Indiana MF-629

This article details the process for updating business contact information with the Indiana Department of Revenue using the official Change of Name or Address form.

The Indiana Department of Revenue Form MF-629, titled the Change of Name / Address Form, is a specialized administrative document used by businesses to update their official records with the state’s Special Tax Division. This form is specifically designed for current license holders who need to report a modification to their legal name, trade name (DBA), physical location, or mailing address. It is important to note that this form is strictly for updating existing entity details and must not be used to report changes in ownership; such structural changes typically require a new registration or different legal filings. By submitting this document, taxpayers ensure that they remain in compliance with state regulations and continue to receive critical tax correspondence, license renewals, and legal notices without interruption. The form covers various license types, including Special Fuel, Gasoline Distributors, and Aviation Fuel Excise Tax licenses, allowing for a consolidated update across multiple fuel tax accounts.

How To File The Form

You can file this form by mailing the completed and signed document to the Indiana Department of Revenue, Special Tax Division, P.O. Box 6080, Indianapolis, IN 46206. If you require assistance or have specific questions before filing, you may contact the Fuel Tax Section directly by calling 317-615-2630 or by sending an email to [email protected]. Ensure that all relevant license numbers are included to prevent processing delays.

How To Complete The MF-629 Form

How To Complete The MF-629 Form

Change Type And Location Selection

Check All That Apply
At the top of the form, indicate the nature of the update by checking the appropriate boxes. You can select “Name Change” if your business name has been legally altered, and “Address Change” if you have moved or changed your mailing destination. You may check both if applicable.

Location Selection
Specify which address type is being updated by marking the “Physical” box for your actual business location or the “Mailing” box for where you receive mail. You can select both if the change affects both addresses.

Previous Information

Previous Name And/Or Address
In the left-hand column labeled “Previous Name and/or Address,” enter the information exactly as it currently appears on your state records before the change.

  • Taxpayer Name: Enter the old legal name of the business.
  • DBA: Enter the old “Doing Business As” trade name, if applicable.
  • Address: Provide the old street address.
  • City, State, ZIP Code: Fill in the city, state, and ZIP Code for the old address.

New Information

New Name And/Or Address
In the right-hand column labeled “New Name and/or Address,” enter the updated information you wish to have on file.

  • Taxpayer Name: Enter the new legal name of the business.
  • DBA: Enter the new “Doing Business As” trade name, if applicable.
  • Address: Provide the new street address.
  • City, State, ZIP Code: Fill in the city, state, and ZIP Code for the new address.

License Identification

License Numbers
To ensure the changes are applied to all your accounts, list every license number affected by this update.

  1. Taxpayer Identification Number (TID): Enter your primary state tax ID.
  2. Special Fuel License Number: If you hold this license, enter the number here.
  3. Gasoline Distributor’s License Number: If you are a distributor, provide your license number.
  4. Indiana Gasoline Use Tax License Number: Enter this number if you are registered for gasoline use tax.
  5. Indiana Aviation Fuel Excise Tax License Number: If you deal in aviation fuel, include this license number.

Authorization And Signature

Signature Section
The form must be validated by an authorized individual.

  • Signature: Sign the document.
  • Date Signed: Enter the date of signing.
  • Printed Name: Clearly print the name of the signer.
  • Title: State the official job title of the signer.
  • Telephone Number: Provide a contact phone number.
  • Email: Enter a valid email address for further communication.
  • Taxpayer Identification Number (TID): Re-enter your main Taxpayer Identification Number in the signature block area to confirm the account identity.
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