Form Rv-F1308201 - Change Of Address - Tennessee Department Of Revenue
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TENNESSEE DEPARTMENT OF REVENUE
CHANGE OF ADDRESS
Complete this form to notify the Department of Revenue of address changes for your account.
1. CHECK ALL TAX TYPES AFFECTED BY THIS CHANGE:
SALES or USE TAX
FRANCHISE and EXCISE TAXES
TOBACCO TAX
ALCOHOLIC BEVERAGES TAXES:
GROSS RECEIPTS TAXES:
PRIVILEGE TAXES:
Beer Barrelage
Bottlers
Auto Rental Surcharge
Brand Registration
Mixing Bars
Bail Bondsmen
Gas, Water, Electric
Liquor-by-the-Drink
Business Tax
Power & Light
Wholesale Beer
Litigation Tax
Wholesale Gallonage
Professional Privilege Tax
Realty Transfer and Mortgage Tax
SOLID WASTE TAXES:
SEVERANCE TAXES:
Tire
Coal
Used Oil
Crude Oil/Natural Gas
MOTOR FUEL TAXES
Mineral
OTHER TAX (Please specify)
2. TAXPAYER’S LEGAL NAME AND CURRENT INFORMATION REFLECTED IN DEPARTMENT OF REVENUE RECORDS.
Name:
Phone Number:
FEIN/SSN:
Street:
City, State, Zip:
Tax Account No:
3. PLACE (a), (b), or (c), AS APPROPRIATE, IN THE SPACE NEXT TO THE ADDRESS BEING CHANGED.
Primary Address
Power of Attorney
Location Address
Mailing Address
Personal Representative
Attorney
Other (Please specify):
3(a). New Address and Identifying Information
Name:
FEIN/SSN:
Street:
Tax Account No:
City, State, Zip:
Fax No:
Phone Number:
E-mail Address:
3(b). New Address and Identifying Information
Name:
FEIN/SSN:
Street:
Tax Account No:
City, State, Zip:
Fax No:
Phone Number:
E-mail Address:
3(c). New Address and Identifying Information
FEIN/SSN:
Name:
Tax Account No:
Street:
City, State, Zip:
Fax No:
Phone Number:
E-mail Address:
When all required blocks are fully and correctly completed, sign below.
4. I declare that the information on this applica-
DEPARTMENT USE ONLY
tion is correct and complete to the best of my
knowledge and belief.
Print Name:
Sign Here:
Date:
RV-F1308201
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Parent category: Financial