requirements.”
13. through 20.
Complete this section if you would like to receive unemployment claims at
a different address.
21. through 30.
Complete this section if your payroll will be paid by another company.
31. through 40.
Complete this section if your employees are leased from another
company.
Section E: SIGNATURES
The application must be signed only by individuals legally responsible for
the business, not agents or representatives.
Section F: AZTaxes.gov SECURITY ADMINISTRATOR INFORMATION
1. THROUGH 6.
Complete this section if you would like to designate a security administrator
for our online service center www.aztaxes.gov.
The authorized individual
will have full access to tax account information including add/delete users,
view tax account information, fi le tax returns, and remit tax payments
on behalf of the business identifi ed in Section A. The name and e-mail
address of the administrator are required for registration.
Section G: PROGRAM CITIES / LICENSE FEES
There are no fees for Withholding, Unemployment, or Use Tax
registrations. To calculate the fees for TPT licenses, calculate the State
fees by multiplying the number of locations in the state by $12. To
calculate the city fees, use the listing of program cities in Section G. First,
indicate the number of businesses or physical locations for each of the
cities for which the Department of Revenue licenses and collects. Then
multiply by the city fee for each city in which you will do business. Add the
columns to determine the total city fees. Fill in the totals for state fees and
city fees on the application form and total to determine the amount due.
Make checks payable to the Arizona Department of Revenue. Be sure to
return the city fees sheet with your application. To obtain licensing for
cities not listed on the form, please contact the city directly.
Section H: INDIAN RESERVATION CODES
If your business is located on an Indian Reservation, select appropriate
code from this table and indicate on Section A-11.
Section I: BUSINESS CLASSES
Select appropriate business classes based on your business activities.
You must indicate at least one business class on Section A-18.
JT-1/UC-001 (12/03) (Page 6)