Form 8822 2012

Do not attach this form to your return. Information about Form 8822-B is available at www.irs.gov/form8822. If you are a representative signing for the taxpayer attach to Form 8822-B a copy of your power of attorney. Form 8822-B must be filed within 60 days of the change. If the change in the identity of your responsible party occurred before 2014 and you have not previously notified the IRS of the change file Form 8822-B before March 1 2014 reporting only the most recent change. Complete Form 8822-B as appropriate use applicable boxes 8a through 9b to report any changes to the identity of your responsible party. 8822-B Form Rev. August 2013 Department of the Treasury Internal Revenue Service Change of Address or Responsible Party Business Please type or print. See instructions on back. Generally it takes 4 to 6 weeks to process your address or Future developments. Information about any future developments affecting Form 8822-B such as legislation enacted after we release it will be posted at www.irs.gov/form8822. Purpose of Form Use Form 8822-B to notify the Internal Revenue Service if you changed your business mailing address your business location or the identity of your change their address or identity of their whether or not they are engaged in a trade or business. O. box. An officer owner general partner or LLC member manager plan administrator fiduciary or an authorized representative must sign. An officer is the president vice president treasurer chief accounting officer etc. If you are a representative signing on behalf of the taxpayer you must attach to Form 8822-B a CAUTION copy of your power of attorney. If you are a tax-exempt organization see instructions check here Check all boxes this change affects Employment excise income and other business returns Forms 720 940 941 990 1041 1065 1120 etc* Employee plan returns Forms 5500 5500-EZ etc* Business location 4b 4a Business name Old mailing address no. street room or suite no. city or town state and ZIP code. If a P. O. box see instructions. If foreign address also complete spaces below see instructions. Foreign country name Foreign postal code New mailing address no. street room or suite no. city or town state and ZIP code. If a P. O. box see instructions. If foreign address also complete spaces Foreign province/county Employer identification number New business location if different from mailing address no. street room or suite no. city or town state and ZIP code. If a foreign address also complete spaces below see instructions. 8a Old name of responsible party 8b New name of responsible party 9a Old SSN ITIN or EIN of responsible party 9b New SSN ITIN or EIN of responsible party Signature Daytime telephone number of person to contact optional Sign Here Signature of owner officer or representative Date Title Where To File Send this form to the Department of the Treasury Internal Revenue Service Center and the address shown next that applies to you. See Responsible Party later for more information* Enter the full name first name middle initial last name if applicable and SSN social security number ITIN individual taxpayer identification number or EIN old and new responsible party as defined next.