8 822

Please type or print.

Change of Address

Form

(Rev. December 2002)

OMB No. 1545-1163

Department of the Treasury Internal Revenue Service

See instructions on back.

Do not attach this form to your return.

Part I

Complete This Part To Change Your Home Mailing Address

Check all boxes this change affects:

1

Individual income tax returns (Forms 1040, 1040A, 1040EZ, TeleFile, 1040NR, etc.)

If your last return was a joint return and you are now establishing a residence separate

from the spouse with whom you filed that return, check here

	

2

Gift, estate, or generation-skipping transfer tax returns (Forms 706, 709, etc.)

For Forms 706 and 706-NA, enter the decedent’s name and social security number below.

Decedent’s name

Social security number

		

5	Prior name(s). See instructions.

		

Part II

Complete This Part To Change Your Business Mailing Address or Business Location

Check all boxes this change affects:

8

Employment, excise, income, and other business returns (Forms 720, 940, 940-EZ, 941, 990, 1041, 1065, 1120, etc.)

9

Employee plan returns (Forms 5500, 5500-EZ, etc.).

10

Business location

11aBusiness name

11b Employer identification number

		

Part III

Signature

Daytime telephone number of person to contact (optional)

Sign

Here

Your signature

Date

If Part II completed, signature of owner, officer, or representative Date

If joint return, spouse’s signature

Date

Title

For Privacy Act and Paperwork Reduction Act Notice, see back of form.

Cat. No. 12081V

Form 8822 (Rev. 12-2002)

3aYour name (first name, initial, and last name)

3b Your social security number

4aSpouse’s name (first name, initial, and last name)

4b Spouse’s social security number

6a	Old address (no., street, city or town, state, and ZIP code). If a P.O. box or foreign address, see instructions.

Apt. no.

6b	Spouse’s old address, if different from line 6a (no., street, city or town, state, and ZIP code). If a P.O. box or foreign address, see instructions.

Apt. no.

7	New address (no., street, city or town, state, and ZIP code). If a P.O. box or foreign address, see instructions.

Apt. no.

12	Old mailing address (no., street, city or town, state, and ZIP code). If a P.O. box or foreign address, see instructions.

Room or suite no.

13	New mailing address (no., street, city or town, state, and ZIP code). If a P.O. box or foreign address, see instructions.

Room or suite no.

14	New business location (no., street, city or town, state, and ZIP code). If a foreign address, see instructions.

Room or suite no.

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Form 8822 (Rev. 12-2002)

Page 2

Purpose of Form

Florida, Georgia, Mississippi,
North Carolina, South Carolina,	Atlanta, GA 39901

Alabama, Alaska, Arizona,

You may use Form 8822 to notify the Internal Revenue Service if you changed your home or business mailing address or your business location. If this change also affects the mailing address for your children who filed income tax returns,

West Virginia

Arkansas, California,

Colorado, Florida, Georgia,

Colorado, Kentucky, Louisiana, Montana, New Mexico,

Hawaii, Idaho, Iowa,

Austin, TX 73301

Kansas, Louisiana,

Oklahoma, Texas, Wyoming

Minnesota, Mississippi,

Missouri, Montana,

Ogden, UT 84201

Alaska, Arizona, California,

Fresno, CA 93888

Nebraska, Nevada, New

complete and file a separate Form 8822 for Washington

Hawaii, Idaho, Nevada, Oregon,

Oklahoma, Oregon, South

Mexico, North Dakota,

each child. If you are a representative signing for the taxpayer, attach to Form 8822 a copy of your power of attorney.

Dakota, Tennessee, Texas,

New York (New York City and counties of Nassau, Rockland,

Utah, Washington,

Suffolk, and Westchester)

Holtsville, NY 00501

Wyoming

Changing Both Home and Business Addresses? If you are, use a separate Form 8822 to show each change.

Outside the United States

Philadelphia, PA 19255

New York (all other counties), Maine, Massachusetts, Michigan, New Hampshire,

Andover, MA 05501

Rhode Island, Vermont

Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. We may give the information to the Department of Justice and to other Federal agencies, as provided by law. We may give it to cities, states, the

Prior Name(s)

If you or your spouse changed your name because of marriage, divorce, etc., complete line 5. Also, be sure to notify the Social Security Administration of your new name so that it has the same name in its records that you have on your tax

Illinois, Indiana, Iowa,

Kansas, Minnesota,

Kansas City, MO 64999

Missouri, Nebraska, North

Dakota, South Dakota,

Utah, Wisconsin

District of Columbia, and U.S.

Alabama, Arkansas, Ohio, Tennessee, Virginia

Memphis, TN 37501

commonwealths or possessions to carry out their tax laws. We may give it to foreign governments because of tax treaties they have with the United States.

return. This prevents delays in processing

your return and issuing refunds. It also

Connecticut, Delaware,

safeguards your future social security

District of Columbia,

benefits.

Maryland, New Jersey,

Pennsylvania

Philadelphia, PA 19255	We may also give this information to

Addresses

American Samoa

Philadelphia, PA 19255

Federal and state agencies to enforce Federal nontax criminal laws and to combat terrorism.

Department of Revenue

Be sure to include any apartment, room, or suite number in the space provided.

Guam:

and Taxation

Our legal right to ask for information is Internal Revenue Code sections 6001 and 6011, which require you to file a statement with us for any tax for which you are liable. Section 6109 requires that you provide your social security number on what you

Permanent residents

Government of Guam

P.O. Box 23607

P.O. Box

GMF, GU 96921

Enter your box number instead of your street address only if your post office does not deliver mail to your street address.

Guam:

Nonpermanent residents Puerto Rico (or if excluding income under Internal Revenue Code section

Philadelphia, PA 19255 file. This is so we know who you are, and can process your form and other papers.

Foreign Address
Enter the information in the following order:

933)

You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act

Virgin Islands:

city, province or state, and country. Follow

Nonpermanent residents

the country’s practice for entering the postal code. Please do not abbreviate the country name.

V. I. Bureau of unless the form displays a valid OMB

Virgin Islands:

Internal Revenue	control number. Books or records relating

Permanent residents

9601 Estate Thomas

 Charlotte Amalie	to a form or its instructions must be

Signature

St. Thomas, VI 00802 retained as long as their contents may

become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103.

Foreign country:

If you are completing Part II, the owner, an officer, or a representative must sign. An officer is the president, vice president, treasurer, chief accounting officer, etc. A

U.S. citizens and those

filing Form 2555,

Form 2555-EZ, or

Philadelphia, PA 19255

Dual-status aliens

Form 4563

The use of this form is voluntary. However, if you fail to provide the Internal Revenue Service with your current mailing address, you may not receive a notice of deficiency or a notice and demand for tax. Despite the failure to receive such notices, penalties and interest will continue to accrue on the tax deficiencies.

representative is a person who has a valid

All APO and FPO addresses

power of attorney to handle tax matters or is otherwise authorized to sign tax returns for the business.

Filers Who Checked the Box on

Line 2 or Completed Part II

Where To File

was in

IF your old business address	THEN use this

. . .

address

. . .

Send this form to the Internal Revenue Service Center shown next that applies to you.

Connecticut, Delaware, District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts,

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is 16 minutes.

If you checked the box on line 2, see Filers Who Checked the Box on Line 2 or

Michigan, New Hampshire,

New Jersey, New York, North Cincinnati, OH 45999 Carolina, Ohio, Pennsylvania,

If you have comments concerning the accuracy of this time estimate or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Tax Forms Committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. Do not send the form to this address. Instead, see Where To File on this page.

Rhode Island, South Carolina,

Completed Part II for where to Vermont, Virginia, West

file this form.

Virginia, Wisconsin

Filers Who Checked the Box on

Line 1 and Completed Part I

IF your old home mailing

address was

THEN use this

in

. . .

address

. . .