New Address or Contact InformationBy wagnertax / December 31, 2016 Change Or Update Your Contact Information Change Or Update Your Contact Information Use this form if your address, phone, email or other contact information has changed. Who Prepared Your Taxes Last Year? * Russell Landon Lois Wagner Lola "Charli" Allsup Other Tax Office Taxpayer Information Taxpayer First & Last Name (or your company name) * Taxpayer Cell Phone * Taxpayer Email Address * Spouse Information Married Filing Joint or Married Filing Separate Only (If you are filing Single or Head of Household do not fill this part out) Spouse First & Last Name Spouse Cell Phone Spouse Email Address Tax Return Mailing Address & Secondary Phone (Update) Current Mailing Address * Current Mailing Address Current Mailing Address Current Mailing Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Is Your Physical Address Different From Your Mailing Address? * Yes No If Yes Please Type Your Physical Address Here (NO PO or Virtual Addresses) This is not to direct mail here but some Government forms require your physical Personal or Company Office Address if it differs from your mailing Address. Secondary Phone? * Authorize & Confirm New or Updated Contact Info * Confirm By confirming, you authorize Wagner Tax to use this contact information as our primary form of communication.
