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PLANNING DEPARTMENT, BUSINESS LICENSE DIVISION 200 S. Anaheim Boulevard, Suite 136 Anaheim, CA 92805 (714) 765-5194 Fax (714) 765-4664 email: [EMAIL REDACTED] REQUEST TO CLOSE BUSINESS LICENSE If you wish to close your City of Anaheim business license, please complete the following information and submit any documents which support your request to our office. Business Tax Certificate Number: BUS - Business Name: Business Address: Owner’s Name: Daytime Contact Number: ( ) Last date of Business: Check any that apply: No longer conducting business (all governmental filings have been closed) Business moved out of Anaheim (all governmental filings updated) Please provide new business location information: Address City State Zip Code City License Please provide date and initial below all that apply to your business: Sellers permit closed. Date: Initial: Fictitious Business Name Abandonment/Publication Date: Initial: Corp/ LLC/ LP Dissolution Date: Initial: Contractor’s License closed Initial: Anaheim Utilities closed as of Initial: Pursuant to Anaheim Municipal Code Section 3.04.070 holding an active permit or license with another government agency indicating that your business is in the City is “evidence of doing business” and would require a valid City of Anaheim business license. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct of my own knowledge. I understand any statements made herein will be verified. Signature Title Date Staff Use: Reviewed by: _ Date: SIGN