Form Wreq - Request For Change
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REQUEST FOR CHANGE
DELAWARE DIVISION OF REVENUE
WREQ
New Booklets Will Be Issued
PO BOX 8750
0089-99
for Account Number Changes Only
WILMINGTON, DE 19899-8750
00899909000000000000012311200000000000000000000000000
ACCOUNT NUMBER
ACCOUNT NUMBER CHANGE
EFFECTIVE DATE
REASON FOR CHANGE
1
2
3
0-000000000-000
4
CORRECT BUSINESS LOCATION ADDRESS
BUSINESS NAME AND ADDRESS
NAME
ADDRESS
CITY
STATE
ZIP CODE
5
CORRECT MAILING ADDRESS IF DIFFERENT FROM ABOVE
NAME
ADDRESS
AUTHORIZED SIGNATURE
DATE
CITY
STATE
ZIP CODE
TELEPHONE NUMBER
E-MAIL ADDRESS
(Revised 10/12/04)
Withholding
Request for Change Form
Use this form to make corrections or changes to your name, address, account number or taxable year-ending date.
Also use this Request for Change form if you have gone out of business and indicate the date your business ceased
operations.
Please Note: The Withholding Request for Change form only makes changes to your withholding account in our
Business Master File. If you need to make similar changes to your Corporate, Sub S Corporate and/or License accounts,
please complete the Corporate Request for Change form, the Sub S Corporate Request for Change form or the License
Request for Change form respectively for each type of tax.
Step-by-Step Instructions
Step 1: Please enter your information as it appears on the Division of Revenue’s current records
Box A.
Account Number – Please enter the Federal Tax Identification Number that the Delaware Division of
Revenue currently has on file for you.
Box B.
Business Name and Address – Please enter the business name and location address that the Delaware
Division of Revenue currently lists as your business name and location address.
Step 2: Fill-in any fields you wish to change on the Request for Change form below
Field 1. Account Number Change – If you wish to change the information in Box A, please enter your correct
accountnumber in Field 1. Otherwise, leave Field 1 blank.
Field 2. Effective Date – Please enter the date you would like this Request for Change form to go into effect.
Field 3. Reason for Change – Please enter the reason you are submitting this Request for Change form (i.e. out of
business, incorporated, moved).
Field 4. New Business Location Address – If you wish to change the information in Box B, please enter your
correct location address in Field 4. Otherwise, leave Field 4 blank.
Field 5. New Mailing Address – Please enter your correct business mailing address.
Step 3: Sign and date the form. Mail to the address listed on the form or fax to 302-577-8203.
If you have any questions, please call the Delaware Division of Revenue Business Master File Section at 302-577-8778.
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