License Requirements (Fuel Tax)

Licensed Suppliers

• EIN verification documents such as:
  • IRS 147C letter
  • W-9 (or other tax document from IRS to verify EIN)
• Companies (Inc., LLC, or LLLC) registered and in good standing the with Arizona Corporation Commission
• Partnerships (LP or LLP) registered with the Arizona Secretary of State
• DBA Names registered with the Arizona Secretary of State
• Power of Attorney Form #96-0611 (only if someone is acting on the applicant’s behalf, once licensed)
• Complete Application
• Post a supplier (surety) bond – Motor Fuel Supplier Bond Form #96-0153 (for suppliers only)
• Electronic Funds Transfer Declaration Form #96-0335 (for suppliers only)
• Application Fee - $50

Licensed Restricted Distributors

• EIN verification documents such as:
  • IRS 147C letter
  • W-9 (or other tax document from IRS to verify EIN)
• Companies (Inc., LLC, or LLLC) registered and in good standing the with Arizona Corporation Commission
• Partnerships (LP or LLP) registered with the Arizona Secretary of State
• DBA Names registered with the Arizona Secretary of State
• Power of Attorney Form #96-0611 (only if someone is acting on the applicant’s behalf, once licensed)
• Complete Application

Licensed Vendor and Vendor Branches

• EIN verification documents such as:
  • IRS 147C letter
  • W-9 (or other tax document from IRS to verify EIN)
• Companies (Inc., LLC, or LLLC) registered and in good standing the with Arizona Corporation Commission
• Partnerships (LP or LLP) registered with the Arizona Secretary of State
• DBA Names registered with the Arizona Secretary of State
• Power of Attorney Form #96-0611 (only if someone is acting on the applicant’s behalf, once licensed)
• Complete Application
• Copies of all outside pump receipts for each diesel dispenser and sample inside cash register receipts for each tax rate of diesel fuel sold to ensure compliance with ARS 28-5617
• Application Fees - Vendor $5 plus $5 for each vendor branch license therein