Get Ga Coam License Cancellation Request Form 2020-2025

This guide provides step-by-step instructions for completing the GA COAM License Cancellation Request Form online. Carefully follow the guidance to ensure your form is accurately filled out and submitted.

Follow the steps to complete your cancellation request form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your COAM license number in the designated field. This number is crucial for identifying your account.
3. Provide the legal business name associated with the license. Make sure this matches the name on file.
4. Fill in the physical address of the location where the COAM is operated, including city, state, and zip code.
5. List the owner(s) full name(s) in the specified section. This ensures that all relevant parties are accounted for.
6. Include the owner(s) phone number for any necessary communication regarding your request.
7. Input the current home address of the owner(s), including city, state, and zip code.
8. State the reason for cancellation clearly. This section helps to document your intent.
9. Indicate the effective date for the cancellation. Make sure this date aligns with your plans for discontinuing operations.
10. Confirm if there is a financial security deposit (FSD) on file by selecting ‘Yes’ or ‘No’.
11. If a financial security deposit is to be returned, provide the address where it should be sent, including city, state, and zip code.
12. Read the acknowledgment statement thoroughly. Ensure you understand the implications of cancellation before signing.
13. Print the owner’s name, sign, and date the form in the respective fields to complete the request.

Complete your GA COAM License Cancellation Request Form online today.