1. Application Form
2. AZ 5000A Form
3. Upload Licenses

Web Site

New Account Application

*** There is a $300.00 minimum for in-house sales and a $700.00 minimum for delivery. ***

Store/Business Name *

Business Address: *

Address Line 2:

City: *

State *
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Zip Code *

EIN No: *
(Employer Identification Number)
AZ TPT License No:

City License No (Non-AZ):

Tobacco Distributor License:
(If Applicable)
Contact Person(s):

Contact 2

Business Phone No: *

Business Fax:

Cell Phone No:

e-mail Address: *

Additional Information:

Full Name: *



Authorized Approval:

Information will ONLY be used to evaluate eligibility to open an account with Sunset Wholesale West LLC. No information will be shared with any third parties.

*

A. Business Name and Address:

B. Check Applicable Box:

Business Name *

TPT/Sales Tax License No. *

Period


Period From
Address *

Address2

From Date *

Through Date *

City *

State *

Zip Code *

(You must choose specific dates for which the certificate will be valid. You are encouraged not to exceed a 12 month period. However, a certificate will be considered to be accepted in good faith for a period not to exceed 48 months if the vendor has documentation the TPT license is valid for each calendar year covered in the certificate.)

Business Email (Optional)

Business Telephone Number (Optional)

Vendor’s Name

C. Precise Nature of Purchaser’s Business:

Nature of Business

D. Description of Property Being Purchased:

Property Purchased

E.

The following sales of tangible personal property do not require the purchaser to provide a TPT or other Sales Tax License
(check appropriate box):

SectionE

Sales to the U.S. government or its departments or agencies for resale (purchased directly by the Federal Government).

Sales to an unlicensed Arizona School District for resale (purchased directly by the school district).

Sales to a nonprofit charitable I.R.C. § 501(c)(3) organization for resale. (Attach I.R.S. determination letter to this form.)

Sales to a nonprofit charitable I.R.C. § 501(c)(3), (c)(4), or (c)(6) organization associated with a major league baseball team or a national professional golfing association for resale. (Attach I.R.S. determination letter to this form.)

Sales to a nonprofit charitable I.R.C. § 501(c)(3), (c)(4), (c)(6), (c)(7), or (c)(8) organization that sponsors a rodeo featuring farm and ranch animals for resale. (Attach I.R.S. determination letter to this form).

Sales to a nonprofit charitable I.R.C. § 501(c)(6) organization that produces, organizes, or promotes a cultural or civic related festival or event – for resale. (Attach I.R.S. determination letter to this form).

No Exemptions

F. Certification

A seller that has reason to believe that this Certificate is not accurate, complete, or applicable to the transaction may not accept the Certificate in good faith and the seller will not be relieved of the burden of proving entitlement to the exemption from tax. A seller that accepts a Certificate in good faith will be relieved of the burden of proof and the purchaser may be required to establish the accuracy of the claimed exemption from tax as provided in A.R.S. § 42-5009. Subsequent use or consumption of the tangible personal property by the purchaser other than sale in the ordinary course of business will subject the purchaser to the Arizona use tax. Willful misuse of this Certificate will subject the purchaser to criminal penalties of a felony pursuant to A.R.S. § 42-1127(B).

I hereby certify that these purchases are for resale in the ordinary course of business and that the information on this Certificate is true, accurate and complete. Further, if purchasing as an agent or officer, I certify that I am authorized to execute this Certificate on behalf of the purchaser named above.

Full Name *

Job Title *

Date *

ADOR 10316 (11/20)

Please attach copies of your TPT (Arizona Customers) or Sales Tax License (Non-AZ) license along with a copy of the business owner’s Driver’s License or State ID and a copy of your EIN.

Click on the “Submit Application” Button at the bottom of the form to complete your application.