City of Lakewood Online Sales/Use Tax Account Change Form

License Number: 

Business Name: 

Email Address: 

Address: 

City: 

State: 

Zip: 

 

 

 
   
   
   
   

 

Effective Date of Change:  Sunday, January 01, 2012 Select a Date Delete the Date

 

Request to Change:

 

Authorized Agent: 

Title: 

Phone Number: