ST. CLAIR COUNTY COMMISSION                                                                            

                 ST. CLAIR COUNTY SALES TAX DEPARTMENT 
                                                                                         
                                                                                     TH                                      
                                                                           165  5  AVENUE   SUITE 102 
                                                                                                                            KELLIE GRAFF 
  PAUL MANNING                                                             ASHVILLE,  ALABAMA  35953                         ADMINISTRATOR 
      CHAIRMAN                                                             TELEPHONE  (205) 594-2108 
                                                                                     FAX  (205) 594-2110 
                                                                                                                              
             BUSINESS   SOLD  /  BUSINESS   CLOSING   FORM                                                                   
 
BUSINESS NAME  _______________________________________________________________________ 
 
STREET  AND MAILING ADDRESSES ______________________________________________________ 
 
                                                                    _______________________________________________________ 
 
                                                                    _______________________________________________________ 
 
TELEPHONE: _____________________________ 
 
FORMER OWNER’S NAME _______________________________________________________ 
 
DATE  OF SALE  __________________________________ 
 
         OR 
 
DATE THAT BUSINESS WILL PERMANENTLY CLOSE _________________________________ 
 
NEW OWNER NAME ____________________________________________________________ 
 
HOME ADDRESS ________________________________________________________________ 
 
HOME TELEPHONE ______________________________________________________________ 
 
COMPLETE THIS FORM AND MAIL TO:   ST. CLAIR COUNTY SALES TAX DEPARTMENT 
                                                                           165  5  THAVENUE     SUITE 102 
                                                                            ASHVILLE,  AL   35953 
                                                                            Phone: 205-594-2108     Fax:  205-594-2110 
                                                                            www.stclairco.com