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ASSESSOR - BUSINESS CHANGE FORM

Questions marked with * are required

* Business Name:
* Account:
* Business Address:
* Contact Person:
* Contact Telephone:
* Contact Email:
Business Owner:
Business Telephone:

Change of Location Address

Previous Address:
New Address:
When:

Change of Mailing Address

Previous Mailing Address:
New Mailing Address:
When:

Business Name Changed

Previous Name:
New Name:

Sold Business

Date Sold:
Business at same location?	Yes No
Who has possession of equipment?
New owner's contact information:

Closed Business

Date Closed:
Business License cancelled?	Yes No
How was equipment disposed?

Filed Bankruptcy

What is the Case Number?
Status of Filing?
Date of Bankruptcy:
Business in operation?	Yes No

Typed Signature


Date Signed:
* Signature: