税勝署受付印
個人事業の開廃業等届出書
住所地・居所地・耶業所等（該当するものを○で囲んでください。）
個人事業の開廃業等について次のとおり届けます。
事業の引継ぎを受けた場合は、受けた先の住所・氏名を書いてください。
届出の区分
事務所・事業所の（新設・増設・移転・廃止）
廃業（事由〉
(事業の引継ぎ（譲渡）による珊合は、引き継いだ（譲渡した）先の住所・氏名を沓いてください。）
開廃業日
開廃業や事務所・事業所の新増設等のあった日 平成 年 月 日
事業所等を新増設、移転、廃止した場合
Seal for acceptance in tax office
Open and close private business notification form
Address, Dwelling place, workplace, etc (Circle all that apply.)
This is to submit about open or close private business accordingly.
Please write the successor's address and name if you are took over the business.
Classification of notification
Office, business facility (New construction, extension, relocation, abolishment)
Close business (Reason)
(In case of business transfer (disposition), please write the address and name who is taken over (disposed). )
Open or Closed date
The date to open or close, or the office or workplace was newly constructed or extended.
Heisei YY, MM,DD
In case that the workplace etc was newly constructed, relocated, and abolished;
新増設、移転後の所在地
移転・廃止前の所在地
廃業の事由が法人の設立に伴うものである場合
設立法人名
代表者名
法人納税地
設立登記
開廃業に伴う届出書の提出の有無
｢青色申告承認申請書j又は「青色申告の取りやめ届出書」
消費税に側する「課税事業者選択届出書」又は「事業廃止届出書」
事業の慨要
相続（平成21年2月17日）による
不動産貸付
できるだけ具作的に醤いてください
給与等の支払の状況
区分
従業員数
給与の定め方
税額の有無
その他参考事項
源泉所得税の納川の特例の承認に関する申諦沓の提出の有無
Location after new construction or relocation
Location before relocation or abolishment
In case that the reason of abolishment was involved with the establishment of corporation,
Established corporate name
Representative's name
Corporate tax payment location
Organizing registration
With or without submission of notification involved with open and close business
"Blue return approval application" or "Blue return cancellation notification"
"Taxation business owner adoption notification" or "business abolishment notification" meeting consumption tax
Business overview
According to inheritance (February 17th, 2009)
Real-estate lending
Write in concrete as much as possible
The situation of the payroll etc
Classification
Number of employees
Determination of salary
With or without tax
Other reference
With or without submission of the application regarding exception approval on payment of withholding income tax
