Request For Certificate Of Good Standing Form

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REQUEST FOR CERTIFICATE OF GOOD STANDING
Date: ______________
Requestor Information
(Business or Personal Information from the entity making the request.)
Your Name: _____________________________________________________________
Business
Name:__________________________________________________________________
Your Address:
_______________________________________________________________________
City: _______________________ State: __________ Zip:___________
Primary Phone: _____________________ Your Fax No:________________________
Your email Address:
_______________________________________________________________________
Requesting Information
(Business for which you are requesting a certificate.)
Business Name:
_______________________________________________________________________
Business FEIN:
_______________________________________________________________________
City: ____________________________State: ______ Zip:__________
Business Phone: ______________________
Reason for Request:
_______________________________________________________________________
_______________________________________________________________________
A response to your request should be mailed within about ten (10) days to the mailing
address you provided above. No tax information will be divulged by phone nor to
anyone other than the successor of the business as allowed in §40-2A-10(f)(1), Code of
Alabama (1975), as amended. Be sure to attach a copy of the signed and dated Purchase
Agreement.
Mail these both to License Commission Office, P. O. Drawer 161009,
Mobile, AL 36616 or fax them to (251) 574-8103.

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