Discontinuation Of Business Activity - City Of Pittsburgh Department Of Finance (Page 2 of 2) in pdf

Discontinuation Of Business Activity - City Of Pittsburgh Department Of Finance Page 2

(BUSINESS ACTIVITY INFORMATION CONTINUED)

Date business moved: ___________________________________________

(5) Do you employ Pittsburgh residents?

YES

(6) Are you a City resident?

YES

(7) Will any business activity be conducted in Pittsburgh?

YES

If YES, please describe: _________________________________________________________

_____________________________________________________________________

C. ADDITIONAL INFORMATION:

Do you own the building where the business or rental was located?

YES

If YES, will you be renting the building to others now or in the future?

YES

Note: Rental property within the City of Pittsburgh limits is considered a taxable business.

If you have any ACTIVE rental property or properties within City limits, you MUST retain

your city account number and report your collected rental revenue.

D. AFFIRMATION:

I, _____________________________________, ___________________________________

(Owner/Operator name, please print)

(Business name)

do hereby affirm that this document has been examined by me and to the best of my knowledge

and belief, is true, correct and complete.

SIGNATURE___________________________, ________________, _(____)______________

(Signature)

(Date)

(Telephone No.)

Resident Address:_____________________________, ____________________, ________________

(Street)

(City)

(State)

Mail completed form to: City of Pittsburgh, Department of Finance, 414 Grant St. Rm 218

Pittsburgh PA 15219. For questions regarding this form, please dial (412) 255-2505.

Discontinuation Of Business Activity - City Of Pittsburgh Department Of Finance Page 2