Excise Tax Division - Contact Information Update Form Submitted by skasif1 on Tue, 09/28/2021 - 12:31 Indicates required field 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 - Select -SSNFEIN Last Four Digits of SSN or FEIN Tax Type - Select -Motor FuelsMotor Carrier (IFTA/Intrastate)Alchohol Tobacco Contact Email Contact Mobile/Cell Number Select contact information you wish to update Mailing Address Email Phone Number Mobile/Cell Number (Depending on your mobile phone service, you may be charged for text messages) New Address New Address Line 1 New Address Line 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code County New Email New Phone Number New Mobile/Cell Number Comments/Suggestions This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
