State of Rhode Island Division of Taxation 
Form RI-COI 
Change of Name or Address Form
Name on record                                                                    Federal employer identification number/social security number

Address on record                                                                 Effective date of change
                                                                                                     MM/DD/YYYY
Address 2

City, town or post office      State        ZIP code                              E-mail address

Record to be changed: (check all that apply)

Corporate Tax

Employer Tax

Personal Income Tax

Sales Tax

Withholding Tax

Other 

Enter Changed Information ONLY:

Name:

dba Name:

Address:

City:

State:

ZIP code:

Telephone number:

Contact name:

Under penalties of perjury, I declare that I have examined this form, and to the best of my knowledge and belief, it is true, accurate and complete.   
                  Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
 Authorized officer signature               Print name                                         Date       Telephone number

 Paid preparer signature                    Print name                                         Date       Telephone number

 Paid preparer address         City, town or post office                    State           ZIP Code                  PTIN

                  May the Division of Taxation contact your preparer?   YES         Revised 04/2021