Town Of Prescott Valley Business License Division

Commercial Rental Application

May 22, 2022
submission #18
Business License Application

Business License Status

What would you like to do today: ---

Business Name and Physical Location

Business name or Trade Name Dorothy Miller FLP
Amount of properties owned in Prescott Valley: (per parcel #) ---
Location of Commercial Building Rental(s): 8740 E Eastridge Dr
Building owner's physical location: ---
Nature of Ownership ---
Mailing Address (Street name and number only) 14440 Pike Road
Mailing Address City, State, & Zip Code Saratoga
Business Phone Number +14088679180
Start of business date ---
Description of your business: RENTAL COMMERCIAL PROPERTY

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

Name (First and Last) ---
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 ONLY) ---

Partnership

1. Partner/Owner (First and Last Name) ---
Home Street Address (cannot be a PO Box) ---
Telephone Number ---
Social Security Number (Last four (4) digits are accepted) ---
2. Partner/Owner (First and Last Name) ---
Home Street Address (cannot be a PO Box) ---
Telephone Number ---
Social Security Number (Last four (4) digits are accepted) ---

Federal Tax ID or Social Security Number

Please enter your Federal Tax ID Number ---

Application Affidavit

Applicant Affidavit ---