This form contains 25 fields organized into 10 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Change Affects (checkboxes)
Individual income tax returns (Forms 1040, 1040-SR, 1040-NR, etc.) Checkbox
Check this box if the change of address applies to your individual income tax returns (for example, Forms 1040, 1040‑SR, 1040‑NR).
Former joint return — now establishing separate residence from spouse Checkbox
Check this box if your last return was a joint return and you are now establishing a residence separate from the spouse with whom you filed that return. Fill only if 'Individual income tax returns (Forms 1040, 1040-SR, 1040-NR, etc.)' is 'Yes'.
Depends on: Individual income tax returns (Forms 1040, 1040-SR, 1040-NR, etc.)
Gift, estate, or generation‑skipping transfer tax returns (Forms 706, 709, etc.) Checkbox
Check this box if the change of address applies to gift, estate, or generation‑skipping transfer tax returns (for example, Forms 706 or 709).
Daytime telephone (Part II)
Daytime telephone number Text
Enter the daytime phone number of the person to contact (include area code and extension if applicable), using digits and any needed separators (e.g., (555) 123-4567 x89).
Decedent's name and Social Security number
Decedent's full name Text
Enter the decedent’s full legal name including first name, middle initial (if any), and last name. Fill only if 'Gift, estate, or generation‑skipping transfer tax returns (Forms 706, 709, etc.)' is 'Yes'.
Depends on: Gift, estate, or generation‑skipping transfer tax returns (Forms 706, 709, etc.)
Decedent's Social Security number Text
Enter the decedent’s Social Security number as issued by the Social Security Administration. Fill only if 'Gift, estate, or generation‑skipping transfer tax returns (Forms 706, 709, etc.)' is 'Yes'.
Max length: 11 characters
Depends on: Gift, estate, or generation‑skipping transfer tax returns (Forms 706, 709, etc.)
New address (7) and foreign fields
New address (street, city, state, ZIP) Text
Enter your new home mailing address including street number and name, apartment or unit (if applicable), city or town, state, and ZIP code.
Foreign country name Text
If your new address is outside the United States, enter the country name for your new mailing address. Fill only if 'New address (street, city, state, ZIP)' is foreign address.
Depends on: New address (street, city, state, ZIP)
Foreign province or county Text
Enter the foreign province, county, or administrative region for your new mailing address, if applicable. Fill only if 'New address (street, city, state, ZIP)' is foreign address.
Depends on: New address (street, city, state, ZIP)
Foreign postal code Text
Enter the postal code for your new foreign mailing address, if applicable. Fill only if 'New address (street, city, state, ZIP)' is foreign address.
Depends on: New address (street, city, state, ZIP)
Prior names (5a/5b)
Your prior name(s) (5a) Text
Enter any previous name(s) you have used (first, middle, last) that the IRS should associate with your records, as instructed for line 5a.
Spouse’s prior name(s) (5b) Text
Enter any previous name(s) your spouse has used (first, middle, last) that the IRS should associate with their records, as instructed for line 5b.
Representative signature/title/date
Signature of representative, executor, or administrator Text
Enter the representative's signature (name of the representative, executor, or administrator signing this form).
Spouse name and Social Security number (4a/4b)
Spouse's name (4a) Text
Enter your spouse's full name (first name, middle initial, and last name) as shown on legal documents.
Spouse's Social Security number (4b) Number
Enter your spouse's Social Security number assigned by the Social Security Administration.
Max length: 11 characters
Spouse old address (6b) and foreign fields
Spouse's old address Text
Enter the spouse's previous mailing address (street number, street name, apartment or suite, city, state, and ZIP code) if different from line 6a.
Foreign country name (spouse) Text
If the spouse's old address is outside the United States, enter the name of the foreign country for that address. Fill only if 'Spouse's old address' is foreign address.
Depends on: Spouse's old address
Foreign province/county (spouse) Text
Enter the foreign province, state, or county for the spouse's old address when applicable. Fill only if 'Spouse's old address' is foreign address.
Depends on: Spouse's old address
Foreign postal code (spouse) Text
Enter the postal code or ZIP code that applies to the spouse's old foreign address. Fill only if 'Spouse's old address' is foreign address.
Depends on: Spouse's old address
Taxpayer name and Social Security number (3a/3b)
Taxpayer name (3a) Text
Enter the taxpayer's full name: first name, middle initial (if any), and last name exactly as you want it to appear on IRS records.
Taxpayer Social Security number (3b) Text
Enter the taxpayer's nine-digit Social Security Number (SSN) associated with this return, including dashes if applicable (e.g., 123-45-6789).
Max length: 11 characters
Taxpayer old address (6a) and foreign fields
Your old address (street, city, state, ZIP) Text
Enter your previous home mailing address including street number and name, apartment or unit number (if any), city or town, state, and ZIP code; if you use a P.O. box enter that, and if the address is foreign also complete the foreign fields below.
Foreign country name Text
Enter the full name of the foreign country for your old address if it is outside the United States; leave blank if not applicable. Fill only if 'Your old address (street, city, state, ZIP)' is foreign address.
Depends on: Your old address (street, city, state, ZIP)
Foreign province or county Text
Enter the foreign province, state, county, or region for your old address if it is outside the United States; leave blank if not applicable. Fill only if 'Your old address (street, city, state, ZIP)' is foreign address.
Depends on: Your old address (street, city, state, ZIP)
Foreign postal code Text
Enter the postal code, ZIP code, or equivalent used for your old address in the foreign country; leave blank if not applicable. Fill only if 'Your old address (street, city, state, ZIP)' is foreign address.
Depends on: Your old address (street, city, state, ZIP)