Taxpayer Change Of Address Form - Massachusetts Department Of Revenue Page 2

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MASSACHUSETTS DEPARTMENT OF REVENUE
Taxpayer Change of Address
Name _________________________________SS. No. _____________________________
Name of Spouse_________________________SS. No. _____________________________
Old Address ________________________________________________________________
__________________________________________________________________________
New Address _______________________________________________________________
__________________________________________________________________________
Type of Return Filed:
Form 1
Telefile
Form 3
Form 1-NR/PY
Form 2
Other _________________________
Signature: _____________________________________Date: ________________________

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