Form Fr-900a - Employer'S/payor'S Withholding Tax - 2011 Page 17

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Government of the
FR-900C Change of Name or Address
District of Columbia
If there are changes to your FEIN, business name, address or contact person, please complete both sides of this form and mail it to the Office of Tax and Revenue, PO Box 470, Washington, DC 20044-0470.
For all other changes, call the Customer Service Administration at (202) 727-4(TAX) 4829.
Important: Print in CAPITAL letters using black ink.
OFFICIAL USE
Previous taxpayer identification number
Fill in
if FEIN
if SSN
Old business name
Old business address
Old mailing address
City
State
Zip Code + 4
FR-900C P1

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