Form DTF 95 PGF95 2 Dtf95 Fill In

User Manual: PGF95-2

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DTF-95
(2/11)

New York State Department of Taxation and Finance

Business Tax Account Update
For office use only

• If you are only reporting an address change, the fastest and easiest way is online (not available for all tax types). Visit our Web site (see
Need help? in Form DTF-95-I, Instructions for Form DTF-95) and select the option to change your address. Use this form to update your
business name, identification number, telephone number, address, owner/officer/responsible person information and business activity.
• You may not use this form to request an entity change. See Legal restrictions in the instructions before completing this form.

Step 1

All business tax types
on file with NYS Tax Dept.

		

Select tax type(s)
to be updated.

Withholding/
MCTMT

Petroleum
business (all fuels)
Alcoholic
beverages

		
Corporation
IFTA
		 		

Identify your
business.

Current information on file (complete all items)
Identification number (with suffix, if any)

Other (list below):

Cigarette/Tobacco
products

Sales and use
Highway use
				

Step 2

Limited Liability Company (LLC) or
Limited Liability Partnership (LLP)

Tax type

Account number

Step 3

Updated information (enter only changed items)
Enter updated 		 *New identification number (with suffix, if any)
information.

Legal name (see instructions)

*New legal name (see instructions for special requirements)

Trade name (DBA)

New trade name (DBA)

Business telephone number

(

Business fax number

)

(

New business telephone number
(
)
New e-mail address

)

E-mail address
Physical address (number and street)

Mark an X here if updating address information in Section A.

City

County

Country if not U.S. (see instr.)

For corporations - Year of incorp.:

		

State

ZIP code

State of incorporation:

Step 4
Enter owner/officer/
responsible person
information and
mark an X in the
appropriate box(es);
see instructions for
legal restrictions.
Attach additional
sheets if necessary.

Step 5
Report sale of
business or change
of business activity.

New business fax number
(
)

Your reason(s) for update(s):
* The new information you report here will be effective for all tax types on file.
All other changes will be made to only the tax types you marked in Step 1.

Name of owner/officer/responsible person

Add

% Ownership

Title

Telephone number
(    )
City, village, or post office

Delete 		

Home address (number and street)

Revise

Name of owner/officer/responsible person

Add

% Ownership

Title

Telephone number
(    )
City, village, or post office

Delete 		

Home address (number and street)

Revise

Mark an X here if you sold your business, and enter the
information below

Social security number
Effective date
State

ZIP code

Social security number
Effective date
State

ZIP code

Describe your new business activity (if changed) and enter
your new NAICS business activity code(s) in the box(es)
below if known (see instructions):

Name of buyer
Address of buyer

Buyer’s EIN

Date of sale

NAICS

NAICS

Important: You may not use this form to close your account. In most cases you must file a final return; 		
corporations must complete a dissolution process. See Closing a business in the instructions.

I certify to the best of my knowledge and belief that this report is true, correct, For office use only
and complete, and that I am authorized to report account updates.
Previous doc loc number

Step 6
Sign and mail
your update. For
where to file see
instructions.

Sign
here

Signature
Title
Print contact name
E-mail address of contact person

Date
Contact’s daytime telephone number
(    )

Page 2 of 2 DTF-95 (2/11)

Address changes for business tax accounts
If not doing so online, you may report an address change for businesses on Form DTF-96, Report of Address Change for
Business Tax Accounts. To prevent you from having to complete two forms when you need to change your address and other
business information at the same time, we have included the address change information on this form. You should be able to
report all your changes on Form DTF-95.
Note: If you wish to change the address for more than one tax type, and the address is different for each tax type, you must
either attach another Form DTF-95 or Form DTF-96 for each additional tax type or, using the same format, create and attach
a separate listing that contains all the address information, indicates the tax type(s) for that address, and your identification
number.
Important: Complete steps 1, 2, and 6 before continuing below. Mail the completed form to the address listed in Step 6 of the
instructions.

Section A
List your new
address(es);
enter only
if different
from current
information.

Note: The
address(es)
you list in
Section A will
be used for
the tax types
you marked in
Step 1.

New
physical
address

New
mailing
address

Note: To change the physical address for petroleum business, alcoholic beverages, and cigarette Effective date of this address change
tax types, see Legal restrictions in the instructions.
Physical location of business (number and street) - Do not enter a PO box here.
New telephone number
		
(
)
City
County
State
ZIP code
Country if not U.S. (see instr.)

Business or firm name to which NYS Tax Department mailings are to be sent

Effective date of this address change

Name of person to whom NYS Tax Department mailings are to be sent (optional)
New number and street or PO box
		
City

County

State

New contact telephone number
(
)
ZIP code
Country if not U.S. (see instr.)



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