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Business Closure Form

  1. Margaret S. Torrence
    Commissioner of Revenue
    Franklin County, Virginia
    1255 Franklin St., Suite 102
    Rocky Mount, VA 24151
    Phone: (540) 483-3083
    Fax: (540) 483-3089

  2. Is the business permanently closed?*

  3. Did the business move to another locality?*

  4. Enter your physical business address (Number and Street Name, City, State, ZIP)

  5. STATUS OF ASSETS

  6. Disposed of Assets?*

  7. Personal Use?*

  8. Sold?*

  9. CONTACT INFORMATION

  10. Enter your mailing address (Number and Street Name or PO Box, City, State, ZIP)

  11. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  12. IMPORTANT MESSAGE: The Commission of Revenue office will contact you to obtain additional information needed to process this request.

  13. Leave This Blank:

  14. This field is not part of the form submission.