Ets Form 103 - Sales/use Tax Vendor Certificate Of Business Discontinuation 2011 printable pdf download

Ets Form 103 - Sales/use Tax Vendor Certificate Of Business Discontinuation 2011

*0-0-3-099*

Wyoming Department of Revenue

Excise Tax Division

122 W. 25th Street, Herschler Bldg.

Cheyenne, Wyoming 82002-0110

Sales/Use Tax Vendor Certificate of Business Discontinuation

The Undersigned hereby certifies:

1. I am the holder of Wyoming sales tax license number__________________________

2. I no longer sell products or provide services subject to sales or use tax and am requesting my

license be canceled effective this date:_________________________

3. I have completely discharged all my sales/use tax liability up to and including the date

specified on line two (2.) above. (Note: This includes tax on all accounts receivable)

4. The business operated under the above sales/use tax license was sold in its entirety to:

______________________________________________________________________________

5. I will retain all business and financial records of the business operated under the above

sales/use tax license for a period of three (3) years at the following location:

______________________________________________________________________________

6. I want any approved and authorized credits refunded to me.

Note: Your sales tax license must be returned to the Department of Revenue along with this

form and other applicable cancellation documents.

_______________________________________

______________________

Signature (Owner or Corporate Officer)

Title

_______________________________________

Date

This form should be printed, completed, and mailed to the Department of Revenue at the above address

ETS Form 103 (Revised 4/25/11)

Ets Form 103 - Sales/use Tax Vendor Certificate Of Business Discontinuation 2011