Notice Of Change Or Discontinuance Form - City Of Muskegon Heights
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1CITY OF MUSKEGON HEIGHTS
INCOME TAX DEPARTMENT
NOTICE OF CHANGE OR DISCONTINUANCE
ACCOUNT NUMBER (FEIN)
CHANGES EFFECTIVE ON (Date)
CURRENT LEGAL NAME
CHANGE LEGAL NAME TO
DBA
CHANGE DBA TO
CURRENT LEGAL BUSINESS ADDRESS
CHANGE LEGAL BUSINESS ADDRESS TO
MAILING ADDRESS
CHANGE MAILING ADDRESS TO
Instructions: Place an “X” in all boxes that apply. Complete all information for that change.
Write any comments or explanations on back of form.
1. The Internal Revenue Service assigned us Federal Employer Identification Number: ____________________________________
2. Our Federal Employer Identification Number is wrong. The correct number is: _________________________________________
3. We have incorporated. Our corporate name is: __________________________________________________________________
4. Our new corporate Federal Employer Identification Number is: ______________________________________________________
5. Discontinue our withholding tax registration:
We no longer have any business activity in the City of Muskegon Heights.
We closed our business on: ___________________
We sold our entire business on: ________________
We sold our business to:
_______________________________________
_______________________________________
_______________________________________
We sold part of our business on: ________________
Their FEIN is: ____________________________
6. Address and phone number where we may be reached following discontinuance of business:
______________________ _____________________ _____________ ____ _________ _____________
CONTACT PERSON
STREET ADDRESS
CITY
STATE
ZIP CODE
PHONE
7. Change in ownership. (Please explain on back)
8. Effective _________________, we changed our fiscal year ending from __________ to __________
MONTH/YEAR
MONTH
MONTH
9. Other changes. (Please explain on back)
SIGNATURE OF PREPARER
PRINTED NAME OF PREPARER
DATE PREPARED
PREPARER’S PHONE NUMBER
(
)
-
MAIL THIS NOTICE AND ANY CORRESPONDENCE TO: CITY OF MUSKEGON HEIGHTS INCOME TAX DIV., 2724 PECK STREET, MUSKEGON HEIGHTS, MI 49444
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Parent category: Financial