Form Tr-697 - Promptax-Prepaid Sales Tax On Motor Fuel And Diesel Motor Fuel Change Of Enrollment Information - Nys Tax Department Page 4

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Page 4 of 4 TR-697 (3/06)
VII. Effective date
/
/
Enter the date the taxpayer wishes these changes to be effective:
mm
dd
yyyy
VIII. Authorized signature
I am empowered to make the commitments stated herein on behalf of the taxpayer.
*
Authorized signature:
*
Name of signatory:
(please print)
*
Title:
*
Date:
Please retain a copy of this form for your records.
Need help?
Mail this form to:
PrompTax Internet access:
NYS TAx DEPARTMENT
PROMPTAx - SALES TAx
PrompTax fax:
(518) 435-2951
W A HARRIMAN CAMPUS
Telephone assistance is available from 8:00 A.M. to 5:00 P.M.
ALBANY NY 12227
(eastern time), Monday through Friday.
PrompTax Customer Service Center:
1 800 338-0054
You may also fax the taxpayer’s form (see Need help?).
From areas outside the U.S. and outside Canada: (518) 485-6800

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