CITY OF BIRMINGHAM
REVENUE DIVISION
ROOM TL-100 CITY HALL
TH
710 N 20  ST
BIRMINGHAM, AL 35203-2227

(205) 254-2198 OFFICE
(205) 254-2963 FAX

CHANGE OF TAXPAYER INFORMATION:
Note: This form is to be used only if a change has occurred in the name, ownership, number of locations, mailing or location address of your
firm, or in your federal employer identification number.
PLEASE PROVIDE THE FOLLOWING INFORMATION AS IT CURRENTLY  APPEARS ON YOUR CITY OF
BIRMINGHAM TAXPAYER ACCOUNT:               Taxpayer ID# ________________________

Name__________________________________________________________________________
Mailing Address__________________________________________________________________
_______________________________________________________________________________
City, State, Zip___________________________________________________________________

Please check the appropriate responses and provide the information requested as follows:

            1.       The mailing address forsales tax  , …       occupational tax   , … sellers use tax  ,…        consumers use
                     tax  ,… lease tax  … , and/or      lodgings tax   …forms has changed. The new address to which forms
                     should now be mailed is as follows: (Attach additional sheets if necessary).

                             Taxpayer Name: _________________________________________________________
                             D/B/A Name:      _________________________________________________________
                             Attention:                  _________________________________________________________
                             Address 1 :                 _________________________________________________________
                             Address 2 :                 _________________________________________________________
                             City, State, Zip Code: _____________________________________________________
                             Phone/Fax Number:   __________________________ / __________________________
                             Name of Contact:       _____________________________________________________
            2.       A total of ______ new business locations have been added as follows:   (Attach additional sheets
                     for additional locations if necessary.)     IMPORTANT  NOTE:  Any  change in the  physical location of  your
                     business must be approved by the City of Birmingham Planning, Engineering and Permits Department, pursuant
                     to the requirements of the City's Zoning Code   Failure.to obtain approval from the Planning, Engineering and
                     Permits  Department  for  a  change  of the physical  location of  your  business invalidates any  business license
                     issued, and may result in the revocation of the business license.

                             Taxpayer Name: _________________________________________________________
                             D/B/A Name:      _________________________________________________________
                             Attention:                  _________________________________________________________
                             Address 1 :                 _________________________________________________________
                             Address 2 :                 _________________________________________________________
                             City, State, Zip Code: _____________________________________________________
                             Phone/Fax Number:   __________________________ / __________________________
                             Name of Contact:       _____________________________________________________

                     The business has been sold … , acquired  ,… or closed  .  A…new Federal Employer Identification
            3.       Number has been issued ….

                             Effective Date of Change: __________________________________________________
                             Former Owner Was:             __________________________________________________
                             The New Owner Is:             __________________________________________________
                             Address of New Owner:    __________________________________________________
                                                           __________________________________________________
                             Phone and/or Fax No.:    __________________________________________________
                             Old Federal Employer Identification Number:  __________________________________
                             New Federal Employer Identification Number: __________________________________
                             Name of Contact:  ________________________________________________________