Excise Tax Division - Contact Information Update Form

Submitted by skasif1 on Tue, 09/28/2021 - 12:31

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In an effort to ensure taxpayer's contact information is valid and up to date, the Department of Revenue Excise Tax Division is requesting that registered Excise Taxpayers submit their updated contact information. Only complete this form if your contact information such as address, email address or phone number has changed.

Legal Name

Trade Name

Select Identification

Last Four Digits of SSN or FEIN

Tax Type

Contact Email

Contact Mobile/Cell Number

Select contact information you wish to update

Mailing Address

Phone Number

Mobile/Cell Number (Depending on your mobile phone service, you may be charged for text messages)

New Address Line 1

New Address Line 2

City/Town

State/Province

ZIP/Postal Code

County

New Email

New Phone Number

New Mobile/Cell Number

Comments/Suggestions

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