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Get Coam License Cancellation Request Form
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How to fill out the COAM License Cancellation Request Form online
The COAM License Cancellation Request Form is an essential document for users seeking to cancel their COAM license. This guide provides clear, step-by-step instructions to help you accurately complete the form online, ensuring that all required information is submitted correctly.
Follow the steps to complete the COAM License Cancellation Request Form online:
- Press the ‘Get Form’ button to access the form and open it in your editor.
- Fill in the COAM license number in the designated field. Ensure that this number matches your current license.
- Enter your business's legal name where indicated. This must be the official name as registered.
- Input the physical address of your business, including the complete street address for accurate identification.
- Provide the city, state, and zip code of your business address. Double-check for spelling errors.
- In the next section, write the full name of the owner or owners of the business.
- Enter the phone number of the owner(s) for any follow-up communication.
- Input the current home address of the owner(s), including city, state, and zip code.
- State your reason for the cancellation in the provided space, ensuring to explain clearly.
- Indicate the effective date of the cancellation accurately. This is the date from which you no longer wish to operate under the COAM license.
- Mark the appropriate option for the Financial Security Deposit (FSD) on file with a ‘yes’ or ‘no’.
- If you selected ‘yes’ for the FSD, provide the address where the FSD should be returned, again including city, state, and zip code.
- Review the acknowledgment statement carefully before signing, as it confirms your understanding of the responsibilities that remain after cancellation.
- Print your name where indicated, sign the form, and include the date you signed it.
- Once completed, save your changes, and you can choose to download, print, or share the form as needed.
Complete your COAM License Cancellation Request Form online today.
Some examples of Class A COAMS are kiddie rides, skeeball, claw machines, pinball games, pool tables, jukeboxes and similar machines. They do not allow points to carry over to subsequent play. Class B machine: An electronic machine that is used by the public to provide amusement or entertainment.