CITY OF PORTLAND BUSINESS LICENSE TAX
& MULTNOMAH COUNTY BUSINESS INCOME TAX
111 SW COLUMBIA, SUITE 600, PORTLAND OR 97201
Office: 503-823-5157 ~ TDD: 503-823-6868 ~ FAX: 503-823-5192
Additional Forms & Information: www.portlandoregon.gov/biztax
MAIL or FAX completed form to:
City of Portland Revenue Division, 111 SW Columbia St., Suite #600, Portland, OR 97201-5840
FAX: 503-823-5192
Upon notification that the business is no longer operating the Revenue Division will make the necessary notations on
your account, however, you are still required to file a final Combined Tax Return for the year you ceased business.
Printed Name: _______________________________________ Date: _______________________
Signature: __________________________________________ Telephone: __________________
FORM OB (Rev 11/30/2016)
Form closes a City of Portland Business License Tax and/or Multnomah County Business Income Tax account.
OUT OF BUSINESS NOTIFICATION FORM
FORM OB
REV 11/30/2016
CITY
STATE/PROV ZIP/POSTAL CODE
BUSINESS ADDRESS
TAX ID #
BOTH PORTLAND &
MULTNOMAH COUNTY
PORTLAND ONLY MULTNOMAH CO. ONLY
DATE BUSINESS CEASED OPERATION
CHECK JURISDICTION(S) AFFECTED BY CLOSURE
BUSINESS/TAXPAYER NAME
BUSINESS TAX ACCOUNT #
BUSINESS INFORMATION
REASON(S) FOR CLOSURE
Select all applicable reasons for closure:
Sold business
If the business is sold, is there continuing income from the sale? Income from the sale of a business is
considered business income and must be reported. Contract (installment) sales are also considered
continuing business income.
If you own the real property and intend to rent or lease to others, check here
Sold property
Did you sell some or all real property on contract (installment) sale?
Provide New Owner information:
CITY
STATE/PROV ZIP/POSTAL CODE
NEW OWNER ADDRESS
NEW OWNER NAME
SIGNATURE
Changed tax entity / incorporated (Attach new business registration form (Form REG))
Ceased all business activity — no longer conduct any business activity anywhere
Ceased business activity in the City and Multnomah County only
Other
SPECIFY “OTHER” REASON (ATTACH ADDITIONAL INFORMATION IF NEEDED)
YES NO
