Business Tax Account Change Request
Please provide the 5-digit business tax number
*
Please provide the business name as it appears on your business tax receipt
Please choose the type of change you are reporting
*
Please Select
Additional Professionals Starting
Business Relocation - Address Change
Change in Nature of Business
Name Change
Mailing Address Change
Other Change
Ownership Change
For additional Professionals starting at your business as EMPLOYEES or OWNERS, please provide the name(s) and state license number(s), if applicable
If additional Professionals are starting, provide the effective starting date
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Month
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Day
Year
Date
For an address change, please provide the new location address including the suite or unit number.
For an address change, provide the date the business opened (or will open) at the new location
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Month
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Day
Year
Date
For a change in the nature of business, please provide a detailed description of the new services the business will offer. In order to better process the change, be sure your description includes all services and define the services. Example: If the business offers lawn services, describe all services including mowing, edging, removing hedges, etc.
For a name change without an ownership change, provide the new business name. This applies to a new/changed fictitious name (dba) or a corporate name change. A copy of the printout from sunbiz.org (Division of Corporations) will be uploaded at the end of this form.
If the change request is for an other change, provide a description of the change being requested.
For an ownership change, choose the type of change being made. Provide the effective date in the next section.
Sole proprietorship selling the business to a new owner
Corporate entity (e.g., LLC, Inc, etc.) where 50% or more shares were exchanged, sold, transferred, etc. to a different individual
Adding a spouse to an existing sole proprietorship
Removing a spouse or business partner from an existing business
Provide the date for the ownership change event.
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Month
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Day
Year
Date
Provide the name of the person submitting this information.
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First Name
Last Name
Title (Owner, Manager, President, etc.)
*
Signature
Provide a copy of the finalized document for a name change from sunbiz.org.
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