Form 51a205 - Account Maintenance Information Page 2

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NEED HELP?
Telephone assistance is available from 8:00 a.m. to 5:00 p.m. Monday through Friday. Assistance and
forms are available from:
Internet Access
Sales and Use Tax Assistance
(502) 564-5170
Telecommunication Device for the Deaf
(502) 564-3058
E-mail Questions
Taxpayer Service Centers
KRCWebResponseSalesTax@ky.gov
Ashland
(606) 920-2037
Louisville
(502) 595-4512
Mailing Address for Assistance
Bowling Green (270) 746-7470
Northern Kentucky (859) 371-9049
Frankfort
(502) 564-5930
Owensboro
(270) 687-7301
Kentucky Department of Revenue
Corbin
(606) 528-3322
Paducah
(270) 575-7148
Division of Sales and Use Tax
Hopkinsville
(270) 889-6521
Pikeville
(606) 433-7675
PO Box 181, Station 53
Frankfort, KY 40602-0181
Cut Here and Enclose Account Maintenance Information With Return
ACCOUNT MAINTENANCE INFORMATION
Account number
Name as it currently appears on permit
 Change mailing address to:
Street
 Request for cancellation (date business terminated) ____________
City
State
ZIP code
Reason: _______________________________________________________
 Change in ownership (Complete Form 10A100, Kentucky Tax
If sold, indicate name and address of new owners _______________
Registration Application, which will be mailed to you upon
receipt of this form.) Form 10A100 may also be obtained
______________________________________________________________
by calling (502) 564-3306 or from the tax forms page of the
Department of Revenue Web site listed above.
______________________________________________________________
Types of Ownership Changes Requiring Form 10A100:
 Change location address to:
Individual to Individual/Partnership/Corporation/LLC
Partnership to Partnership/Individual/Corporation/LLC
Corporation to Corporation/Individual/Partnership/LLC
Street
LLC to LLC/Individual/Partnership/Corporation
City
State
ZIP code
The statements indicated are hereby certified to be correct to
the best knowledge and belief of the undersigned who is duly
Current Telephone Number___________________________________
authorized to sign this request.
 Change of business name
Signature
Date
Name change only

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