Town Of Prescott Valley Business License Division

Commercial Rental Application

Sep 22, 2023
submission #123
Business License Application

Business License Status

What would you like to do today: ---

Business Name and Physical Location

Business name or Trade Name Atlantic Jasper LLC, d/b/a The Flats at Jasper
Amount of properties owned in Prescott Valley: (per parcel #) ---
Location of Commercial Building Rental(s): 4901 N. Jasper Parkway,, Prescott Valley, AZ 86314
Building owner's physical location: ---
Nature of Ownership ---
Mailing Address (Street name and number only) 5 Chestnut Street
Mailing Address City, State, & Zip Code Unit 4
Business Phone Number +18579919149
Alternate # (Emergency Phone Number) ---
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 ---

Federal Tax ID or Social Security Number

Please enter your Federal Tax ID Number ---

Application Affidavit

Applicant Affidavit ---