Example: tourism industry

DO-5 Name or Address Change Form Rev. 8-17

kansas department OF REVENUED ivision of TaxationNAME OR Address Change FORMI ndividualCurrent name :o I am changing my name . ( name return was filed under)o I am changing my Security Number Contact me by Home Phone Number Old Email Address_____Spouse Social Security Number Contact me by Cell Phone Number Current Email Address_____New name (Include spouse s full name if filed jointly)_____New Address (street, city, state and zip code)_____SignatureDateBusiness_____Curr ent Business name Current EIN/SSNo I am changing my business name . New name : _____oI am changing my Address : o Business Mailing Addresso Business Location AddressoI am correcting my EIN: o New EINo Old EIN _____This Change will affect the following tax accounts:o Retailers Sales Taxo Dry Cleaning Surcharge o Tire Excise Taxo Withholding Taxo Liquor Drink Taxo Transient Guest Taxo Consumers Compensating Use Tax o Liquor Enforcement Tax o Vehicle Rental Excise Taxo Retailers Compensating Use Taxo Nonresi

KANSAS DEPARTMENT OF REVENUE Division of Taxation. NAME OR ADDRESS CHANGE FORM. Individual. Current Name: o I am changing my name. (Name

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Transcription of DO-5 Name or Address Change Form Rev. 8-17

1 kansas department OF REVENUED ivision of TaxationNAME OR Address Change FORMI ndividualCurrent name :o I am changing my name . ( name return was filed under)o I am changing my Security Number Contact me by Home Phone Number Old Email Address_____Spouse Social Security Number Contact me by Cell Phone Number Current Email Address_____New name (Include spouse s full name if filed jointly)_____New Address (street, city, state and zip code)_____SignatureDateBusiness_____Curr ent Business name Current EIN/SSNo I am changing my business name . New name : _____oI am changing my Address : o Business Mailing Addresso Business Location AddressoI am correcting my EIN: o New EINo Old EIN _____This Change will affect the following tax accounts:o Retailers Sales Taxo Dry Cleaning Surcharge o Tire Excise Taxo Withholding Taxo Liquor Drink Taxo Transient Guest Taxo Consumers Compensating Use Tax o Liquor Enforcement Tax o Vehicle Rental Excise Taxo Retailers Compensating Use Taxo Nonresident Contractor o Water Protection/Clean Drinking Water Feeo Cigarette Vending Machine Permito Privilege Taxo Charitable Gamingo Corporate Income Tax o Retail Cigarette LicenseMailing Address .

2 _____New Mailing Address (street, county, city, state and zip code)_____Contact me by Home Phone Number Old Email Address_____Contact me by Cell Phone Number Current Email AddressLocation Address : Effective Date (mm/dd/yyyy): _____o Outside City Limits o Inside City LimitsOld Location Address (street, county, city, state and zip code)_____o Outside City Limits o Inside City LimitsNew Location Address (street, county, city, state and zip code)_____Contact me by Home Phone Number Old Email Address_____Contact me by Cell Phone Number Current Email Address_____SignatureDateMail to: kansas department of revenue , Correspondence, 915 SW Harrison St, Topeka KS 66612-1588 or fax to 785-296-2073.

3 If you have questions about the completion of this form , call (Rev. 8-17)_____Current SSN.


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