4
                                                                                                  6
           NC-AC                                                                         PRINT    CLEAR
Web-Fill
12-18      Business Address Correction

Account Information
SSN or FEIN
                                                            Fill in all applicable circles: 
                                                                   All Business Accounts 
Account ID                                                         Franchise and Corporate Income 
                                                                   Partnership 
                                                                   Sales and Use* 
Effective date of change:
                                                                   Withholding
                                                                   Other
Legal Name

*If you registered via the Streamlined Sales Tax Registration System, do not use this form. Any updates must be made at www.sstregister.org.

Old Address
Old Address

City                                                  State             Zip Code

New Address
New Street Address

City                                                  State             Zip Code

New Mailing Address (if different from street address)

City                                                  State             Zip Code

If business has moved to another N.C. county, indicate new county: Phone number:

Mail to:  North Carolina Department of Revenue, P.O. Box 25000, Raleigh, North Carolina 27640-0001
                         (Do not send this form with a tax return.)