Change of Address Form 8822

(Rev. December 2004)  Please type or print.

Department of the Treasury

Internal Revenue Service

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.)

3a Your name (first name, initial, and last name) 3b Your social s

4a Spouse’s name (first name, initial, and last name) 4b Spouse’s so

5 Prior name(s). See instructions.

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 instruc

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

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

Sign

Here

If joint return, spouse’s signature Date Title

Cat. No. 12081V Form 

 See instructions on back.  Do not attach this form to your return.

Complete This Part To Change Your Home Mailing Address

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

Your signature Date If Part II completed, signature of owner, officer, or rep

Daytime telephone number of person to contact (optional)  ( )

Signature

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

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

11a Business name 11b Employer i

Check all boxes this change affects:

8

9

10

Employment, excise, income, and other business returns (Forms 720, 940, 940-EZ, 941, 990, 1041, 106

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









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

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

Business location

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

Part III

Part I

Part II

 Decedent’s name  Social security number
Form 8822 (Rev. 12-2004) 

Fresno, CA 93888

District of Columbia,

Maryland, New Jersey,

Pennsylvania

IF your old home mailing

address was in . . .

Philadelphia, PA 19255

Ohio*

Alabama, Florida, Georgia,

Mississippi, North Carolina,

Rhode Island, South Carolina,

West Virginia

Atlanta, GA 39901

Memphis, TN 37501

Connecticut, Delaware,

Illinois, Indiana, Iowa,

Kansas, Michigan,

Minnesota, Missouri,

Nebraska, North Dakota,

South Dakota, Wisconsin

Kansas City, MO 64999

American Samoa Philadelphia, PA 19255

Maine, Massachusetts,

New Hampshire, New York,

Vermont

Department of Revenue

and Taxation

Government of Guam

P.O. Box 23607

GMF, GU 96921

Andover, MA 05501

Guam:

Permanent residents

Guam:

Nonpermanent residents

Puerto Rico (or if excluding

income under Internal

Revenue Code section

933)

Virgin Islands:

Nonpermanent residents

Philadelphia, PA 19255

V. I. Bureau of

Internal Revenue

9601 Estate Thomas

Charlotte Amalie

St. Thomas, VI 00802

Virgin Islands:

Permanent residents

Foreign country:

U.S. citizens and those

filing Form 2555,

Form 2555-EZ, or

Form 4563

Philadelphia, PA 19255

All APO and FPO addresses

Privacy Act and Paperw

Act Notice. We ask for 

this form to carry out the 

laws of the United State

information to the Depar

and to other Federal age

by law. We may give it t

District of Columbia, and 

commonwealths or poss

out their tax laws. We m

this information to other 

tax treaty, to federal and 

enforce federal nontax c

federal law enforcement 

agencies to combat terro

The time needed to co

this form will vary depen

circumstances. The estim

is 16 minutes.

If you have comments 

accuracy of this time est

suggestions for making t

we would be happy to h

can write to the Internal 

Tax Products Coordinati

SE:W:CAR:MP:T:T:SP, 1

Ave. NW, IR-6406, Wash

Do not send the form to 

Instead, see Where To F

Purpose of Form

You can 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,

complete and file a separate Form 8822 for

each child. If you are a representative

signing for the taxpayer, attach to Form

8822 a copy of your power of attorney.

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 return.

This prevents delays in processing your

return and issuing refunds. It also

safeguards your future social security

benefits.

P.O. Box

Enter your box number instead of your

street address only if your post office does

not deliver mail to your street address.

Foreign Address

Enter the information in the following order:

city, province or state, and country. Follow

the country’s practice for entering the

postal code. Please do not abbreviate the

country name.

Where To File

The use of this form is 

However, if you fail to pr

Revenue Service with yo

address, you may not re

deficiency or a notice an

Despite the failure to rec

penalties and interest wi

accrue on the tax deficie

THEN use this

address . . .

You are not required t

information requested on 

subject to the Paperwor

unless the form displays 

control number. Books o

to a form or its instructio

retained as long as their 

become material in the a

any Internal Revenue law

returns and return inform

confidential, as required 

Alaska, Arizona, California,

Hawaii, Idaho, Montana,

Nevada, Oregon, Utah, Virginia,

Washington, Wyoming

Addresses

Be sure to include any apartment, room, or

suite number in the space provided.

Signature

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

representative is a person who has a valid

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 1 and Completed Part I

Changing both home and business

addresses? If you are, use a separate

Form 8822 to show each change.

IF your old business address

was in . . .

Outside the United States 

Connecticut, Delaware,

District of Columbia, Illinois,

Indiana, Kentucky, Maine,

Maryland, Massachusetts,

Michigan, New Hampshire,

New Jersey, New York, North

Carolina, Ohio, Pennsylvania,

Rhode Island, South Carolina,

Vermont, Virginia, West

Virginia, Wisconsin

Cincinnati, OH 45999

THEN use this

address . . .

Filers Who Checked the Box on

Line 2 or Completed Part II

Arkansas, Colorado, Kentucky,

Louisiana, New Mexico,

Oklahoma, Tennessee, Texas

Austin, TX 73301

Alabama, Alaska, Arizona,

Arkansas, California,

Colorado, Florida, Georgia,

Hawaii, Idaho, Iowa,

Kansas, Louisiana,

Minnesota, Mississippi,

Missouri, Montana,

Nebraska, Nevada, New

Mexico, North Dakota,

Oklahoma, Oregon, South

Dakota, Tennessee, Texas,

Utah, Washington,

Wyoming

Our legal right to ask 

Internal Revenue Code s

6011, which require you 

with us for any tax for w

Section 6109 requires th

your social security num

file. This is so we know 

can process your form a

If you checked the box on line

2, see Filers Who Checked the

Box on Line 2 or Completed

Part II for where to file this

form.

Dual-status aliens

Send this form to the Internal Revenue

Service Center shown next that applies to

you.

*If you live in Ohio and mail Form 8822 after

June 30, 2005, send it to: Internal Revenue

Service Center, Fresno, CA 93888.

CAUTION