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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
INSTRUCTIONS TO PRINTERS
FORM 8822, PAGE 2 of 2
MARGINS: TOP 13mm (
1
⁄2 ”), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (8
1
⁄2 ”) x 279mm (11”)
PERFORATE: (NONE)
Page 2Form 8822 (Rev. 12-2005)
Austin, TX 73301
IF your old home mailing
address was in . . .
New Jersey, Pennsylvania
District of Columbia, Maine,
Maryland, Massachusetts,
New Hampshire, New York,
Vermont
Andover, MA 05501
Philadelphia, PA 19255
Connecticut, Illinois,
Indiana, Iowa, Michigan,
Minnesota, Missouri, North
Dakota, Ohio, Wisconsin
Kansas City, MO 64999
Alaska, Arizona, California,
Colorado, Hawaii, Idaho,
Montana, Nebraska,
Nevada, New Mexico,
Oregon, South Dakota,
Utah, Washington,
Wyoming
Fresno, CA 93888
Privacy Act and Paperwork Reduction
Act Notice. We ask for the information on
this form to carry out the Internal Revenue
laws of the United States. We may give the
information to the Department of Justice
and to other Federal agencies, as provided
by law. We may give it to cities, states, the
District of Columbia, and U.S.
commonwealths or possessions to carry
out their tax laws. We may also disclose
this information to other countries under a
tax treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to
federal law enforcement and intelligence
agencies to combat terrorism.
The time needed to complete and file
this form will vary depending on individual
circumstances. The estimated burden for
individual taxpayers filing this form is
approved under OMB control number
1545-0074 and is included in the estimates
shown in the instructions for their individual
income tax return. The estimated burden
for all other taxpayers who file this form is
16 minutes.
If you have comments concerning the
accuracy of this time estimate or
suggestions for making this form simpler,
we would be happy to hear from you. You
can write to the Internal Revenue Service,
Tax Products Coordinating Committee,
SE:W:CAR:MP:T:T:SP, 1111 Constitution
Ave. NW, IR-6406, Washington, DC 20224.
Do not send the form to this address.
Instead, see Where To File on this page.
Purpose of Form
You can use Form 8822 to notify the
Internal Revenue Service if you changed
your home or business mailing address or
your business location. If this change also
affects the mailing address for your
children who filed income tax returns,
complete and file a separate Form 8822 for
each child. If you are a representative
signing for the taxpayer, attach to Form
8822 a copy of your power of attorney.
Prior Name(s)
If you or your spouse changed your name
because of marriage, divorce, etc.,
complete line 5. Also, be sure to notify the
Social Security Administration of your new
name so that it has the same name in its
records that you have on your tax return.
This prevents delays in processing your
return and issuing refunds. It also
safeguards your future social security
benefits.
P.O. Box
Enter your box number instead of your
street address only if your post office does
not deliver mail to your street address.
Foreign Address
Enter the information in the following order:
city, province or state, and country. Follow
the country’s practice for entering the
postal code. Please do not abbreviate the
country name.
Where To File
The use of this form is voluntary.
However, if you fail to provide the Internal
Revenue Service with your current mailing
address, you may not receive a notice of
deficiency or a notice and demand for tax.
Despite the failure to receive such notices,
penalties and interest will continue to
accrue on the tax deficiencies.
THEN use this
address . . .
You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records relating
to a form or its instructions must be
retained as long as their contents may
become material in the administration of
any Internal Revenue law. Generally, tax
returns and return information are
confidential, as required by section 6103.
Arkansas, Kansas,
Kentucky, Louisiana,
Mississippi, Oklahoma,
Tennessee, Texas, West
Virginia
Addresses
Be sure to include any apartment, room, or
suite number in the space provided.
Signature
If you are completing Part II, the owner, an
officer, or a representative must sign. An
officer is the president, vice president,
treasurer, chief accounting officer, etc. A
representative is a person who has a valid
power of attorney to handle tax matters or
is otherwise authorized to sign tax returns
for the business.
Filers Who Checked the Box on
Line 1 and Completed Part I
Changing both home and business
addresses? If you are, use a separate
Form 8822 to show each change.
IF your old business address
was in . . .
Outside the United States Philadelphia, PA 19255
Connecticut, Delaware,
District of Columbia, Illinois,
Indiana, Kentucky, Maine,
Maryland, Massachusetts,
Michigan, New Hampshire,
New Jersey, New York, North
Carolina, Ohio, Pennsylvania,
Rhode Island, South Carolina,
Vermont, Virginia, West
Virginia, Wisconsin
Cincinnati, OH 45999
THEN use this
address . . .
Filers Who Checked the Box on
Line 2 or Completed Part II
Alabama, Delaware, Florida,
Georgia, North Carolina,
Rhode Island, South
Carolina, Virginia
Atlanta, GA 39901
Alabama, Alaska, Arizona,
Arkansas, California,
Colorado, Florida, Georgia,
Hawaii, Idaho, Iowa,
Kansas, Louisiana,
Minnesota, Mississippi,
Missouri, Montana,
Nebraska, Nevada, New
Mexico, North Dakota,
Oklahoma, Oregon, South
Dakota, Tennessee, Texas,
Utah, Washington,
Wyoming
Ogden, UT 84201
Our legal right to ask for information is
Internal Revenue Code sections 6001 and
6011, which require you to file a statement
with us for any tax for which you are liable.
Section 6109 requires that you provide
your social security number on what you
file. This is so we know who you are, and
can process your form and other papers.
If you checked the box on line
2, see Filers Who Checked the
Box on Line 2 or Completed
Part II for where to file this
form.
Send this form to the Internal Revenue
Service Center shown next that applies to
you.
CAUTION
American Samoa
Guam:
Nonpermanent residents
Puerto Rico (or if excluding
income under Internal
Revenue Code
section 933)
Virgin Islands:
Nonpermanent residents
Dual-status aliens
Those filing Form 4563
Philadelphia, PA 19255
Foreign country:
U.S. citizens and those
filing Form 2555 or
Form 2555-EZ
All APO and FPO addresses
Austin, TX 73301
Guam:
Permanent residents
Department of Revenue
and Taxation
Government of Guam
P.O. Box 23607
GMF, GU 96921
Virgin Islands:
Permanent residents
V.I. Bureau of
Internal Revenue
9601 Estate Thomas
Charlotte Amalie
St. Thomas, VI 00802
