Business License Application
Business License Status
| What would you like to do today: |
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Business Name and Physical Location
| Business name or Trade Name |
Cohere Life, Inc.
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| Amount of properties owned in Prescott Valley: (per parcel #) |
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| Location of Commercial Building Rental(s): |
Jasper Community Association, Inc. NOTE: We (Cohere) lease office space at J Club which is owned by Arizona EcoDevelopment.
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| Building owner's physical location: |
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| Nature of Ownership |
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| Mailing Address (Street name and number only) |
18001 N. 79th Avenue
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| Mailing Address City, State, & Zip Code |
Suite C56
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| Business Phone Number |
+16027677249
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| Start of business date |
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| Description of your business: |
RENTAL COMMERCIAL PROPERTY
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Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
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| Home Address (No PO Boxes) |
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| Phone number |
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| Driver's License Number |
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| Driver's License Expiration Date |
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| Date of Birth |
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| Social Security Number (Last four (4) digits ONLY) |
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LLC Ownership Information
| State in which the LLC was legally established |
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| Name of the Business (If owned by another LLC) |
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| 1. Name of Owner (First and Last) |
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| Title |
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| Home Street Address of Owner (Cannot be a PO Box) |
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| Telephone Number |
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| 2. Name (First and Last) |
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| Title |
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| Home Street Address (cannot be a PO Box) |
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| Telephone Number |
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Federal Tax ID or Social Security Number
| Please enter your Federal Tax ID Number |
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Application Affidavit
