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CITY OF SAGINAW S-6-IT
INCOME TAX OFFICE
NOTICE OF CHANGE OR DISCONTINUANCE
ACCOUNT NUMBER CHANGES EFFECTIVE ON (Date)
CURRENT LEGAL NAME CHANGE LEGAL NAME TO
DBA CHANGE DBA TO
CURRENT LEGAL BUSINESS ADDRESS CHANGE LEAGE 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 explanation in back of form.
1. The Internal Revenue Service assigned us a 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 Saginaw
• 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 SAGINAW INCOME TAX OFFICE, 1315 S. WASHINGTON AVE., SAGINAW, MI 48601-2599
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