![]() ***Do not enter new name or new address information here.įederal Identification (provide at least one) *įederal Employer Identification Number (FEIN):ĭepartment of Revenue (DOR) Account NumberĪccount Name (name of business or individual): * ![]() ![]() Select the type of change(s) you are requesting * Business Name ChangeĮnter your current account information as shown on your certificate of exemption, certificate of registration, tax return, or otherĬorrespondence issued to you by the Department. * Indicates a required field information must be provided.
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