Request To Close Occupational License Account And Notification Of Business Activity Ceasing Within The City Limits Of Bowling Green, Ky Form - Bowling Green

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CITY OF BOWLING GREEN, KY
REQUEST TO CLOSE
OCCUPATIONAL LICENSE ACCOUNT
AND
NOTIFICATION
OF
BUSINESS ACTIVITY CEASING
WITHIN THE CITY LIMITS
OF BOWLING GREEN, KY
BUSINESS NAME:_____________________________________________________________
CITY ACCOUNT NUMBER:_____________________________________________________
REASON FOR CLOSURE REQUEST:_____________________________________________
DATE ALL BUSINESS ACTIVITY
CEASED IN THE CITY:_________________________________________________________
ADDRESSES
(CURRENT OWNER’S FORWARDING)
*IF BUSINESS UNDER NEW OWNERSHIP
ADDRESS
PLEASE PROVIDE INFORMATION BELOW
_________________________________
NAME:________________________________
_________________________________
_______________________________________
_________________________________
_______________________________________
PHONE :__________________________
PHONE :________________________________
**DOES THIS BUSINESS HOLD AN ALCOHOL LICENSE YES ( )
NO ( ) **
I CERTIFY THAT ALL BUSINESS ACTIVITY HAS CEASED WITHIN THE CITY
LIMITS OF BOWLING GREEN, KY AS OF THE DATE ABOVE. IT IS UNDERSTOOD
THAT THE CLOSING OF THIS ACCOUNT SHALL IN NO WAY RELIEVE THE
OWNERS OF THIS BUSINESS FROM ANY OCCUPATIONAL LICENSE FEES DUE
THE CITY CURRENTLY, OR IN THE FUTURE, FROM BEING PAID.
_______________________________________
__________________
SIGNATURE
TITLE
DATE
Return to: Ctiy of Bowling Green | Department of Finance | P.O. Box 1410 | Bowling Green, KY 42102-1410

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