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 – “Occupational Tax Office” Link 
   
 Business Name:  
  
 Federal Empoyer ID #:                                              or  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: 
  
 Na:me        P   e                                         hoNrnu:ebm                     
  
 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. 
  
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