Close Account Application

Legal Name / Business Name:

FEIN / Tax ID Number:

Business Type *

Sole Proprietor
LLC
Corporation (C-Corp / S-Corp)
Partnership
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Phone *

Email *

Business Address *

Account Information

Account/Permit Number:

Type of Account to be Closed

Sales Tax
Fuel Tax
IFTA
Payroll
Other
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State of Filing:

Last Filing Period Submitted:

Date to be Closed:

Reason for Closing Account

Business Dissolved
Business Sold/Transferred
No Longer Operating in State
Duplicate Account
Other
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Supporting Documents

Please upload clear copies of the following:

Certificate of Dissolution / Articles of Dissolution

Bill of Sale (if business sold)

Final Return Confirmation

Other supporting document:

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