Change of Business Information - Wa
Change of Business Information
Form BLS 700 160
Business Licensing Service PO Box 9034 Olympia WA 98507-9034 360-705-6741 BLS@dor. Fax: 360-705-6699
Business Information Change Form
For faster services make these changes online at dor.change
This form can be used to make simple changes to your business account.
This form cannot be processed if the required signature in Section E (on page 3) is not complete. Business Licensing Service will contact you if additional forms or fees are required.
The information you provide will be shared with regulatory state agencies and/or local jurisidictions that currently have endorsements listed on your business license.
A Current account information
Name of an owner, partner, corporate officer, or LLC manager/member (last, first, middle):
Business name/trade name: Current UBI number (Required):
B Update the following information
Change license mailing address
Change mailing address for all business locations
Change mailing address for: DOR/Excise tax account Employment Security Labor & Industries
Change mailing address to:
If additional tax registration accounts need to be updated, please provide:
Old mailing address:
Change business location address to: Include street address, city, state and zip. Cannot use a PO Box or PMB as a physical/location address.
Old business location address:
Change phone number to:
Old business phone number:
Change email to:
Old email:
Continued ...
To ask about the availability of this publication in an alternate format for the visually impaired, please call 360-705-6705. Teletype (TTY) users may use the WA Relay Service by calling 711.
BLS 700 160 (5/17/22)
Page 1
Change of Business Information
Change business location name to: To change the business location name for a liquor or vehicle dealer endorsement, contact 360-705-6744 for instructions.
Change owner's legal name to: To change ownership structure, e.g., sole owner to corporation, or to assume an existing business, visit dor.changeownership.
Owner's prior name:
Add Spouse
Remove Spouse
Spouse name:
Effective date:
Reason for adding/removing name:
Do you want spouses name to appear on license?
Yes
No
Change in business activities:
C Cancel the following
City endorsement
State endorsement
List all endorsements and/or trade names you want to cancel:
Trade name
D Close account(s), business, or location
Close account at:
DOR/Excise Tax Account
Employment Security
Labor & Industries
Note: To close a corporate account with the Secretary of State, visit sos..
Business Licensing
Date business closed:
Date last wages paid:
Reason for account closure:
Did you sell your business?
Yes
No
If yes, indicate the purchaser name and UBI if available:
Other information:
Close location address: (If closing multiple locations, add an attachment with location address, closure date, and reason.)
Closure date:
BLS 700 160 (5/17/22)
Reason:
Page 2
Change of Business Information
E Signature (REQUIRED)
I declare under the penalties of perjury that:
? I am a governing person or authorized representative of this business making this change; and
? The answers contained, including any accompanying information, have been examined by me and are true, correct, and complete.
I certify that I understand a misrepresentation of fact is cause for rejection of this application or revocation of any license issued.
Print name:
Date:
Signature: _________________________________________________________________________________
Phone:
Email:
BLS 700 160 (5/17/22)
Page 3
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