TRADE NAME (if different):
WAS THIS BUSINESS SOLD? YES NO WERE ASSETS SOLD? YES NO
IF YES, WHO WAS IT SOLD TO?
CONTACT INFORMATION FOR NEW OWNER:
TITLE OR CAPACITY FOR SIGNING:
SIGNATURE OF AUTHORIZED PERSON:
MAILING ADDRESS FOR FINAL TAX BILL:
(Separate Form Needed For Each Location)
The owner must sign and date this form. If the business is an entity such as a trust, partnership,
limited liability company or corporation, it must be signed by a member, partner, executive officer
or other person specifically authorized in writing by the trust, partnership, limited liability company
or corporation to sign.
NOTIFICATION OF BUSINESS CLOSING
MONTGOMERY COUNTY, VIRGINIA
Helen P. Royal, Master Commissioner of the Revenue
755 Roanoke St, Suite 1A, Christiansburg, VA 24073
Business Personal Property Division
huffhn@montgomerycountyva.gov
Declaration: I hereby declare, under penalty of perjury, that the statements made herein are true,
complete and correct to the best of my knowledge and belief and that I am the owner or a member,
partner, executive officer or other person specifically authorized in writing to sign.
click to sign
signature
click to edit
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