Business Change Form

Assessor - Business Change Form

Business Change Form (Questions marked with * are required)

*Business Name:
*Account:
*Business Address:
*Contact Person:
*Contact Telephone:
Contact Email:
Business Owner:
Business Telephone:

Change of Location Address

Previous Address:
New Address:
When:

Change of Mailing Address

Previous Mailing Address:
New Mailing Address:
When:

Business Name Changed

Previous Name:
New Name:

Sold Business

Date Business Sold:
Business at same location?	Yes No
Who has possession of equipment?
New Owner's Contact Information

Closed Business

Date Business ceased operation:
Business License cancelled?	Yes No
How was equipment disposed?

Filed Bankruptcy

What is the Case Number?
Status of Filing?
Date of Bankruptcy?
Business in operation?	Yes No

Typed Signature


Date: 05-08-21
*Signature: