Town Of Prescott Valley Business License Division

Home Occupancy Application

Dec 14, 2022
submission #496
Business License Application

Business Name and Physical Location

Business Name or Trade Name FAST First Aid Solutions and Training
Business Street Address (Physical location of the business cannot be a PO Box) ---
Mailing Address (Street name and number only) ---
Mailing Address City, State, & Zip Code ---
Business Phone Number +19707011325
Number of Employees ---
Please read trough the list carefully and select the closest description of your business: SERVICE BUSINESS
Business Description (Please describe in detail the nature of the business) ---
Start of business date 2021-07-07
Locations where the business or applicant has operated during the last five (5) years ---
is the business location: ---
Nature of Ownership ---

LLC Ownership Information

1. Name of Owner (First and Last) ---
Title ---
Home Street Address of Owner (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 ---

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

Home Address (No PO Boxes) ---
Phone number ---
Date of Birth ---
Social Security Number (Last four (4) digits only) ---

Application Affidavit

Applicant Affidavit ---