Tax 69 C Form PDF Details

Do you know what the Tax 69 C form is? If not, don't worry - most people don't. This article will explain what the Tax 69 C form is, and more importantly, when you need to file it.

You will discover more details regarding the tax 69 c form by looking through the table we compiled for you.

Form NameTax 69 C Form
Form Length3 pages
Fillable fields83
Avg. time to fill out17 min 25 sec
Other names69c form, tc 69 form, utah change, tc 69c

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Utah State Tax Commission


210 N 1950 W • SLC, UT 84134 •


Notice of Change for a

Rev. 11/21

Business and/or Tax Account

NOTE: You can make account changes online at



































Submit a separate TC-69C for each Utah tax account number.



































To register a NEW business, use (Tax Commission only),































 (multiple agencies) or form TC-69.


































This section is required. Provide your CURRENT


1 – General Information












information on file with the Tax Commission.


1a. Social Security Number (SSN)


Federal Employer Identification Number (EIN)


(required for individual sole proprietor)


(required for all business types other than sole proprietor)














































































































































1b. Utah tax account number































































































































































1c. Name of Legal Entity - PRINT If you are a sole proprietor, write your name here

Daytime phone number

Cell phone number















































Legal entity’s street address (before any changes)










Foreign country (if not U.S.)

ZIP Code















































Legal entity’s mailing address (before any changes)










Foreign country (if not U.S.)

ZIP Code















































Business website address (URL)











Email address




















































1d. Account type to change (mark only the accounts affected by this change; submit additional copies of this form as needed)

Beer tax

Brine shrimp


Fuel Taxes

 Aviation fuel

 Compressed natural gas

 Environment assur. fee

 Hydrogen

 Liquefied natural gas

Motor fuel

Special fuel supplier

Gross receipts

Insurance premium

Mining severance

Oil & gas conservation

Oil & gas severance

Radioactive waste

Property Taxes

 Centrally assessed


Sales Taxes

E-911 emergency srvcs.


Locomotive Fuel

Lubricating oil

Multi-channel video/audio

Municipal telecom

MV rental tax

Prepaid disp. cell phones

Restaurant tax

Sales and use tax

Sexually explicit business

Transient room

Waste tire


Tobacco, cigarette, e-cigarette

Withholding (employer)

Withholding mineral production

International Fuel Tax Agreement

Special Fuel User

2 – Address Change

Mark all that apply:

Corporate office / legal entity’s street address

Your business offices (if any).

Mailing address

The address you want to receive all written communications for this account.

Tax return mailing address

The address you want to receive tax returns, if different than your mailing address.

Outlet (for other changes, complete Section 5)

A physical location where you are licensed to make retail sales.

NEW Address: _______________________________________

City, State, ZIP:_______________________________________

3 – Account Closure

To close only a single sales outlet, use Section 5.

Do not use this form to close a corporation. A corporation must withdraw or dissolve through the Utah Dept. of Commerce.

You must file all tax returns for periods during which the account(s) was open.

Closure date: ________________

Close all accounts

Continued on next page

Closure date: ___________ Outlet number*: ______________
*The outlet number is printed on the sales tax license.
Closure date: ___________ Outlet number*: ______________
*The outlet number is printed on the sales tax license.
Closure date: ___________ License number: ______________
Closure date: ___________ License number: ______________

4 — Other Account Changes

Print Form

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4a. New phone number(s)

Day: ____________ Evening: ____________ Mobile: ____________

4b. Change or add email address:

The Tax Commission will send all electronic mail to this address.


New email address: _______________________________________


4c. Change DBA/Business name:





Legal business name


  

Mark here and attach Dept. of Commerce Articles of Incorporation (not required for sole proprietors)

New name: ___________________________________________


4d. Add/remove officer/owner:





Mark here and attach Dept. of Commerce Change Form.


Add (name and address):


SSN: ____________

Add (name and address):


SSN: ____________

Add (name and address):


SSN: ____________

Add (name and address):


SSN: ____________


4e. Other – explain: _____________________________________________________________


5 — Outlet Changes and Closure

If changing more than one outlet, attach additional sheets in this format.

Use Section 5 to report CHANGES to EXISTING outlets.

To add NEW SALES TAX or TRANSIENT ROOM outlets, use form TC-69B.

To add NEW CIGARETTE, TOBACCO or E-CIGARETTE outlets, use form TC-69.

Current physical street address for this sales tax outlet





ZIP code

Close sales tax outlet

Close transient room outlet

Close cigarette/tobacco license outlet Close e-cigarette license outlet

Change phone number: ____________________________

Other: ___________________________________________________________________


6 — Authorized Signature

This form will be rejected without a signature.




Authorized Applicant or Owner


TC-69C Instructions


Use this form to report changes to existing businesses already registered with the Tax Commission.

You can make most tax account changes online. Before filling out this form, see:

Do not use this form to register a new business.

To register a new business, use from TC-69, or register online at: or

To register a new business location (outlet) for an existing sales tax account, use form TC-69B.

Get forms online at:

Section Instructions

Section 1 Fill out Section 1 completely.

In 1c, provide your business information as it was or is before the change you are reporting on this form. For example, if you are changing your business name, enter the old business name in Section 1.

Only report changes for one Utah account number on this form. If you need to report changes for multiple account numbers, submit separate copies of this form.

Section 2 Use Section 2 to report address changes. Mark the box matching the type of address you are changing.

If you are reporting a new address for an outlet that has moved, complete Section 5 and provide the address currently on file with the Tax Commission.

You cannot use this form to report a new outlet for a sales tax account. Use form TC-69B (Additional

Business Locations for a Sales Tax Account).

Section 3 Use Section 3 to close your tax account. If this account has outlets, all outlets will also be closed.

If you only need to close a single outlet for a sales tax account, complete Section 5.

Section 4 Use Section 4 to report all other account changes.

Section 5 Use Section 5 to report changes to single sales outlets, such as a closure or new phone number.

If changing more than one outlet, attach additional sheets in the same format.

Section 6 Sign and date. We will not process this form without an authorized signature.

Return this form to:

Master Records

Utah State Tax Commission

210 N 1950 W

Salt Lake City, UT 84134-3310

or fax to 801-297-3573.


If you need an accommodation under the Americans with Disabilities Act, email, or call 801-297-3811 or TDD 801-297-2020. Please allow three working days for a response.

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portion of empty spaces in formtc69c

Note the required data in the section Business, website, address, URL Email, address Railcar, Property, Taxes Special, Fuel, User Address, Change Mark, all, that, apply Your, business, offices, if, any Mailing, address Tax, return, mailing, address NEW, Address and City, State, ZIP

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The application will ask you for information to instantly fill out the field Closure, date Close, all, accounts and Continued, on, next, page

step 3 to completing formtc69c

The Other, Account, Changes a, New, phone, numbers Day, Evening, Mobile b, Change, or, add, email, address New, email, address T, CC c, ChangeD, BA, Business, nameD, BA Legal, business, name New, name d, Add, remove, officer, owner Add, name, and, address S, SN Add, name, and, address S, SN and Add, name, and, address area allows you to point out the rights and responsibilities of all sides.

Filling in formtc69c part 4

Check the fields Remove, e, Other, explain Outlet, Changes, and, Closure Phone, City, County, State, ZIP, code Close, sales, tax, outlet Close, transient, room, outlet Closure, date, Outlet, number Closure, date, Outlet, number and License, number and next complete them.

step 5 to finishing formtc69c

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