Business Tax Receipt Update Form

Business Tax Receipt Update Form
This form is for submitting changes to an existing Business Tax Receipt. Physical business address changes are not permitted.
This form cannot be used to update any of the following:
- Physical business location
- New owner information
- New EIN
- New legal entity / legal business name
I acknowledge that the items listed above cannot be changed using this form.
Current Business Information
Business Tax Receipt (BTR) Number:*
Business DBA (Doing Business As):*
Business Phone:*
Format: (000) 000-0000.
Business Email:*
example@example.com
Type of Update Requested
Type of Update Requested*
Updated Information*
I acknowledge that certain updates may require additional documentation or review.
Applicant Certification
I certify that the information provided is true and correct to the best of my knowledge.
Printed Name:*
Signature:*

Clear
Date:*

MonthDayYear
Date
Should be Empty: