Fillable Printable Form Coa

Form Coa

Massachusetts Department of Revenue

Form COA

Taxpayer Change of Address

Rev. 5/16

Name of taxpayer Social Security number

Name of taxpayer’s spouse Social Security number

Previous address

City/Town State Zip

New address

City/Town State Zip

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.

Signature Date

Mail to: Massachusetts Department of Revenue, PO Box 7011, Boston, MA 02204.