Fillable CERTIFICATION OF CLOSED OR SOLD BUSINESS (City of Winchester)

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CERTIFICATION OF CLOSED OR SOLD BUSINESS (City of Winchester)

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Elected to Serve
Ann T. Burkholder, Commissioner of the Revenue Telephone: (540) 667-1815
Creamery Building, 21 S Kent St, Suite 100 FAX: (540) 667-8937
Winchester, VA 22601 TDD: (540) 722-0782
Email: commrevenue@winchesterva.gov Website: www.winchesterva.gov
CERTIFICATION OF CLOSED OR SOLD BUSINESS
Business Name: ______________________________________________________________
Trade Name (if different): _______________________________________________________
This business was:
PERMANENTLY CLOSED AS OF DATE: __________________________________
SOLD AS OF DATE: __________________________________________________
Signature: __________________________________________________________________
Print Name and Title: __________________________________________________________
Telephone: ______________________________ Date: ________________________
UPDATED INFORMATION FOR CLOSED/SELLING OWNER:
Mailing Address: ______________________________________________________________
____________________________________________________________________________
Phone / Email: ________________________________________________________________
IF SOLD, INFORMATION FOR NEW OWNER:
Name: ______________________________________________________________________
Mailing Address: ______________________________________________________________
____________________________________________________________________________
Phone / Email: ________________________________________________________________
---------------------------- Commissioner of the Revenue Office Use Only ----------------------------
Control #: ________ Initials: ___________________ Date:___________________
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CERTIFICATION OF CLOSED OR SOLD BUSINESS (City of Winchester)

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Completed 17 July 2020

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