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

Form DO-5 is a Kansas Department of Revenue form also known as the "Name Or Address Change Form". The latest edition of the form was released in December 1, 2018 and is available for digital filing.

Download a PDF version of the Form DO-5 down below or find it on Kansas Department of Revenue Forms website.

ADVERTISEMENT

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

1494 times
Rate
4.8(4.8 / 5) 90 votes
800518
KANSAS DEPARTMENT OF REVENUE
Division of Taxation
NAME OR ADDRESS CHANGE FORM
Individual
Current Name:
Current SSN:
___________________________________________________________________
______________________
o
I am changing my name (Name return was filed under)
.
___________________________________________________________
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 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 66675-3506 or fax to 785-296-2073. If you have questions about
the completion of this form, call 785-368-8222.
DO-5 (Rev. 12-18)
800518
KANSAS DEPARTMENT OF REVENUE
Division of Taxation
NAME OR ADDRESS CHANGE FORM
Individual
Current Name:
Current SSN:
___________________________________________________________________
______________________
o
I am changing my name (Name return was filed under)
.
___________________________________________________________
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 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 66675-3506 or fax to 785-296-2073. If you have questions about
the completion of this form, call 785-368-8222.
DO-5 (Rev. 12-18)
ADVERTISEMENT
Fill PDF online