Request For Copy of Tax Return

1a. Name shown on tax return. *

1b. Social Security Number *

2a. Spouse name shown on tax return.

2b. Social Security Number *

3. Current address/city/state/zip *

4. If the tax return is being sent to a third party, please list their name, address, phone number.

5. Tax return request: Form 1040, 1120, 941, etc. and all attachments as originally submitted to the IRS, including Form(s) W-2, schedules or amended returns. When requesting copies, keep in mind that we keep copies generally for 3-5 years before they are destroyed. Enter only ONE (1) type return number. If you need a copy of another form, you will have to fill out another request form.

ENTER FORM

6. How Do You Want To Receive Your Documents? *

7. Form Requested Date *

8. Year or period requested: Enter ending date of the year requested, using the mm/dd/yyyy format. If you are requesting more than three (3) years, you must be get must request your copy from the IRS.

__________________ _____________________ ____________________

9. FEE: There is a $25.00 fee for each return requested. FULL Payment must be paid before your request will be honored. *

	$	$
a. Cost of each return	$	$
b. Number of returns requested on line 8	$	$
c. Total cost. Multiply 9a by line 9b	$	$

9. If we cannot find your tax return, we will refund the fee. If the refund shoud go to the third party listed on line 4 check here _____.

Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the tax return requested. If the request applies to a join return, either husband or wife must sign.

X__________________________________________________________________________ ____________________________________

Signature Date

X________________________________________________________ _____________________________

Spouse Signature Date

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *