Town Of Prescott Valley Business License Division

Home Occupancy Application

Jul 25, 2023
submission #848
Business License Application

Business Status

What would you like to do today: ---

New Application

Is this a: None of the above

Business Name and Physical Location

Business Name or Trade Name JG Seamless Gutters
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 +19282259002
Alternate # (Emergency Phone Number) ---
Number of Employees ---
Please read trough the list carefully and select the closest description of your business: CONTRACTOR MISCELLANEOUS
Business Description (Please describe in detail the nature of the business) ---
Start of business date 2023-08-24
is the business location: ---
Nature of Ownership ---

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

Name (First and Last) Betel Gutierrez
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) ---

Application Affidavit

Applicant Affidavit ---