CDTFA-65 (FRONT) REV. 32 (10-17) STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF TAX AND FEE ADMINISTRATIONNOTICE OF CLOSEOUT
INSTRUCTIONS: Please provide the following information to assist us in closing your account(s), releasing security, or issuing an
escrow clearance. If you have a seller’s permit, before completing this form, you should refer to a copy of the California Department
of Tax and Fee Administration (CDTFA) publication 74, Closing Out Your Account. Publication 74 contains important information about
closing out your permit. If you have any questions, please call our Customer Service Center at 1-800-400-7115 (TTY:711).
SECTION I: ACCOUNT INFORMATION
NAME ACCOUNT NUMBER(S)
CURRENT ADDRESS (street address) DAYTIME TELEPHONE NUMBER
( )
CITY STATE ZIP CODE
SECTION II: CLOSEOUT INFORMATION (see back for instructions)
1. Date business was closed
2. Did you make any purchases for your own use using your seller’
s permit? YES
NO
If YES, did you pay tax on those purchases to: a. your vendor b. the CDTFA
3. Do you have a prepaid Mobile Telephony Services (MTS) account? YES
NO
a. Date you discontinued selling prepaid phone cards and/or services
b. If you qualify as a small seller, date you want your account closed out
4. Your forwarding address and telephone number
5. Location of your books and records
6. Was the business sold? YES
NO
a. Date the business was sold
b. Total sales price $
c. Name, address, and telephone number of the purchaser
d. Didyousellthexturesandequipment(F&E)? YES
NO If no, proceed to line h.
e. SellingpriceofF&E$
f. DidthesaleofF&Eoccurattheplaceofbusinessthatwassold? YES
NO
g. If not, provide address for the place of business where the sale took place
a. Note: Ifyousoldyourxturesandequipment,evenifyoudidnotsellyourbusiness,youmustincludethesellingpriceof
theseitemsonyournalreturnunder“PurchasesSubjecttoUseTax”
h. Escrow number
i. Name, address, and telephone number of escrow company
SECTION III: LIST OF ITEMS NEEDED FOR CLOSEOUTS
(see back for instructions)
Thefollowingitemsmaybeneededtonalizetheclosingofyouraccount(s),thereleasingofanypostedsecurity,orissuingofan
escrow clearance.
•
Payments of any other outstanding balances due.
• Yournaltaxreturnwithpayment(ifareturnisnotavailable,call1-800-400-7115TTY:711).Paymentofanyamountsdue
mustbemadeincertiedfundsinordertoexpeditenalizingyourtransaction.IfyouarerequiredtomakepaymentsbyEFT,
youmustalsomakeyournalpaymentthroughtheEFTprocess.
• Acopyofyourescrowinstructionsorbillofsaleshowingthevalueofinventory,xtures,andequipmentsold.
Send this completed form and your supporting documents to:
California Department of Tax and Fee Administration
Customer Service Center
PO Box 942879
Sacramento, CA 94279-0090
SECTION IV: SIGNATURE
SIGNATURE PRINT NAME AND TITLE DATE