Change Of Taxpayer Information Form - City Of Birmingham Revenue Division
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1CITY OF BIRMINGHAM
REVENUE DIVISION
ROOM TL-100 CITY HALL
TH
710 N 20
ST
BIRMINGHAM, AL 35203-2227
(205) 254-2198 OFFICE
(205) 254-2963 FAX
CHANGE OF TAXPAYER INFORMATION:
Note: This form is to be used only if a change has occurred in the name, ownership, number of locations, mailing or location address of your
firm, or in your federal employer identification number.
PLEASE PROVIDE THE FOLLOWING INFORMATION AS IT CURRENTLY APPEARS ON YOUR CITY OF
Taxpayer ID# ________________________
BIRMINGHAM TAXPAYER ACCOUNT:
Name__________________________________________________________________________
Mailing Address__________________________________________________________________
_______________________________________________________________________________
City, State, Zip___________________________________________________________________
Please check the appropriate responses and provide the information requested as follows:
1.
The mailing address for sales tax
, occupational tax
, sellers use tax
, consumers use
tax
, lease tax
, and/or lodgings tax
forms has changed. The new address to which forms
should now be mailed is as follows: (Attach additional sheets if necessary).
Taxpayer Name: _________________________________________________________
D/B/A Name:
_________________________________________________________
Attention:
_________________________________________________________
Address 1 :
_________________________________________________________
Address 2 :
_________________________________________________________
City, State, Zip Code: _____________________________________________________
Phone/Fax Number: __________________________ / __________________________
Name of Contact:
_____________________________________________________
A total of ______ new business locations have been added as follows: (Attach additional sheets
2.
for additional locations if necessary
.)
IMPORTANT NOTE: Any change in the physical location of your
business must be approved by the City of Birmingham Planning, Engineering and Permits Department, pursuant
to the requirements of the City's Zoning Code. Failure to obtain approval from the Planning, Engineering and
Permits Department for a change of the physical location of your business invalidates any business license
issued, and may result in the revocation of the business license.
Taxpayer Name: _________________________________________________________
D/B/A Name:
_________________________________________________________
Attention:
_________________________________________________________
Address 1 :
_________________________________________________________
Address 2 :
_________________________________________________________
City, State, Zip Code: _____________________________________________________
Phone/Fax Number: __________________________ / __________________________
Name of Contact:
_____________________________________________________
The business has been sold
, acquired
, or closed
. A new Federal Employer Identification
3.
Number has been issued
.
Effective Date of Change: __________________________________________________
Former Owner Was:
__________________________________________________
The New Owner Is:
__________________________________________________
Address of New Owner:
__________________________________________________
__________________________________________________
Phone and/or Fax No.:
__________________________________________________
Old Federal Employer Identification Number: __________________________________
New Federal Employer Identification Number: __________________________________
Name of Contact: ________________________________________________________
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