Form Tr-389 - Withholding Tax - Change Of Registration Information
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3PrompTax
Withholding Tax
Change of Registration Information
I
Complete this form if any of your current PrompTax Withholding Tax registration data has changed. Please complete Section
,
Taxpayer identification as currently enrolled, and Section
VII
, Authorized signature, and only the section(s) related to the
registration data to be changed.
This form should be mailed to: NYS Tax Department
PrompTax - Withholding Tax
Building 8
W A Harriman Campus
Albany NY 12227-0250
I.
Taxpayer identification as currently enrolled
You must complete this section before reporting any changes to your PrompTax Withholding Tax enrollment data. You
may not use this form to report a change in identification number, name, or address. If you wish to change your company
identification number, name, and/or address, you must complete and return DTF-95, Business Tax Account Update.
Taxpayer ID:
DBA company name:
Legal company name:
Address:
City and state:
ZIP code:
II.
Change of primary/secondary contact data
Please indicate below any change to information concerning your primary contact person with whom we should
communicate regarding the PrompTax Withholding Tax Program. This individual will receive all material related to
PrompTax Withholding Tax participation, including access code, confidential password, forms, and payment notices. Do
not designate a payroll service vendor as a primary contact person. Your primary contact must be a member of
your organization. Complete only the fields requiring change.
Primary contact person:
(please print)
Address:
City and state:
ZIP code:
Telephone number:
Fax number:
Email address
(optional)
If you wish to change any data regarding a secondary contact, do so in the space provided below.
Secondary contact person:
(please print)
Address:
City and state:
ZIP code:
Telephone number:
Fax number:
Email address
(optional)
TR-389 (5/02)
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