CITY AND COUNTY OF DENVER                                            TREASURY  DIVISION  
                                                                                           WELLINGTON  WEBB BLDG.  
                      DEPARTMENT OF FINANCE                                                201 WEST COLFAX AVE, DEPT 403 
                                                                                           DENVER, COLORADO,  80202-5329 
Michael  B.  Hancock                                                                       FAX: (720) 913-9475  
   Mayor              Account Change  OR  Closure Request Form  

Please complete the form below reflecting all the requested changes to your business account(s): 

Account # :______________________________ Business Name            :____________________________________________ 

Please indicate which account(s) the change or closure should be applied to:  
                      Sales/Use           Occupational Privilege         Lodgers        FDA/TBT 

Please provide the following information regarding the requested changes to the selected account(s): 
ACCOUNT CLOSURE:  
Date of business closure:________________________  

       Out of business              Never began business           Opened account in error 
       No taxable sales             Seasonal business   
       Business, employees and all sales, services, or other taxable activity have moved out of Denver.  
       (Please include the new address below) 

       Business has moved out of Denver: BUT sales       and employee activity in Denver will continue. 
       (Sales & OPT accounts should remain open  - please complete address change below)  

       Business and all employees have moved out of Denver: BUT       sales activity in Denver will continue. 
       (Sales account should remain open – please complete address change below)  

       Business has been sold or changed ownership:  Date of business sale:____________________________________ 
       Name of new owner:_____________________________________Phone#:_______________________________  
       Address:_________________________________________ City/State/Zip:_______________________________  
ACCOUNT REACTIVATION: 

       Closed in error. Reactivate with original start date. 
       Business Reopened. New Start Date:___________              

NAME, ADDRESS OR PHONE# CHANGE:  

New Business Name:_______________________________________________________________(FEIN cannot change)  

New Address:__________________________________________City/State/Zip:________________________________  
       Location Address                MailingAddress       Both Location & Mailing Address 
New Phone #:_____________________________ 

In order to complete any of the requested changes, a signature  must  be included.             

Cancel my account effective:__________________(date)  Cause of Closure:____________________________________  

Print Name:__________________________________  
Contact  #:____________________________________  

SIGNATURE:____________________________________                     DATE:_________________________ 

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