FORM        MARYLAND CHANGE OF ADDRESS
■       109-I            FOR INDIVIDUALS

First Name                                     Initial  Last Name                                SSN 

Spouse’s First Name                            Initial  Last Name                                Spouse’s SSN 

OLD ADDRESS 

Mailing Address - Line 1 

Mailing Address - Line 2 (PO Box, Apt No., Suite No.) 

City or Town                                                                  State ZIP Code + 4 

Telephone number                 Email address 

NEW ADDRESS 

Current Mailing Address - Line 1 

Current Mailing Address - Line 2 (PO Box, Apt No., Suite No.) 

City or Town                                                                  State ZIP Code + 4 

Telephone number                 Email address 

Please update my address information per the information above. I certify that the foregoing information is true, correct and 
accurate to the best of my knowledge. 

  __________________________________                     ___________________________________    ___________________________ 
                     Print name                                    Signature                         Date 

■ COM/RAD 109-I      Rev. 01/20                                                                                               ■ 

         FORM               MARYLAND CHANGE OF ADDRESS
■      109-I                FOR INDIVIDUALS

General Information                                                                   For more information 
You can use Form 109-I to notify the Comptroller of Maryland                          Visit www.marylandtaxes.gov or call Taxpayer Service at 
that you have changed your home mailing address. If                                   410-260-7980 in Central Maryland or 1-800-638-2937 from 
you have changed both your home and business mailing                                  elsewhere. For the hearing impaired: Maryland Relay Service 
addresses, please submit Form 109-I along with Form 109-B.                            711. 
Filling out Form 109-I                                                                Mail to: 
  • Please print using blue or black ink.                                             COMPTROLLER OF MARYLAND 
                                                                                      REVENUE ADMINISTRATION DIVISION 
•  Enter OLD  address   information   the in   first  section; enter                  TAXPAYER IDENTIFICATION 
  NEW address in the second section.                                                  110 CARROLL STREET 
  • Be sure to include any apartment, room, or suite number                           ANNAPOLIS MD 21411-0001 
  information using the common designators as shown 
  below. 
   Common Designators 
   The most common unit designators are: 
   Apartment          APT 
   Building           BLDG 
   Floor              FL 
   Suite              STE 
   Unit               UNIT 
   Room               RM 
   Department         DEPT 
•  Only enter   P.O. Box   information      yourif post  office       does  
  not deliver mail to your street address. 
  • Do not use “#” signs or other special characters, except 
  the  dash   the in   “ZIP code”   field  when      a9-digit          + 4ZIP is      
  used. 
  • Please remember to sign and date the form prior to 
  submission. 

■ COM/RAD 109-I       Rev. 01/20                                                                                      ■