Form Dr 1102 - Account Change Or Closure Form - Colorado - 2004
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1DR 1102 (09/17/04)
COLORADO DEPARTMENT OF REVENUE
ACCOUNT CHANGE OR CLOSURE FORM INSTRUCTIONS
THE ACCOUNT CHANGE OR CLOSURE FORM MUST BE USED TO NOTIFY THE DEPARTMENT OF NAME/ADDRESS
CHANGES, OR TO NOTIFY THE DEPARTMENT THAT YOU ARE NO LONGER LIABLE FOR COLORADO SALES TAX,
WITHHOLDING TAX, RETAILER'S USE TAX, OR TRADE NAME.
CHANGE IN OWNERSHIP
If there has been a change in ownership and you are the new owner, you must request a Colorado Business Registration
(CR 0100) for a new account to be established.
F.E.I.N.
This is your federal employer's identification number. If the F.E.I.N. space on the Account Change or Closure form is blank,
please enter your number. If the number printed is not correct, please make any necessary changes.
NOTE: A new F.E.I.N. will require a new Department of Revenue Account. Please fill out a Colorado Business
Registration Form (CR 0100).
CHANGE OF NAME/ADDRESS
Use the right hand block to change any portion of your name/address. Mail the completed form to the Department of Rev-
enue and continue to file the returns in your booklet. If you are changing a corporate name, you must include the Amended
Articles of Incorporation from the Secretary of State's Office.
NOTE: If you relocated to a new address in a different city and/or county, the sales tax rates are likely to be different from
your previous location and there may be other types of taxes at the new location (for example, RTD, local taxes,
etc.). You would need to file two sales tax returns - one for the previous location and one for the new location. For
example, if you file a monthly return and on the 15th moved from El Paso County to Douglas County, you would
need to file one return for sales tax activity that occurred while still in El Paso County and a second return for sales
tax activity in Douglas County.
IMPORTANT
DO NOT make changes to the name and address on your returns after you have notified the Department on the Account
Change or Closure Form.
DATE OF CLOSURE
Check the appropriate tax type box and indicate the date your account should be closed . This box should be checked
ONLY if:
1. Your business was sold or discontinued.
2. You are no longer liable for the tax indicated.
3. The structure of your business changed and a new Federal Employer's I.D. Number (F.E.I.N.) was issued.
4. Your corporation merged into another corporation.
Mail the completed forms to: Department of Revenue
Registration Control Section
1375 Sherman Street
✁
Denver, CO 80261-0009
ACCOUNT CHANGE OR CLOSURE FORM
DR 1102 (09/17/04)
DATE ACCOUNT CLOSED:
Entire Account _________
Sales Tax _____________
Withholding Tax ________
Other ________________
ACCOUNT NO.
F.E.I.N./SSN
USE THIS FORM TO NOTIFY
ADDRESS CHANGE ONLY
THE DEPARTMENT OF NAME
AND/OR ADDRESS CHANGES
PREVIOUS/CURRENT NAME AND ADDRESS
NEW NAME AND ADDRESS
OR TO NOTIFY THE DEPART-
Name
Name
MENT THAT YOU WANT TO
CLOSE YOUR ACCOUNT.
Address
Address
City
State
ZIP
City
State
ZIP
Telephone Number
Telephone Number
Mailing Address
Physical Address
Both
MAIL TO: COLORADO DEPARTMENT OF REVENUE
REGISTRATION CONTROL SECTION
Authorized Signature
1375 SHERMAN STREET B 132
DENVER, COLORADO 80261-0009
Please indicate county where business is located
Inside City
Outside City
County___________________________________________
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