Nebraska 22A Form
The Nebraska 22A form serves as a vital tool for individuals seeking to update their address with the Nebraska Department of Revenue specifically for individual income tax purposes. This form captures essential information, including the taxpayer's Social Security number and Nebraska ID number, ensuring that the state has accurate records. It requires the previous name and mailing address, alongside the new name and mailing address, facilitating a seamless transition for taxpayers. For those filing jointly, the form also accommodates the inclusion of a spouse's information. The document includes a declaration that the information provided is correct and complete, reinforcing the importance of accuracy. Taxpayers must sign the form and provide contact details, such as a phone number and email address, acknowledging that the Department of Revenue may use email for communication. This method, while convenient, comes with a note on confidentiality risks. Submissions can be made via fax or traditional mail, and it is advised that individuals retain a copy of the completed form for their records. Overall, the Nebraska 22A form is an essential component of maintaining updated tax information, ensuring compliance and facilitating communication with the state tax authorities.
Document Preview Example
Nebraska Change of Address Request
for Individual Income Tax Only
FORM
22A
Social Security Number |
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Nebraska ID Number |
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Previous Name and Mailing Address |
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New Name and Mailing Address |
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Your First Name and Initial |
Last Name |
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Your First Name and Initial |
Last Name |
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If a Joint Return, Spouse’s First Name and Initial |
Last Name |
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If a Joint Return, Spouse’s First Name and Initial |
Last Name |
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Street or Other Mailing Address |
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Street or Other Mailing Address |
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City |
State |
Zip Code |
City |
State |
Zip Code |
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Reason for Request |
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Under penalties of law, I declare that I have examined this request, and to the best of my knowledge and belief, it is correct and complete.
sign here
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Duly Authorized Signature |
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Phone Number |
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Email Address
Instructions
Email Address. By entering an email address, the taxpayer acknowledges that DOR may contact the taxpayer by email. The taxpayer accepts any risk to confidentiality associated with this method of communication. DOR will send all confidential information by secure email or the State of Nebraska’s file share system.
You may fax this request to
mail to: Nebraska Department of Revenue, PO Box 98911, Lincoln, NE
Please keep a copy for your records.
File Information
| Fact Name | Details |
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| Form Purpose | The Nebraska 22A form is used to request a change of address for individual income tax purposes. |
| Governing Law | This form is governed by the Nebraska Revised Statutes, specifically those related to tax administration. |
| Submission Methods | Taxpayers can submit the 22A form via fax, mail, or email, ensuring they keep a copy for their records. |
| Contact Information | Taxpayers must provide their phone number and email address, acknowledging potential confidentiality risks. |
| Signature Requirement | A duly authorized signature is required to validate the request, affirming the accuracy of the information provided. |
| Form Updates | The Nebraska 22A form has undergone revisions, with the latest version being revised in September 2021. |
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