Form B-2a-Notice Of Change June 2006 printable pdf download

Vermont Department of Taxes

Phone: (802) 828-2551, option #3

Business Tax Division

Fax:

(802) 828-5787

PO Box 547

Montpelier, VT 05601-0547

Form

NOTICE OF CHANGE

B-2a

Complete Section A with information as it currently is in our files. Any corrections should be made in Section B.

Federal ID Number

VT Account Number

Registered Business Name

Address

City, State, ZIP Code

Check all appropriate boxes below and mail to us at the address above.

Cancel Account*

Tax Type: _____________ Account No: ___________________________________ Date taxable activity discontinued: ___________________

* If you are requesting a cancellation of a Sales and Use tax and/or Meals and Rooms tax account(s), please also enclose the tax license you were

issued, or explain the absence of same below (i.e.: lost, destroyed, etc.). LICENSES ARE NOT TRANSFERABLE TO NEW OWNER OR ENTITY.

Add __________________________ Tax Type to this account beginning _______________________________________________________

Name, Address, Federal ID No. changed as noted below.

NEW Name ___________________________________________________________________________________________________

NEW Address _________________________________________________________________________________________________

NEW Federal ID Number ________________________________________________________________________________________

Business sold to: ________________________________________________________________________ Date sold: ___________________

Change of entity type** (Example: Sole Proprietor to Corporation). Describe: __________________________________________________

** You may use this form to cancel the original account, but you need to register the new entity by completing Form S-1, Application for Business

Tax Account. Both returns can be mailed in the same envelope.

Reason for requesting this change: ________________________________________________________________________________________

____________________________________________________________________________________________________________________

Signature of Officer or Authorized Agent

Title

Date

Printed Name of Officer or Authorized Agent

Phone Number

E-mail address

Form B-2a

Rev. 6/06

Form B-2a-Notice Of Change June 2006