egov.oregon.gov DOR PERTAX 800-735

This document is a form for notifying the Oregon Department of Revenue of changes to a taxpayer's name or mailing address. The form can be used to report an address change, name change, or establishment of a separate residence from a spouse. It instructs taxpayers to print the form, fill it out, and mail or fax it to the provided addresses. Taxpayers are asked to provide their name, Social Security number, old and new addresses, and sign and date the form.