Department of Taxation and Finance DTF-95 (9/22) 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 website and select the option to change your address. See Need help? in Form DTF-95-I, Instructions for Form DTF-95. Use this form to update your business name, identification number, telephone number, address, owner/officer/partner/member/director/controlling person/responsible person/affiliated person information and business activity. • Attach additional sheets if necessary. • 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 Withholding/ Petroleum Limited liability company (LLC) or on file with NYS Tax Dept. MCTMT business (all fuels) limited liability partnership (LLP) Select tax type(s) to be updated. Corporation IFTA Alcoholicbeverages Other (list below): Tax type Account number Cigarette/tobacco Sales and use Highway use products Step 2 Current information on file (complete all items) Step 3 Updated information (enter only changed items) Identify your Identification number (with suffix, if any) Enter updated *New identification number (with suffix, if any) business. 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 business fax number ( ) ( ) ( ) ( ) Email address New email address Physical address (number and street) Mark an Xhere if updating address information in Section A. City County State ZIP code Your reason(s) for update(s): Country if not U.S. (see instr.) For corporations - Year of incorp.: * The new information you report here will be effective for all tax types on file. State of incorporation: All other changes will be made to only the tax types you marked in Step 1. Name of owner/officer/partner/member/director/controlling person/responsible person Ownership (%) Social Security number Step 4a Add Enter owner/officer/ Title Telephone number Effective date partner/member/ Remove ( ) director/controlling Home address (number and street) City, village, or post office State ZIP code person/responsible Revise person information Name of owner/officer/partner/member/director/controlling person/responsible person Ownership (%) Social Security number and mark an Xin the Add appropriate boxes. Title Telephone number Effective date See instructions for Remove ( ) legal restrictions. Home address (number and street) City, village, or post office State ZIP code Revise Name of affiliated person SSN for individual or EIN for business* Step 4b Add Enter affiliated person Ownership (%) Effective date Telephone number Email (AP) information for Remove ( ) purposes of cigarette and Address (home address for individuals) City, village, or post office State ZIP code tobacco tax only. Mark Revise an Xin the appropriate Name of affiliated person SSN for individual or EIN for business* boxes. Ownership (%) Add must be 5% or less to Ownership (%) Effective date Telephone number Email remove an AP. See instr. Remove ( ) Attach additional sheets Address (home address for individuals) City, village, or post office State ZIP code if necessary. Revise Mark an Xhere if you sold your business, and enter the Describe your new business activity (if changed) and enter Step 5 information below your new NAICS business activity code(s) in the box(es) Report sale of below if known (see instructions): business or change Name of buyer of business activity. 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. |
Page 2 of 2 DTF-95 (9/22) I certify to the best of my knowledge and belief that this report is true, correct, For office use only Step 6 and complete, and that I am authorized to report account updates. Previous doc loc number Sign and mail Signature your update. For Sign where to file see Title Date instructions. here Print contact name Contact’s daytime telephone number ( ) Email address of contact person 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 want to update the information or change the address for more than one tax type, and the information 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 Note: To change the physical address for petroleum business, alcoholic beverages, adult-use Effective date of this address change address(es); New cannabis, medical cannabis, and cigarette tax types, see Legal restrictions in the instructions. enter only physical Physical location of business (number and street) - Do not enter a PO Box here. New telephone number if different address from current City County State ZIP code Country if not U.S. (see instr.) information. Note: The New Business or firm name to which NYS Tax Department mailings are to be sent Effective date of this address change address(es) you list in mailing Name of person to whom NYS Tax Department mailings are to be sent (optional) Section A will address be used for New number and street or PO Box New contact telephone number the tax types you marked in City County State ZIP code Country if not U.S. (see instr.) Step 1. |