Form DO-5 "Name or Address Change Form" - Kansas

What Is Form DO-5?

This is a legal form that was released by the Kansas Department of Revenue - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2019;
  • The latest edition provided by the Kansas Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DO-5 by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

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Download Form DO-5 "Name or Address Change Form" - Kansas

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800518
KANSAS DEPARTMENT OF REVENUE
NAME OR ADDRESS CHANGE FORM
Individual
Current Name:
Current SSN:
_____________________________________________________________________________________________________________
____________________________________
o
I am changing my name. New Name:
____________________________________________________________________________________________________________________________________
o
I am changing my address
_____________________________________________________
______________________________________________
_____________________________________________________________________________________
Social 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)
____________________________________________________________________________________________________________________________________________________
_______________________________________
Signature
Date
Business
Current Business Name:
Current EIN/SSN:
________________________________________________________________________________________
_____________________________________
o
I am changing my business name. New Business Name:
_________________________________________________________________________________________________________
o
I am changing my DBA name. New DBA Name:
_____________________________________________________________________________________________________________________
o
o
o
I am changing my address:
Business Mailing Address
Business Location Address
o
o
o
I am correcting my EIN:
New EIN
Old EIN
________________________________
__________________________________
This change will affect the following tax accounts:
o
o
o
Retailers’ Sales Tax
Dry Cleaning Surcharge
Tire Excise Tax
o
o
o
Withholding Tax
Liquor Drink Tax
Transient Guest Tax
o
o
o
Consumers’ Compensating Use Tax
Liquor Enforcement Tax
Vehicle Rental Excise Tax
o
o
o
Retailers’ Compensating Use Tax
Nonresident Contractor
Water Protection/Clean Drinking Water Fee
o
o
o
Cigarette Vending Machine Permit
Privilege Tax
Charitable Gaming
o
o
Corporate Income Tax
Retail Cigarette License
Mailing Address:
________________________________________________________________________________________________________________________________________________________________________________________________
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 Address
Location Address: Effective Date (mm/dd/yyyy):
____________________________________________
o
o
Outside City Limits
Inside City Limits
______________________________________________________________________________________________________________________________
Old Location Address (street, county, city, state and zip code)
o
o
Outside City Limits
Inside City Limits
______________________________________________________________________________________________________________________________
New 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
___________________________________________________________________________________
_____________________________________________________________________________
__________________________
(Signature)
(Printed Name)
(Date)
Mail to: KDOR - Taxpayer Assistance Center, PO Box 3506, Topeka KS 66625-3506 or fax to 785-296-2073. If you have questions about
the completion of this form, call 785-368-8222.
DO-5 (Rev. 10-20)
800518
KANSAS DEPARTMENT OF REVENUE
NAME OR ADDRESS CHANGE FORM
Individual
Current Name:
Current SSN:
_____________________________________________________________________________________________________________
____________________________________
o
I am changing my name. New Name:
____________________________________________________________________________________________________________________________________
o
I am changing my address
_____________________________________________________
______________________________________________
_____________________________________________________________________________________
Social 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)
____________________________________________________________________________________________________________________________________________________
_______________________________________
Signature
Date
Business
Current Business Name:
Current EIN/SSN:
________________________________________________________________________________________
_____________________________________
o
I am changing my business name. New Business Name:
_________________________________________________________________________________________________________
o
I am changing my DBA name. New DBA Name:
_____________________________________________________________________________________________________________________
o
o
o
I am changing my address:
Business Mailing Address
Business Location Address
o
o
o
I am correcting my EIN:
New EIN
Old EIN
________________________________
__________________________________
This change will affect the following tax accounts:
o
o
o
Retailers’ Sales Tax
Dry Cleaning Surcharge
Tire Excise Tax
o
o
o
Withholding Tax
Liquor Drink Tax
Transient Guest Tax
o
o
o
Consumers’ Compensating Use Tax
Liquor Enforcement Tax
Vehicle Rental Excise Tax
o
o
o
Retailers’ Compensating Use Tax
Nonresident Contractor
Water Protection/Clean Drinking Water Fee
o
o
o
Cigarette Vending Machine Permit
Privilege Tax
Charitable Gaming
o
o
Corporate Income Tax
Retail Cigarette License
Mailing Address:
________________________________________________________________________________________________________________________________________________________________________________________________
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 Address
Location Address: Effective Date (mm/dd/yyyy):
____________________________________________
o
o
Outside City Limits
Inside City Limits
______________________________________________________________________________________________________________________________
Old Location Address (street, county, city, state and zip code)
o
o
Outside City Limits
Inside City Limits
______________________________________________________________________________________________________________________________
New 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
___________________________________________________________________________________
_____________________________________________________________________________
__________________________
(Signature)
(Printed Name)
(Date)
Mail to: KDOR - Taxpayer Assistance Center, PO Box 3506, Topeka KS 66625-3506 or fax to 785-296-2073. If you have questions about
the completion of this form, call 785-368-8222.
DO-5 (Rev. 10-20)