HomeMy WebLinkAboutHCTAT-COA (Change of Address) updated 1-2-25Form HCTAT - COA
Form HCTAT - COA
COUNTY OF HAWAII – DEPARTMENT OF FINANCE
Hawaii County Transient Accommodations Tax
CHANGE OF ADDRESS FORM
TA Number: TA-___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___ - ___ ___
Registered Name: ___________________________________________________________________
Taxpayer Name: (if different from registered name)
____________________________________________________________________________________
(FIRST) (MIDDLE) (LAST)
Old Mailing Address: _______________________________________________________________ STREET UNIT TYPE/NO.
____________________________________________________________________________________
CITY STATE ZIPCODE COUNTRY
NEW Mailing Address: ______________________________________________________________ STREET UNIT TYPE/NO. ____________________________________________________________________________________ CITY STATE ZIPCODE COUNTRY
Phone number: ( ) _____________________________________________________________
Email Address: _____________________________________________________________________
☐ Please check here if you would like to opt in to receive electronic mailings (statements, billing, etc.)
Print Name: ________________________________________________________________________
Signature: __________________________________ Date: _________________________________
By signing this form, I attest under penalty of perjury that the above information is true and correct.
(FOR OFFICE USE)
Received by: ____________________________________ Date Received: ____________________________
Scanned: ______________________________________ Date updated: _____________________________
Hawaii County Transient Accommodations Tax (HCTAT)
25 Aupuni St. STE 1101
Hilo, HI 96720
Phone: (808) 961-8273
Email: hawaiicountytat@hawaiicounty.gov