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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'Information' section. Enter your name as the permit holder, followed by your FEIN/SSN, trade name, and store number. Ensure all details are accurate for processing.
In the 'Tax Types' section, specify which tax types apply to your new address. Provide the relevant permit or account numbers for sales, use, cigarette, tobacco, beer, mixed beverage, withholding, waste tire, franchise, and any other applicable taxes.
Indicate whether this is a change of mailing address or physical location by selecting 'Yes' or 'No' for each question.
Complete the 'Business Information' section with your new mailing address and effective date. Also provide details of your previous and new business locations.
Finally, sign and date the form in the 'Signature' section to certify that all information is true and correct.

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