Business Tax Penalty Waiver Request Form

Please provide the following information for your waiver request to be reviewed. All correspondence related to this request will be sent to the current address of record. You may update your business contact information by visiting Only one Business Account Number (BAN) may be referenced per waiver request.

Business Information

(Sole proprietors, enter first & last name)

Owner Name

(Name of business owner)

Applicant Name

(Name of person filling out application)

Contact Information

Business Tax Bill Information

Please enter the below information for each Tax/Fee Type you are requesting a waiver for. You may submit up to 4 waiver requests by selecting “Add Tax/Fee Type” below. If you wish to submit more than 4 requests, you will be to submit another application. Once complete, select “Add Waiver Reason” to continue.