Nebraska Form 22A PDF Details

Are you a Nebraska resident searching for information about Form 22A? We understand the Tax Code can be difficult to decipher and filing taxes is often times frustrating. That’s why we’ve put together this brief guide that outlines some general facts about Form 22A, how it affects your tax obligation in the state of Nebraska, and what documentation you'll need as a filer. Whether you're new to Nebraska or an experienced filerer, let's take a look at what makes up Form 22A and dive into some of its key requirements.

QuestionAnswer
Form NameNebraska Form 22A
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names Nebraska Change of Address Request for Individual Incom

Form Preview Example

Nebraska Change of Address Request

for Individual Income Tax Only

FORM

22A

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

Nebraska ID Number

 

 

 

 

 

 

 

 

 

Previous Name and Mailing Address

 

New Name and Mailing Address

 

 

 

 

 

 

 

Your First Name and Initial

Last Name

 

Your First Name and Initial

Last Name

 

 

 

 

 

 

 

If a Joint Return, Spouse’s First Name and Initial

Last Name

 

If a Joint Return, Spouse’s First Name and Initial

Last Name

 

 

 

 

 

 

 

Street or Other Mailing Address

 

 

Street or Other Mailing Address

 

 

 

 

 

 

 

 

City

State

Zip Code

City

State

Zip Code

 

 

 

 

 

 

Reason for Request

 

 

 

 

 

Under penalties of law, I declare that I have examined this request, and to the best of my knowledge and belief, it is correct and complete.

sign here

 

 

 

 

 

Duly Authorized Signature

 

Date

 

Phone Number

 

 

 

Email Address

Instructions

Email Address. By entering an email address, the taxpayer acknowledges that DOR may contact the taxpayer by email. The taxpayer accepts any risk to confidentiality associated with this method of communication. DOR will send all confidential information by secure email or the State of Nebraska’s file share system.

You may fax this request to 402-471-5927, or

mail to: Nebraska Department of Revenue, PO Box 98911, Lincoln, NE 68509-8911.

Please keep a copy for your records.

8-548-1996 Rev. 9-2021

8-548-1996 Rev. 11-2016

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Filling out section 1 in Nebraska Form 22A

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