Fillable Printable Form Coa
Fillable Printable Form Coa
Form Coa
Massachusetts Department of Revenue
Form COA
Taxpayer Change of Address
Rev. 5/16
Name of taxpayerSocial Security number
Name of taxpayer’s spouseSocial Security number
Previous address
City/TownStateZip
New address
City/TownStateZip
Type of return filed (fill in one only):
Form 1 Form 1-NR/PY Form 2 Form 3 Other
Important notice
To expedite your address change request, notify DOR electronically at mass.gov/masstaxconnect. The online service is quick, easy and secure, and
you will receive immediate confirmation that your address request has been submitted. If you have any questions about your MassTaxConnect account,
call us at (617) 887-6367 or toll-free in Massachusetts at (800) 392-6089.
SignatureDate
Mail to: Massachusetts Department of Revenue, PO Box 7011, Boston, MA 02204.
