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CITY OF OWENSBORO/DAVIESS COUNTY FISCAL COURT
Business License Change Request
PO BOX 10008, OWENSBORO KY 42302
PHONE: (270) 687-5600 FAX: (270) 687-8526 www.owensboro.org
Name of Business ___________________________________ Account # ______________________________
Name change ONLY
(if changing entity, you must complete NEW business license application)
Current Name of Business _______________________________ New Name _____________________________
Business activity change
(must be signed by OMPC)
Current business activity __________________________________ New Activity ____________________________
Physical address change
(must be signed by OMPC)
Current physical address _____________________________________________________________________________
New physical address ________________________________________________________________________________
Mailing address change ONLY
Current mailing address ______________________________________________________________________________
New mailing address _________________________________________________________________________________
Change employee type (adding employees or terminating employees)
Employee start date: ____________________________ Employee end date: ____________________________
Mail form to: Fax to: Drop off at:
City of Owensboro 270-687-8526 City Hall
PO Box 10008 101 E 4
th
St
Owensboro KY 42302 Owensboro Kentucky
PLANNING & ZONING ADMINISTRATOR/BUILDING INSPECTOR (270) 687-8665
Approval: ______________________________________ Date: ___________________________
Comments: _______________________________________________________________________________
____
_____________________________________________________________________________________
I hereby certify all information and statements herein are true and correct
Signature ____________________________________________ Date: _______________________
Print Name: _________________________________________ Title: _
______________________
CHANGES WILL ONLY BE MADE IF YOUR BUSINESS LICENSE ACCOUNT IS CURRENT
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(if changing entity, you must complete NEW business

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Completed 8 July 2022

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