Account Change Or Closure Request Form - Denver Department Of Finance

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CITY AND COUNTY OF DENVER
TREASURY DIVISION
WELLINGTON WEBB BLDG.
DEPARTMENT OF FINANCE
201 WEST COLFAX AVE, DEPT 403
DENVER, COLORADO, 80202-5329
Michael B. Hancock
FAX: (720) 913-9475
Account Change OR Closure Request Form
Mayor
Please complete the form below reflecting all the requested changes to your business account(s):
Account #:______________________________ Business Name:____________________________________________
Please indicate which account(s) the change or closure should be applied to:
Sales/Use
Occupational Privilege
Lodgers
FDA/TBT
Please provide the following information regarding the requested changes to the selected account(s):
ACCOUNT CLOSURE:
Date of business closure:________________________
Out of business
Never began business
Opened account in error
Seasonal business
No taxable sales
Business, employees and all sales, services, or other taxable activity have moved out of Denver.
(Please include the new address below)
Business has moved out of Denver: BUT sales and employee activity in Denver will continue.
(Sales & OPT accounts should remain open - please complete address change below)
Business and all employees have moved out of Denver: BUT sales activity in Denver will continue.
(Sales account should remain open – please complete address change below)
Business has been sold or changed ownership: Date of business sale:____________________________________
Name of new owner:_____________________________________Phone#:_______________________________
Address:_________________________________________ City/State/Zip:_______________________________
ACCOUNT REACTIVATION:
Closed in error. Reactivate with original start date.
Business Reopened. New Start Date: ___________
NAME, ADDRESS OR PHONE# CHANGE:
New Business Name:_______________________________________________________________(FEIN cannot change)
New Address:__________________________________________City/State/Zip:________________________________
Location Address
Mailing Address
Both Location & Mailing Address
New Phone #:_____________________________
In order to complete any of the requested changes, a signature must be included.
Cancel my account effective:__________________(date) Cause of Closure:____________________________________
Print Name:__________________________________
Contact #:____________________________________
SIGNATURE:____________________________________
DATE:_________________________
7/17

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