Phone No. (270) 842-7168        REQUEST TO CLOSE OCCUPATIONAL LICENSE ACCOUNT             Fax No. (270) 842-3411 

                         WARREN COUNTY SCHOOLS OCCUPATIONAL TAX OFFICE 
                                 P.O. Box 51530, 303 Lovers Lane, Bowling Green, KY 42103 
                                      www.warren.kyschools.us 

Business Name:  
                                                                             
Federal Empl oyer ID #:                                       SSN: 

Date All Business Activity was Discontinued/Ceased within the Warren County School 
District:  

Date Business Last Paid Wages to Employees in Warren County, Kentucky:  

Reason for Closure Request: (business sold, closed, etc.): 

Current Owners  
Forwarding Address: 
(Business site &/or local address) 

Mailing Address (if different from above): 

Telephone Number:      Fax Number: 

If Business is Under New Ownership, Please Provide New Owner Information Below: 

N a m e :                                          P h o n e   N u m b e r :  

Other Information: 

I certify that all business activity has ceased within the Warren County School District (i.e., 
business has been sold, closed, transferred ownership, merged with another entity, etc.) as of 
the date above. I understand that the closing of this account shall in no way relieve the owners 
of this business from any Occupational License Fees due the Warren County School District 
currently, or in the future, from being paid. 

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