Change of Address Form 8822

OMB No. 1545-1163 (Rev. Oct. 1997) © 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, 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 security number

4a Spouse’s name (first name, initial, and last name) 4b Spouse’s social security number

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 instructions.

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.

Please

Sign

Here

If joint return, spouse’s signature Date Title

Cat. No. 12081V Form 8822 (Rev. 10-97)

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

Complete This Part To Change Your Home Mailing Address

Apt. no.

Apt. no.

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

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

( ) 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 identification number

Check ALL boxes this change affects:

8

9

10

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

Employee plan returns (Forms 5500, 5500-C/R, and 5500-EZ). See instructions.

©

©

©

©

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. Room or suite no.

Room or suite no.

Room or suite no.

Part III

Part I

Part II

Apt. no.

© Decedent’s name © Social security number
Form 8822 (Rev. 10-97) Page 2

Send this form to the Internal Revenue

Service Center shown below for your old

mailing address. But if you checked the

box on line 9 (employee plan returns), send

it to the address shown in the far right

column.

Fresno, CA 93888

Indiana, Kentucky, Michigan,

Ohio, West Virginia Cincinnati, OH 45999

THEN use this

address . . .

IF the principal office of

the plan sponsor or the

plan administrator was

in . . .

Kansas, New Mexico,

Oklahoma, Texas Austin, TX 73301

Delaware, District of

Columbia, Maryland,

Pennsylvania, Virginia

IF your old mailing

address was

in. . .

Philadelphia, PA 19255

Connecticut, Delaware,

District of Columbia, Maine,

Maryland, Massachusetts,

New Hampshire, New Jersey,

New York, Pennsylvania,

Puerto Rico, Rhode Island,

Vermont, Virginia

Alabama, Arkansas, Louisiana,

Mississippi, North Carolina,

Tennessee

Florida, Georgia,

South Carolina

Holtsville, NY 00501

Atlanta, GA 39901

Memphis, TN 37501

New Jersey, New York (New

York City and counties of

Nassau, Rockland, Suffolk,

and Westchester)

Illinois, Iowa, Minnesota,

Missouri, Wisconsin Kansas City, MO 64999

Holtsville, NY 00501

American Samoa Philadelphia, PA 19255

Alabama, Alaska, Arkansas,

California, Florida, Georgia,

Hawaii, Idaho, Louisiana,

Mississippi, Nevada, North

Carolina, Oregon, South

Carolina, Tennessee,

Washington New York (all other counties), 

Connecticut, Maine,

Massachusetts,

New Hampshire,

Rhode Island, Vermont

Department of Revenue

and Taxation

Government of Guam

P.O. Box 23607

GMF, GU 96921

Andover, MA 05501

Guam:

Permanent residents

Atlanta, GA 39901

Guam:

Nonpermanent residents

Puerto Rico (or if excluding

income under Internal

Revenue Code section 933)

Virgin Islands:

Nonpermanent residents

Alaska, Arizona, California

(counties of Alpine, Amador,

Butte, Calaveras, Colusa,

Contra Costa, Del Norte,

El Dorado, Glenn, Humboldt,

Lake, Lassen, Marin, Mendocino, 

Modoc, Napa, Nevada, Placer,

Plumas, Sacramento, San 

Joaquin, Shasta, Sierra,

Siskiyou, Solano, Sonoma,

Sutter, Tehama, Trinity, Yolo,

and Yuba), Colorado, Idaho,

Montana, Nebraska, Nevada,

North Dakota, Oregon, South

Dakota, Utah, Washington,

Wyoming

Philadelphia, PA 19255

Arizona, Colorado, Illinois,

Indiana, Iowa, Kansas,

Kentucky, Michigan,

Minnesota, Missouri,

Montana, Nebraska, New

Mexico, North Dakota, Ohio,

Oklahoma, South Dakota,

Texas, Utah, West Virginia,

Wisconsin, Wyoming

V. I. Bureau of

Internal Revenue

9601 Estate Thomas

Charlotte Amalie

St. Thomas, VI 00802

Virgin Islands:

Permanent residents

Memphis, TN 37501

Ogden, UT 84201

Foreign country:

U.S. citizens and those

filing Form 2555,

Form 2555-EZ, or

Form 4563 Philadelphia, PA 19255

All Form 5500-EZ filers Memphis, TN 37501

All APO and FPO

addresses

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 also give it to cities,

states, the District of Columbia, and U.S.

commonwealths or possessions to carry

out their tax laws. And we may give it to

foreign governments because of tax

treaties they have with the United States.

The time needed to complete and file

this form will vary depending on individual

circumstances. The estimated average time

is 16 minutes.

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.

Purpose of Form

You may use Form 8822 to notify the

Internal Revenue Service if you changed

your home or business mailing address or

your business location. Generally,

complete only one Form 8822 to change

your home and business addresses. 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

If your post office does not deliver mail to

your street address, show your P.O. box

number instead of your street address.

Foreign Address

If your address is outside the United States

or its possessions or territories, 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

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.

Employee Plan Returns

A change in the mailing address for

employee plan returns must be shown on a

separate Form 8822 unless the Exception

below applies.

Exception. If the employee plan returns

were filed with the same service center as

your other returns (individual, business,

employment, gift, estate, etc.), you do not

have to use a separate Form 8822. See

Where To File on this page.

THEN use this

address. . .

Note: If you moved after you filed your

return and you are expecting a refund, also

notify the post office serving your old

address. This will help forward your check

to your new address.

Foreign country Holtsville, NY 00501

You are not required to provide the

information requested on a form that is

subject to the Paperwork Reduction Act

unless the form displays a valid OMB

control number. Books or records relating

to a form or its instructions must be

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 Internal

Revenue Code section 6103.

California (all other

counties), Hawaii

Employee Plan Returns ONLY

(Form 5500 series)

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.