Request For Information Changes - City And County Of San Francisco - California - Office Of The Treasurer & Tax Collector
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1
2Office of the Treasurer & Tax Collector
City and County of San Francisco
Street Address:
City Hall, Room 140, 1 Dr. Carlton B. Goodlett Place, SF, CA 94102
Mailing Address: P. O. Box 7425, San Francisco, CA 94120-7425
Tel: (415) 554-4400; Fax: (415) 554-6207; TTY: (415) 554-4455
JOSÉ CISNEROS, Treasurer
GEORGE PUTRIS, Tax Administrator
REQUEST FOR INFORMATION CHANGES
Please Complete the Following Information:
Business Tax I.D. No:_____________________________________
Certificate No:________________________________
Registered Ownership Name:_____________________________________________________________________________
Registered Business Name (DBA):_________________________________________________________________________
Check the Appropriate Boxes:
1.
ADDRESS CHANGES
o
o
o
Mailing
Location
Accounting
Change Date:___________
:
_________________________________________________________
_________________________________ ___________
New Address
Suite No.
City & State
Zip Code
2.
NEW or ADDITIONAL DBA/LOCATION:
(Additional spaces are available on the reverse side) If you are
adding, renewing or abandoning a fictitious business name, you must submit a declaration with the County Clerk’s Office.
o
Business Name:______________________________________________________________
Start Date:_____________
o
Business Location:___________________________________________________________
Start Date:_____________
Street Address/Suite
City/State
Zip Code
Describe the nature of business done at the above location:
______________________________________________ $___________________
___________
____________
_________
Business Description
Est. Payroll
# Employees
Bus. Class
PBC
(12 mos.)
For Apartment Building Owner/Operator: No. of Apt. Units:__________ No. of Commercial Units:___________
3.
INACTIVATE/DELETE:
o
o
o
Inactivate Location:___________________________________
No Longer Doing Business in S.F.
Business Sold
o
Reason Business Ceased Operation:______________________________________ Last Date of Operation: ___________
Section 4 on the reverse side must be completed before a business is closed or no longer doing business in San Francisco.
Account will be inactivated once all city obligations are cleared. A new application is required upon change of ownership or
Social Security/Federal Employer ID number. Call Taxpayer Assistance at (415) 554-4400, TTY (415) 554-4455, to request
an application or visit our website,
If business is sold, or if you are no longer doing business as a parking lot operator at the location of record, provide
new owner information:
________________________________________
__________________________________________ (____)_______________
New Ownership Name
Mailing Address
Phone Number
4.
OWNERSHIP TYPE HAS CHANGED TO:
o
o
o
o
Sole Proprietorship
Partnership
Corporation
Other___________________ Effective Date:__________
_
CONTINUE ON THE REVERSE SIDE
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