Town Of Prescott Valley Business License Division

Home Occupancy Application

Apr 10, 2022
submission #18
Business License Application

Business Name and Physical Location

Business Name or Trade Name Petite Treats
Business Street Address (Physical location of the business cannot be a PO Box) ---
Business Phone Number +17607925679
Number of Employees ---
Please read trough the list carefully and select the closest description of your business: HOME OCCUPANCY MANUFACTURER
Business Description (Please describe in detail the nature of the business) ---
is the business location: ---
Nature of Ownership ---

Applicant Information (Must be completed by the person filling out this application)

Name (First and Last) Valerie Gambill
Home Address (No PO Boxes) ---
Phone number ---
Driver's License Number ---
Driver's License Expiration Date ---
Date of Birth ---
Social Security Number (Last four (4) digits are accepted) ---

Individual/ Sole Proprietor Owner Information (Eligibility Form)

Name (First and Last) ---
Title ---
Home street address (cannot be a PO Box) ---
Social Security Number (Last four (4) digits are accepted) ---
Phone Number ---
*Check the box next to the document you are presenting to the Town, indicating lawful presence ---
Attach a copy of said document ---