Form 92-033 - Request For Change, Correction, Cancellation, Or Reinstatement Of Tax Permit Page 2
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2Iowa Business Tax Change, page 2
5. Change Partners, Corporate Officers, or Responsible Parties
(include a separate list, if needed)
Check the box and provide the permit number for each tax type for which you want to change the partner, officer, or responsible party.
Check the box to add or deactivate the individual and provide the effective date, name, SSN, and personal address. Add additional
sheet if necessary.
Consumer’s Use Tax
Retailer’s Use Tax
Tax Type
Sales Tax
Withholding Tax
Permit Number
Reason for Change
Add or
Effective Date
Individual Name
SSN
Personal Address
Deactivate
Add
Deactivate
Add
Deactivate
Add
Deactivate
Add
Deactivate
6. Cancel Permit
Check the box and list the permit number only for the tax types you want to cancel.
Cancel Permit for
Permit Number
Effective Date
Reason For Cancellation
(last date of sales or withholding)
Sales Tax
Consumer’s Use
Tax
Retailer’s Use Tax
Withholding Tax
Fuel Tax
7. Reinstate Permit
Check the box and list the permit number only for the tax types you want to reinstate.
Reinstate Permit for
Permit Number
Effective Date
Reason For Change
(first date of sales or withholding)
Sales Tax
Consumer’s Use
Tax
Retailer’s Use Tax
Withholding Tax
8. Request for Copy of Permit and Business eFile Number (BEN) Letter
Check the box and list the permit number only for the tax types for which you need a BEN letter. You will receive a letter with your
BEN, your permit number, and a permit. The letter will be sent to the mailing address.
Copy of Permit/BEN Letter for
Permit Number
Questions? Contact Taxpayer Services
Sales Tax
Phone: 515-281-3114 or 800-367-3388
Consumer’s Use Tax
Email: idr@iowa.gov
Retailer’s Use Tax
eFile & Pay: https://tax.iowa.gov
Withholding Tax
Request changes online:
https://tax.iowa.gov
9. Signature
Or, submit this form by:
Note: This form must be signed by an owner, a partner, or a corporate officer.
Fax: 515-281-3906, ATTN: Registration Services
Mail: Registration Services
Signature
Iowa Department of Revenue
PO Box 10470
Print name
Des Moines IA 50306-0470
SSN
Date
For Office Use Only
Title
Contact name
Phone
Email
92-033b (07/14/15)
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