Town Of Prescott Valley Business License Division

Home Occupancy Application

Apr 13, 2022
submission #23
Business License Application

Business Status

What would you like to do today: ---

Business Name and Physical Location

Business Name or Trade Name Elevation Closets
Business Street Address (Physical location of the business cannot be a PO Box) ---
Business Mailing Address ---
Business Phone Number +19283615629
Alternate # (Emergency Phone Number) ---
Number of Employees ---
Please read trough the list carefully and select the closest description of your business: CONTRACTOR CARPENTRY
Business Description (Please describe in detail the nature of the business) ---
Start of business date 2022-04-13
is the business location: ---
Nature of Ownership ---

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

Name (First and Last) Andrew Yoder
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) ---

LLC Ownership Information

State in which the LLC was legally established ---
Name of the Business (if business is owned by another LLC) ---
1. Name (First and Last) ---
Title ---
Home Street Address (cannot be a PO Box) ---
Telephone Number ---
2. Name (First and Last) ---
Title ---
Home Street Address (cannot be a PO Box) ---
Telephone Number ---

Federal Tax ID or Social Security Number

Please provide your Federal ID or Social Security Number ---

Professional Licenses

Professional License or Permit Number & Description ---

Application Affidavit

Applicant Affidavit ---