F-6-IT
                                                  CITY OF FLINT
                                                  INCOME TAX DEPARTMENT

                                 NOTICE OF CHANGE OR DISCONTINUANCE
ACCOUNT NUMBER (FEIN)                                         CHANGES EFFECTIVE ON (Date)

CURRENT LEGAL NAME                                            CHANGE LEGAL NAME TO:

DBA                                                           CHANGE DBA TO:

CURRENT LEGAL BUSINESS ADDRESS                                CHANGE LEGAL BUSINESS ADDRESS TO:

MAILING ADDRESS                                               CHANGE MAILING ADDRESS TO:

                   Instructions:  Place an “X” in all boxes that apply.  Complete all information for that change.
                                 Write any comments or explanations on back of form.

‰ 1. The Internal Revenue Service assigned us Federal Employer Identification Number: ____________________________________

‰ 2. Our Federal Employer Identification Number is wrong.  The correct number is: _________________________________________

‰ 3. We have incorporated.  Our corporate name is: __________________________________________________________________

‰ 4. Our new corporate Federal Employer Identification Number is: ______________________________________________________

‰ 5. Discontinue our withholding tax registration:

    ‰ We no longer have any business activity in the City of Flint.

    ‰ We closed our business on: ___________________

    ‰ We sold our entire business on: ________________        We sold our business to:

    ‰ We sold part of our business on: _______________        _______________________________________
                                                              _______________________________________
                                                              _______________________________________

                                                              Their FEIN is: ____________________________

‰ 6. Address and phone number where we may be reached following discontinuance of business:

    ______________________  _____________________  _____________  ____  _________  _____________
     CONTACT PERSON              STREET ADDRESS               CITY                 STATE  ZIP CODE                PHONE

‰   7. Change in ownership.  (Please explain on back)

‰   8. Effective _________________, we changed our fiscal year ending from __________ to __________
                      MONTH/YEAR                                                         MONTH       MONTH

‰   9. Other changes.  (Please explain on back)
SIGNATURE OF PREPARER            PRINTED NAME OF PREPARER                   DATE PREPARED      PREPARER’S PHONE NUMBER

                                                                                   (      )         -MAIL THIS NOTICE 

AND ANY CORRESPONDENCE TO:  CITY OF FLINT  INCOME TAX  DEPT., Attn: Withholding Section, PO Box 529, Eaton Rapids, MI  48827-0529