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2. Former Name of Business*
3. Contact Phone Number*
5. New Name of Business*
7. Business Address*
9. 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.

   1. I agree.
11. I,Being the owner or representative of the Business stated above, request the Business Tax Department of the City of Lebanon to change the former name to the new name that is listed above.*
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13. 1. Receive an email copy of this form.
14. Email address

    This field is not part of the form submission.

15. Submit

* indicates a required field