CHICAGO DEPARTMENT OF FINANCE 
                BUSINESS CHANGE FORM FOR TAX PURPOSES ONLY                                                                           BCF 
       (DO NOT USE THIS FORM IF YOU HOLD A CHICAGO BUSINESS LICENSE. FOR LICENSE CHANGES, CALL 312-747-IRIS (4747)) 
                         Please email completed document to: RevenueDatabase@cityofchicago.org                                                                                                     
                 OR mail to: Chicago Department of Finance, Database Unit, 2 N. La Salle Street, Suite 1310, Chicago IL 60602 
  I. Account Information Before Business Change 

  IRIS Account #  ________________  Site # ____________  Medallion # _____________  Date Acquired ______________   
  Business Name  ________________________________________________  Owner Name _____________________________  
  Business Address ______________________________________________________________  F.E.I.N.  __________________  
  Mailing Address  ______________________________________________________________  I.B.T.N. __________________  
  II. Change in Business Name or Address 

  New Business Name                     
  New Business Address  ________________________________ City ____________ State __________Zip Code ____________  
  New Mailing Address _________________________________ City ____________ State __________Zip Code ____________  
  III. Change of Responsible Person(s) 
  Provide the name and title of all new officers, general partners, or Limited Liability Company managers. 
  (Attach separate sheets if necessary). 
       Name                                                                                                    Title 
       Name                                                                                                    Title 
  IV. Change in Business Operations 
  Identify and explain any changes in services, products, or internal operations that may require your business to pay other 
  Chicago taxes. (Attach separate sheets if necessary). If your change makes your business subject to a Chicago tax, complete 
  an Affidavit (For Initial Taxable Period). If your change makes your business no longer subject to a tax, complete an Affidavit 
  (For Final Taxable Period). If your business ceased operations you must file all tax returns within 45 days after the close of 
  the business. 

  If your business ceased operations (out-of-business), provide date, and attach supporting documents. Date __________________  
  If your business ceased operations due to a change in ownership, please provide buyer’s information in Section V. 
  V. Change in Ownership 
  If you sold or transferred the business or medallion named in section I above, provide the buyer information below and check 
  Transferee. If you purchased or acquired by transfer the business or medallion named in section I above, provide your 
  information below and check Transferee. If you are the business in section I above and you are acquiring another business, 
  provide the information of the acquired entity and check Transferor. Provide the date of change in ownership.             You must 
  contact the Department of Finance Bulk Sales Unit and complete a Bulk Sales Notification Form 45 days before the 
  date of sale. 
  Name ____________________________________________________________________ Phone (                                         ) _________________  
  Address _____________________________________________________________ IRIS Account # (if known) ____________  
  (Check one) Transferee  _______ Transferor  _________ Date of Change in ownership               

  VI. Comments 
  
  VII. Owner/Officer Statement 
  Under penalty or perjury, I certify that I have examined this Business Change Form and it is true, correct, and complete. 
  Print Name                                                                                                          Date  
  Signature                                                                             Title                                                                                                     
    Phone (     )                                                                         Email Address