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DOR > Individual Taxpayers > Change of Address Form for Individuals Change of Address Form for Individuals

Who is preparing this form?
Please enter the following information of the person preparing this form so that we can contact you if necessary.

:: These are required fields.

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(xxxxxxxxxx no dashes):
(xxxxxxxxxx no dashes):

Name of Individual:
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:: Last four digits of XXX-XX-

Enter your entire Old Mailing Address:
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Enter your entire New Mailing Address:

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