Legal Name Change Affidavit {MCS-NC}

State Form 50861 (R4 / 8-16) FORM MCS-NC Legal Name Change Affidavit Motor Carrier Services Division Indiana Department of Revenue Note: If your FEIN has changed, do not complete this form. Instead, contact Motor Carrier Services at (317) 615-7200. Partnerships must have a FEIN. Federal Employer Identification Number (FEIN) Company's Previous Legal Name Name Under Which You Are Doing Business As (DBA) (only if it is different than your legal name) Street Address (principal place of business) Effective Date of Legal Name Change (mm/dd/yyyy) Social Security Number (SSN) (Sole Proprietor with no FEIN) Company's New Legal Name New DBA Name Telephone Number This form must be signed by an individual authorized to sign documents on behalf of the company listed above. Print or type the name, in the space provided, of the authorized individual signing this return. This individual must sign, date, and enter his/her title in the spaces provided. I swear or affirm that the information I have entered on this form is correct. I understand that making a false statement on this form may constitute the crime of perjury. ___________________________________________________ Signature ___________________________________________________ Type or Print Name ___________________________________________________ Title Mail this form to: Indiana Department of Revenue 7811 Milhouse Road, Suite M Indianapolis, IN 46241-9612 __________________________________ Date Signed __________________________________ Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com Instructions for Completing Form MCS-NC What is a Legal Name? Your legal name is the name under which your company is USDOT Numbers legally organized. Normally, this will be the name under which If your legal name changes, you will need to update your you report and pay federal income tax. USDOT number registration. You can do this through our office by completing a Form BAS-1, and/or by completing What is a Legal Name Change? A legal name change occurs when an entity changes its name federal Form MCS-150 if you are an interstate carrier. Call but makes no change in structure. For example, a partnership (317) 615-7350 with questions. is still a partnership with the same partners, a corporation is still a corporation with the same corporate officers, no change IRP to the federal employer's identification number (FEIN) occurs, If you are a member of the International Registration Plan and and the only change is to the name the entity refers to itself. obtain your plates from Indiana, your title work will be affected by a legal name change. You will owe processing fees for Husband & Wife Businesses title and cab card changes. If you have questions about your If you marry, and you and your spouse jointly own and operate Indiana IRP account, call the department at (317) 615-7340. a business and share in the profits and losses, you are partners in a partnership, whether or not you have a formal partnership IFTA agreement. This means that your income will no longer be If you are a member of the International Fuel Tax Agreement reported on federal Schedule C or C-EZ. Instead, you will file and file your returns with Indiana, a legal name change will the federal partnership return, Form 1065. require new cab cards. There is no charge for this. Contact Consequently, if you marry and change from a sole the department at (317) 615-7345 if you have any questions. proprietorship to a partnership, this is not a legal name change: this is a change in legal entity. Do not complete this form. OSW Instead, contact our office at (317) 615-7200 to cancel your If you are registered in Indiana as a Transporting Company sole proprietorship account and to open your partnership that obtains Oversize and/or Overweight Vehicle Permits, account. you will need to amend your agreement with Indiana on Form M-203. Contact the department at (317) 615-7320 for more What if the FEIN Changes? information. Generally, if the federal employer's identification number changes, the account is considered a separate, or new, entity: this is not a name change. If the FEIN changes, do not complete this form. Instead, contact Motor Carrier Services at (317) 615-7200. If the FEIN does not change, then it may be considered simply a name change. Indiana Passenger and Household Goods Carriers If you hold Indiana Operating Authority as an intrastate passenger or household goods carrier, you will also need to complete a petition for a name change, pay a $25 filing fee, and provide new insurance and a tariff. Call the department at (317) 615-7350 if you have questions. American LegalNet, Inc. www.FormsWorkFlow.com