Form R-3 - Registration Change Request
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1Form R-3
REGISTRATION CHANGE REQUEST
READ INSTRUCTIONS BEFORE COMPLETING
USE THIS FORM TO REPORT NAME OR ADDRESS CHANGES OR TO NOTIFY US THAT YOU ARE NO LONGER LIABLE FOR ONE
OR MORE TAXES. SEE INSTRUCTIONS.
MAIL TO: VA DEPARTMENT OF TAXATION, REGISTRATION UNIT, PO BOX 1114, RICHMOND, VA 23218-1114 or FAX to (804) 367-2603.
FOR INFORMATION CALL (804) 367-8037.
INSTRUCTIONS
FOR ALL CHANGES
b. The structure of your business changed from one type to
another (Sole Proprietorship, Partnership or Corporation)
1. Enter your Virginia Account Number - required.
and a new Federal employer ID Number was issued; or
2. Enter your Federal Employer ID (FEIN) number, if applicable.
c. Your corporation merged with another corporation.
2. Mail this completed form to the address below.
TO REPORT A CHANGE OF NAME OR ADDRESS:
3. If you were registered for Employer Withholding Tax, file Form
VA-6 and a Form W-2 for each employee within 30 days after
the last month in which wages were paid.
1. Check the CHANGE TO NAME OR ADDRESS INFORMATION
block. Enter your previous business name, physical location,
4. Discard your remaining tax returns.
mailing address and business telephone number in the left
IF YOU ARE NO LONGER LIABLE FOR THIS TAX BUT WILL
column. Complete all spaces in the left column.
2. Use the spaces in the right column to make changes to your
REMAIN LIABLE FOR OTHER BUSINESS TAXES:
business name, physical location, mailing address or phone
1. Check the NO LONGER LIABLE FOR THIS TAX block, enter
number. Fill in the spaces only for items that need to be changed
or added.
the name of the tax (“SALES”, “WITHHOLDING”, etc.) and the
3. If the physical location of your business has changed, also
date your liability for this tax ended.
check the CHANGE IN BUSINESS LOCATION block, enter the
2. Mail this completed form to the address below.
city or county in which your business is now located and the
3. If you are ending your liability for Employer Withholding Tax,
effective date. Note that the physical location of your business
file Form VA-6 and a Form W-2 for each employee within 30
may be different from the mailing address.
days after the last month in which wages were paid.
4. Mail this completed form to the address below.
4. Discard the remaining returns for this tax but continue to file
5. Continue to file returns as you normally do. DO NOT make
returns for other taxes for which you are still liable.
changes to the name or address on your tax returns. Only
ONE notification of name or address change is needed.
IF THERE HAS BEEN A CHANGE IN OWNERSHIP:
IF YOU ARE COMPLETELY OUT OF BUSINESS:
Note that every new owner or organization must file a new
Business Registration Application, Form R-1. If you are the new
owner:
1. Check the COMPLETELY OUT OF BUSINESS block and enter
the date your account should be closed. Check this block only
1. Do not submit this form. Send a letter to the address below
if one or more of the following conditions apply:
requesting a Form R-1. Business Registration Application, to
a. Your business was sold or terminated and you are no longer
establish a new account.
liable for any Virginia business taxes.
VIRGINIA ACCOUNT NUMBER ___________________________
FEDERAL EMPLOYER ID# (FEIN) _________________________
h CHANGE TO NAME OR ADDRESS INFORMATION.
h CHANGE IN BUSINESS LOCATION:
NEW CITY or COUNTY NAME ______________________________________________________
EFFECTIVE DATE
/
/
h COMPLETELY OUT OF BUSINESS. DATE BUSINESS WAS TERMINATED:
EFFECTIVE DATE
/
/
h NO LONGER LIABLE FOR THIS TAX: TAX NAME ______________________________________
EFFECTIVE DATE
/
/
PREVIOUS BUSINESS NAME & ADDRESS
NEW BUSINESS NAME & ADDRESS
LEGAL BUSINESS NAME
NEW LEGAL BUSINESS NAME
TRADING-AS NAME
NEW TRADING-AS NAME
PHYSICAL STREET ADDRESS
NEW PHYSICAL STREET ADDRESS
CITY
STATE
ZIP
CITY
STATE
ZIP
MAILING ADDRESS
NEW MAILING ADDRESS
CITY
STATE
ZIP
CITY
STATE
ZIP
AREA CODE (
) TELEPHONE NUMBER
AREA CODE (
) TELEPHONE NUMBER
VA DEPT OF TAXATION
1501225
(REV 10/11)
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