Fillable 109-I MARYLAND CHANGE OF ADDRESS FOR INDIVIDUALS (Comptroller of Maryland)

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109-I MARYLAND CHANGE OF ADDRESS FOR INDIVIDUALS (Comptroller of Maryland)

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FORM
109-I
MARYLAND CHANGE OF ADDRESS
FOR INDIVIDUALS
COM/RAD 109-I Rev. 01/20
Please update my address information per the information above. I certify that the foregoing information is true, correct and
accurate to the best of my knowledge.
Print name Signature Date
■
■ ■
__________________________________ ___________________________________ ___________________________
First Name Initial Last Name SSN
Spouse’s First Name Initial Last Name Spouse’s SSN
OLD ADDRESS
Mailing Address - Line 1
Mailing Address - Line 2 (PO Box, Apt No., Suite No.)
City or Town State ZIP Code + 4
Telephone number Email address
NEW ADDRESS
Current Mailing Address - Line 1
Current Mailing Address - Line 2 (PO Box, Apt No., Suite No.)
City or Town State ZIP Code + 4
Telephone number Email address
FORM
109-I
MARYLAND CHANGE OF ADDRESS
FOR INDIVIDUALS
COM/RAD 109-I Rev. 01/20
■
■ ■
General Information
You can use Form 109-I to notify the Comptroller of Maryland
that you have changed your home mailing address. If
you have changed both your home and business mailing
addresses, please submit Form 109-I along with Form 109-B.
Filling out Form 109-I
• Please print using blue or black ink.
• Enter OLD address information in the rst section; enter
NEW address in the second section.
• Be sure to include any apartment, room, or suite number
information using the common designators as shown
below.
Common Designators
The most common unit designators are:
Apartment APT
Building BLDG
Floor FL
Suite STE
Unit UNIT
Room RM
Department DEPT
• Only enter P.O. Box information if your post oce does
not deliver mail to your street address.
• Do not use “#” signs or other special characters, except
the dash in the “ZIP code” eld when a 9-digit + 4 ZIP is
used.
• Please remember to sign and date the form prior to
submission.
For more information
Visit www.marylandtaxes.gov or call Taxpayer Service at
410-260-7980 in Central Maryland or 1-800-638-2937 from
elsewhere. For the hearing impaired: Maryland Relay Service
711.
Mail to:
COMPTROLLER OF MARYLAND
REVENUE ADMINISTRATION DIVISION
TAXPAYER IDENTIFICATION
110 CARROLL STREET
ANNAPOLIS MD 21411-0001
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109-I MARYLAND CHANGE OF ADDRESS FOR INDIVIDUALS (Comptroller of Maryland)

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Completed 20 July 2020

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