Form It Whc - Change Of Ohio Employer, Name, Address Or Status
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IT WHC
Change of Ohio Employer, Name, Address or Status
Rev. 1/08
Please use the top and bottom of this form to report any changes of mailing address, name, merger information or out-of-business informa-
tion. If this change is because you are out of business, you must fi le a fi nal reconciliation for the fi nal period you were in business on form
IT 941. If a change in ownership or a change in business status (such as changing from a sole proprietorship to a corporation) occurs,
and you receive a new federal employer identifi cation number (FEIN), you must fi le a fi nal reconciliation form IT 941 for the old account
and complete the bottom of this form to obtain a new Ohio withholding account number. If a merger has taken place, the nonsurvivor must
fi le a fi nal reconciliation form IT 941 and complete the merger information on the bottom of this form.
FEIN
Ohio Tax ID No.
New Name, Mailing and Location Address
Previous Business Name and Mailing Address
Business name
Business name
Address
Owner’s name/responsible party
City
State
ZIP code
New mailing address
City
State
ZIP code
Please send your completed form to us by fax or by mail.
Physical location (street address and number)
Fax to: 614-387-1851 or
City
State
ZIP code
Mail to: Ohio Department of Taxation
Taxpayer Services Division
Registration Section
NAICS code
Telephone number
P.O. Box 182215
Columbus, OH 43218-2215
Indicate changes or additions only by checking the appropriate box and entering the information requested.
M M D D Y Y
Out of business
Effective date
No employees at this time –
inactivate account
M M D D Y Y
Merged
Effective date
Survivor’s name
Survivor’s
Survivor’s
federal ID
Ohio ID
M M D D Y Y
Business status
Effective date
New business type
change
New federal ID
New name
to be registered
Form IT 941, the fi nal reconciliation, is enclosed.
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