Business Change Form

	JOHN ULIBARRI Weber County Assessor Machel Maycock Chief Deputy Assessor 2380 Washington Blvd. STE 380 Ogden UT 84401 Phone: (801) 399-8572 Fax: (801) 399-8308

Business Change Form
Business Name:	Account:
Owner:	Telephone:
Address:
Contact Person:
Telephone:	Email:
Change of Address
Previous Address:
New Address:	When:
Business Name Changed
Previous Name:
New Name:
Sold Business
Date Business Sold:	Business at same location? Yes No
Who has possession of equipment?
Closed Business
Date Business ceased operation:	Business License cancelled? Yes No
How was equipment disposed?
Filed Bankruptcy
What is the case Number?	Status of Filing?
Date of Bankruptcy?	Business in operation? Yes No

Electronic Signature:	Date: