FORM MCS - NC State Form 50861 (5-03) Indiana Department of Revenue Motor Carrier Services Division Legal Name Change Affidavit 1. Enter your Federal Employer Identification Number (FEIN): (Partnerships must have a FEIN number). 2. Enter your Social Security Number (SSN): (Only if you are a sole proprietor and do not have an FEIN). 3. Enter your company’s previous legal name: 4. Enter your company’s new legal name: 5. Enter the name under which you were “Doing Business As” (DBA) only if it is different than your legal name: 6. If your DBA has changed, enter the new DBA here: 7. Enter your principal place of business street address: 8. Enter your telephone number: ( ) 9. Enter the effective date of the legal name change (mm/dd/yyyy): / / 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 Date Signed Type or Print Name ( ) Telephone Number Title Mail this form to: Indiana Department of Revenue 5252 Decatur Boulevard, Suite R Indianapolis, IN 46241-9524 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 legally organized. Normally, this will be the name under which you report and pay federal income tax. What is a Legal Name Change? A legal name change occurs when an entity changes its name but makes no change in structure. For example, a partnership is still a partnership with the same partners, a corporation is still a corporation with the same corporate officers, no change to the federal employer’s identification number (FEIN) occurs, and the only change is to the name the entity refers to itself. Husband & Wife Businesses If you marry, and you and your spouse jointly own and operate a business and share in the profits and losses, you are partners in a partnership, whether or not you have a formal partnership agreement. This means that your income will no longer be reported on federal Schedule C or C-EZ. Instead, you will file the federal partnership return, Form 1065. USDOT Numbers If your legal name changes, you will need to update your USDOT number registration. You can do this through our office by completing a Form BAS-1, and/or by completing federal Form MCS-150 if you are an interstate carrier. Call (317) 615-7350 with questions. SSRS If you are currently a member of the Single State Registration System (SSRS), you will need to request the Federal Highway Administration re-entitlement documents. A new SSRS registration receipt must be issued in the new name. Call our office at (317) 615-7350 if you have questions about this. IRP If you are a member of the International Registration Plan and obtain your plates from Indiana, your title work will be affected by a legal name change. You will owe processing fees for title and cab card changes. If you have questions about your Indiana IRP account, call our office at (317) 615-7340. IFTA If you are a member of the International Fuel Tax Agreement Consequently, if you marry and change from a sole and file your returns with Indiana, a legal name change will proprietorship to a partnership, this is not a legal name require new cab cards. There is no charge for this. change: this is a change in legal entity. Do not complete Questions? Call us at (317) 615-7345. this form. Instead, contact our office at (317) 615-7200 to cancel your sole proprietorship account and to open your OSW If you are registered in Indiana as a Transporting Company partnership account. that obtains Oversize and/or Overweight Vehicle Permits, you will need to amend your agreement with Indiana on What if the FEIN Changes? Form M-203. Call our office at (317) 615-7320 for more Generally, if the federal employer’s identification number information. changes, the account is considered a separate, or new, entity: this is not a name change. 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 $25.00 filing fee, and provide new insurance and a tariff. Call our office at (317) 615-7350 if you have questions about this. American LegalNet, Inc. www.FormsWorkflow.com