Instructions For Form 22a - Nebraska printable pdf download

INSTRUCTIONS

WHO MUST FILE. Any taxpayer who has a name or

LINE 5. Check the tax program(s) affected by this request.

address change, who needs to correct, terminate, reinstate,

If there is a change in more than one type of certificate,

or change a Nebraska tax permit, license, or certificate,

license, or permit, check the appropriate boxes.

or who needs to change the filing frequency for sales and

LINE 6. A taxpayer ceasing to do business must request

use tax, tire fee, lodging tax, and income tax withholding

termination of the certificate, license, or permit. A taxpayer

returns. One request may be used to correct, terminate, or

having a seasonal type of business may request termination

change more than one certificate, license, or permit held

of the certificate, license, or permit for the period in which

by the taxpayer for the tax programs listed, provided the

no business activity is conducted. Returns must be filed for

Nebraska identification number is the same. Form 22A is to

all periods ending prior to the date of termination.

be used for individual income tax name/address changes.

A change in ownership or type of ownership will require

WHEN AND WHERE TO FILE. Mail to the Nebraska

a new certificate, license, or permit. When possible, the

Department of Revenue, P.O. Box 98903, Lincoln, NE

Nebraska Tax Application, Form 20, used to obtain a

68509-8903, or fax to (402) 471-5927, prior to the change.

new certificate, license, or permit, should accompany or

precede this request for termination.

PERMANENTLY CEASING TO DO BUSINESS.

LINE 7. A person whose certificate, license, or permit

Form 22 is used to terminate one or more of the tax programs

was previously terminated may have it reinstated provided

listed in line 5. You are required to file all tax returns for

no change in the business has occurred which would

tax periods through the date of your last transaction or last

necessitate the issuance of a new certificate, license, or

wage payment as indicated on line 6.

permit.

Employers who terminate their income tax withholding

LINE 8. Permitholders filing a sales and use tax, consumer’s

account should, within 30 days after discontinuing

use tax, or tire fee return with a tax liability of $900 to

business, file a final Nebraska Reconciliation of Income

$3,000 annually may request a quarterly filing frequency.

Tax Withheld, Form W-3N, and attach the state copy of

Those with a tax liability of less than $900 annually may

each Wage and Tax Statement, Federal Form W-2, that was

request an annual filing frequency. Permitholders filing

issued to each employee.

a lodging tax return and remitting $99 or less of tax

annually may request to file an annual return. Employers

SPECIFIC INSTRUCTIONS

withholding less than $500 annually in state income tax

withholding may request to file an annual return, rather

LINE 1. Enter the Nebraska identification number which

than quarterly returns.

you hold or have previously held. Do not enter your social

security number.

Changes in filing frequency are not effective until approval

has been received from the Department. The taxpayer must

LINE 2. Enter your federal employer identification number

complete and file all preidentified returns received for

if you hold one. If one has been applied for, enter “Applied

periods prior to the approval.

For.” If no federal employer identification number is held or

LINE 9. Enter the new name and address. The location

has been applied for, enter your social security number.

address box cannot contain a P.O. Box Number; it must

LINE 3. Enter the Nebraska county of the business

show the street address. If the applicant requests a return

location. If more than one location is within Nebraska,

to be sent to another person, the name and mailing address

enter the location which is considered to be the principal

should be completed to show this change.

location in Nebraska.

LINE 11. Give a detailed explanation of the reason for this

request. If there has been a change in ownership, give the

NAME AND ADDRESS. Enter the name and address

name and address of the new owner or owners.

as last filed with the Department or which is printed on

your present certificate, license, or permit. A new name

SIGNATURE. This request must be signed by the owner,

and address should be entered in the area immediately

partner, corporate officer, or other individual authorized to

following line 9 of this request.

sign by a power of attorney on file with the Department.

FOR NEBRASKA DEPARTMENT OF REVENUE USE ONLY

Check the forms below that were sent or received (Tax Year = TY Tax Period = TP)

Forms sent with Form 22.

Form 10, TP ______________

Form 941N, TP ______________

Form W-3N, TY ______________

Other _______________________________________________________________________ Initials ______ Date ________________

Forms received with Form 22.

Form 10, TP ______________

Form 941N, TP ______________

Form W-3N, TY ______________

Other ________________________________________________________________________________________________________

Instructions For Form 22a - Nebraska

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