Form Itps-Coa - Change Of Address Form Hawaii - Department Of Taxation

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DO NOT WRITE IN THIS AREA
03
STATE OF HAWAII
FORM ITPS-COA
(REV. 2006)
DEPARTMENT OF TAXATION
CHANGE OF ADDRESS FORM
NAME:
SSN or FEIN:
SPOUSE’S NAME:
SPOUSE’S SSN:
CONTACT PHONE NO. (daytime):(
)
PLEASE CHANGE MY:
£
£
MAILING ADDRESS TO:
BUSINESS ADDRESS (PHYSICAL LOCATION) TO:
c/o or “In care of”
Street
(If this is to be deleted, please write “Delete”)
(This address cannot be a P. O. Box.)
Street
City/State
Zip Code + 4
Phone No.
(
)
(Business)
City/State
Zip Code + 4
(
)
(Residence)
THE CHANGE OF ADDRESS APPLIES TO MY ACCOUNT(S) CHECKED OFF BELOW:
£
MY NET INCOME ACCOUNT
£
MY GENERAL EXCISE ACCOUNT
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
£
MY WITHHOLDING ACCOUNT
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
£
MY TRANSIENT ACCOMMODATIONS ACCOUNT
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
£
MY RENTAL MOTOR VEHICLE AND TOUR VEHICLE ACCOUNT
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
For Hawaii Tax I.D. No. W ___ ___ ___ ___ ___ ___ ___ ___ - ___ ___
Signature
Title
Date
Spouse’s Signature
Date
— MAILING ADDRESS —
HAWAII DEPARTMENT OF TAXATION
P.O. BOX 259
HONOLULU, HI 96809-0259
THIS SPACE FOR DATE RECEIVED STAMP
03
FORM ITPS-COA

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