Town Of Prescott Valley Business License Division

Commercial Rental Application

Dec 07, 2022
submission #62
Business License Application

Business License Status

What would you like to do today: ---

Business Name and Physical Location

Business name or Trade Name Fulkerson Properties LLC
Amount of properties owned in Prescott Valley: (per parcel #) ---
Location of Commercial Building Rental(s): 103-26-56905 103-26-57007
Building owner's physical location: ---
Nature of Ownership ---
Mailing Address (Street name and number only) 13208 N 40th Way
Mailing Address City, State, & Zip Code Phoenix, Arizona 85032
Business Phone Number +14802383727
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) ---

LLC Ownership Information

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

Federal Tax ID or Social Security Number

Please enter your Federal Tax ID Number ---

Application Affidavit

Applicant Affidavit ---