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Enter Contact Information

Street Address: Enter the address for the business. Do not use a rural route or a post office box address.

City: Enter the city for the business address.

State: Enter the state for the business address.

Zip Code: Enter the zipcode for the business address.

County: Select the county in which the business address is located.

Province: If the business is located in a country other than the United States, enter the province name.

Country: Select the country in which the business is located.

Postal Code: If the business is located in a country other than the United States, enter the postal code.

Primary Contact

Contact Name: Enter name of the person who serves as contact for this taxpayer.

Phone Number: Enter a telephone number for the contact.

Email Address: Enter an email address for the contact.

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