City of Farmington
 800 Municipal Drive
Farmington, NM 87401
Phone (505) 599-1170
Fax (505) 599-1113

Business Registration/Licensing Change Form
Business name currently on file:
 
Business Name (or dba) and Registered or Legal Name
New Business Information: (Only complete the information that has changed)


Business Name (or dba) and Registered or Legal Name


Physical Address


Mailing Address

Phone Number(s)
  
Emergency Number

 

Business is a: | Sole Proprietorship | Partnership | LLC | Corporation |Other

New Mexico State Taxation & Revenue ID # or (CRS#):
Approximate hours of business operation:
Open
to
Close
 
Is this business operated from your home ? Yes   No  
Type of business (describe):
Name(s), home address(es) and home phone(s) of the owner(s), partners, or corporate officers:
Were any renovations required in order for you to operate at this location ? Yes No
Date information changed or is to change:
    Signature
By accepting this change form, the city does not guarantee approval.