Form Tx-13 - Employer Termination Of Registration Report
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1TX-13 (Revision Date 12/13/2005)
STATE OF RHODE ISLAND
DIVISION OF TAXATION - EMPLOYER TAX SECTION
ONE CAPITOL HILL STE 36, PROVIDENCE, RI
02908 - 5829
Telephone - (401) 574-8700 (Option 1)
Fax (401) 574-8940
EMPLOYER TERMINATION OF REGISTRATION REPORT
R. I. Reg. No.
Person having custody of Books and Records
EMPLOYER
1.
2.
NAME
NAME
BUSINESS
ADDRESS
ADDRESS
CITY,
CITY, STATE,
STATE
ZIP CODE
zip code
3. (a) Reason for Termination of Registration:
Sale
Lease
Foreclosure
Liquidation
Death of Owner
Receivership
Reorganization
Bankruptcy
Merger
Other (Explain)
(b) What percentage of the business was transferred? (If Applicable )
(c) Date of Action in 3(a) above
(d) Date of Last Payroll
(e) Give the following information concerning Owners, Partners, Corporate Officers, etc.:
HOME ADDRESS
& ZIP CODE
NAME
TITLE
TEL. NO.
4. (a) Name of new business (If any):
(b) Name, address and ZIP code of New Owners, (If any):
Tel. No.
5. (a) Are you continuing any other business in Rhode Island ?
YES
NO
If Yes,
(b) Name, address and zip code of Continuing Business:
TITLE
DATE
SIGNATURE
THIS FORM MUST BE SIGNED
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