Form 8822 example, filled in line by line
Form 8822 is shorter than it looks — for a normal home move it’s a name, an SSN, two addresses, and a signature. Here’s a completed sample with made-up details so you can see exactly what goes where, then the few ways your own form might differ.
The sample scenario
Jordan Q. Sample filed a single (not joint) return last year from an old address in Ohio, and has just moved to Phoenix, Arizona. No name change, no gift or estate filing. Here’s the completed Part I:
| Line | What it asks | In this example |
|---|---|---|
| 1 | Individual income tax returns | ☑ checked |
| 2 | Gift, estate, or GST tax returns | — left blank — |
| 3a | Your name | Jordan Q. Sample |
| 3b | Your SSN | •••-••-1234 (your real SSN here) |
| 4a/4b | Spouse’s name and SSN | — blank (not a joint return) — |
| 5a/5b | Prior name(s) | — blank (no name change) — |
| 6a | Your OLD address | 100 Maple St, Apt 4, Columbus, OH 43215 |
| 7 | Your NEW address | 250 Cactus Ln, Phoenix, AZ 85001 |
| Part II | Signature & date | Signed “Jordan Q. Sample,” dated by hand |
That’s the whole form for most people. Each line is explained in full on our plain-English instructions.
How might your form differ?
- Joint return: add your spouse on lines 4a/4b, and both of you sign.
- You changed your name (marriage, etc.): fill line 5 so the IRS can match your old records.
- Gift or estate filer (Forms 706/709): check line 2 — that routes the form to Kansas City regardless of your state.
- Foreign new address: use the country/province/postal-code boxes on line 7.
Where does this example get mailed?
It’s the old state that decides, not the new one. Jordan moved away from Ohio, so this form goes to the IRS center in Ogden, UT — even though Jordan now lives in Arizona. Look up the address for your old state.
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Common questions
Is there an example of a filled-out Form 8822?
Yes — this page shows a completed sample using made-up details. Form 8822 is short: check the income-tax box, enter your name and SSN, your old address, your new address, and sign.
What do you actually fill in on Form 8822?
For a normal home move: line 1 (individual income tax returns), lines 3a/3b (your name and SSN), line 6a (old address), line 7 (new address), and Part II (sign and date). Joint filers add the spouse on lines 4a/4b and both sign.
Where does the finished form get mailed?
To the IRS center for your OLD state — page 2 of the form maps it. In the example on this page, an old Ohio address routes to the IRS in Ogden, UT.
Sample details are fictional. Source: Form 8822 (Rev. 2-2021), verified against the live PDF.