Mesa Arizona Form 12180 2017-2025

Mesa Arizona Form 12180: What You Should Know

Taxable to business entity. 3 Businesses must designate their own employees. Enter name, address, phone and fax numbers of employee (include city). Example: “Mr Jones” Example: “Singer” 4 Taxpayer Identification Number (TIN) and your certification from the city. If you work for an organization, include their certified employee number. If you provide services to an organization you certify that this organization is your principal place of business (see question 5 below). 5 (1) “For Tax Preparers Only” or  (“T.O.P.” — You are not a tax preparer. (2) “Do Not Enter” or “) (3) (if using TIN) Your Certification. (4) (if using TIN & Certification) Form ST-101.3 Taxes on Utilities and Heating Fuels Revised 2, in box 5. Part 1. Residential gas, propane (100 pounds or more), electricity, and steam (continued) (1) (2) “For Tax Preparers Only” or “TOC” (3) (if using TIN) (4) Do not enter a 3D or a “Singer” as your tax preparer, if this person is engaged in tax preparation services, or in any other activity that is a tax preparation activity. 6 (enter if you provide other services to individuals, such as a lawyer and office services) If TIN is not provided, enter this instruction (e.g., a TIN is required). If you furnish, maintain or provide certification on another person's behalf, report on lines 6 – 6 through 6 — 6a only. Your name, address, phone number and fax number must be on lines 6a and 6b. Your TIN, address, and phone number is also, on lines 6b — 6b. Your certification must be on lines 7a through 7b. A TIN is also required for individuals that are not TIN holders but provide certification on their behalf on another individual's behalf (see question 8 below). (4) (2) (3) This form must be completed in duplicate, signed by you and a notary public. (5) Provide the name, address, and phone number of the organization (i.e., “Mr. Jones”) in the “Do Not Enter” column, as well as the name and address of the individual you certify.

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