Form Bt-115-C - Application For Business Location Change

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Oklahoma Tax Commission
Form BT-115-C
Revised 3-08
Application for Business Location Change
(To be used only for relocation of a business, otherwise a registration form (Packet A) must be completed)
I. Information
Name of Permit Holder: ____________________________________________________ FEIN/SSN:_______________________
Mailing Address: __________________________________________________________________________________________
City: _____________________________________________________ State: ________ Zip Code: _______________________
Business Telephone Number: _________________________________
Daytime Telephone Number: __________________________________
II. Tax Types
Tax types for which the new address is applicable: (provide the permit or account number for each)
Sales: __________________ Use: ___________________ Cigarette: ___________________ Tobacco: __________________
Beer*: _______________________ Mixed Beverage**: _______________________ Withholding: _______________________
Waste Tire: ___________________ Franchise: ___________________ Other: _______________________________________
Your cigarette license, beer license, sales tax permit and mixed beverage license are transferable to your new business location
without an additional fee subject to the limitation stated below.
a.
* Beer License. You must obtain a new county beer license or obtain an amended county license from the county clerk for
the new location (A copy must be attached to the application) before the permit can be transferred to the new location.
b. ** Mixed Beverage. You must obtain permission from the ABLE Commission to change the location for your mixed beverage
permit. Upon approval from the ABLE Commission, we will process the transfer of your permit.
III. Business Location/Information
A) Previous Location of Business:
Trade Name/DBA of Business: ______________________________________________ Store Number: ____________________
Street Address:
____________________________________________________________________________
(do not use PO Box)
City: _____________________________________________________ State: ________ Zip Code: _______________________
B) New Location of Business:
Trade Name/DBA of Business: ______________________________________________ Store Number: ____________________
Street Address:
_____________________________________________________________
(do not use PO Box or rural route number)
City: _____________________________________________________ State: ________ Zip Code: _______________________
office use only
County: __________________________________________________
Check here if in City Limits:
COPO
iv. Signature
I declare that the information contained in this application and any attachment is true and correct to the best of my knowledge.
Mail To:
Authorized Signature: ____________________________________________________
Oklahoma Tax Commission
Post Office Box 26920
Title: ________________________________________ Date: ____________________
Oklahoma City, OK 73126-0920

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