📄 Extracted Text (2,378 words)
Form 4506-T Request for Transcript of Tax Return
(Rev. September 2013)
Department of Iho Treasury Ito Request may be rejected if the form is Incomplete or Illegible. we No 1645.1872
lel anal Revenue Sonko 420361321
Tip: Use Form 4506- T to order a transcript or other return Information free of charge. See the product list below. You can quickly
request
transcripts by using our a lomat ed sett-help service tools. Pleasevisit us at 1FtS.gov and Nick on "Order a Return or Account Transcript" or
cal 1.800.908.9946. If you need a copy of your return, use Form 4606, Request for Copy of Tax Return. There Is a fee to get a copy of
your return,
is Name shown on I ex return. it a joint return, ant er the name shown f nat. lb First social security number on tax return.
Indit4dual taxpayer Identification number, or
number Nee Instructions)
IIIIIIIIIIIIII . e's name shown on t ax return y numberor Individual
taxpayer Identification numbed( joint tax return
3 Current name.address finclud.ne ant rnnm or time, na 1 My .-ogeo, and ZIP codo (see Instructions)
(see Instructions)
If the transcript or tax Information Is to be mailed to a third party (such as a mortgage company), enter the third party's name, address,
and to'ephone number.
Caution:ifMe tax transcript is being malted toe third party. ensure that you have fared In lines 6 through 9 bat ore signing. S tan and date the
form once you have filled In these lines. Completing these steps helps to protect your privacy. Once the IRS dscloses your tax transcript to
the third party listed on line 5, the IRS has no control over what the thin/party don lath the information. If you would like to limit the third
party's authority to stolen your transcript Information, you can specify this irritation In your wane° agreement toilh the third party.
6 Transcript requested. Enter the tax form number here (1040, 1065, 1120, et c.) and check the appropriate box below. Enter only one tax
form number per request. ► 1040,e/2,1099
a Return Transcript, which includes most of the line Items of a tax return as filed with the IRS. A tax return transcript does not reflect
changes made to the account alter the return Is processed. Transcripts are only available for the following returns: Form 1040 series,
Form 1065, Form 1120, Form 1120A , Form 112011, Form 11201, and Form 11205 . Return transcripts are tweed° for the current
year and returns processed during the prior 3 processing years. Most requestsv.4n be processed wit Mil 10 business days_ _
b Account Transcript, which contains information on the financial status of the account, such as payments made on the account.
penal y assessments, and adjustments made by you or the IRS after the return was Med. Return Information Is limited to Items such as
tax liabilty and estimated lax payments. Account transcripts are available for most returns. Most requests will be processed within 10
beakless days DE
c Record of Account, which provides the most detailed Information as l is a combination of the Return Transcript and the Account
Transcript. Available for current year and 3 prior tax years. Most requests wilt be processed wit bin 10 business days
7 Verification of Nonliling,whkh Is proof from the IRS that you did not file a return for the year. Current year requests are only available
after June 15th There are no availability restrictIons on prior year requests. Most requestswil be processed within 10 businessdays.
8 Form W.2, Form 1099 series, Form 1098 series, or Form 6498 series transcript. The IRS can provide a transcript that includes
data from these Information returns. Slate or local Information Is not Included w Ith the Form W-2 Information. The IRS may be able
to provide this transcript Information for up to 10 years. Information for the current year Is generaly not available until the year
after it Is filed with the IRS. For example, W2 Information for 2011, hied In 2012, wil Rely not be available from the IRS uMil
2013. If you need W-2 Information for retirement purposes, you should contact the Social Security Administration at
1.4100.772. 1213. Mos t requests will bo processed within 10 bus bless days al
Caution: If you need a copy of Form W.2 or AVM 1099, you should first contact the payer. To got a copy of the Form W-2 or Form
1099 f fled with your return, you must use Form 4506 and request a copy of your return, tvhkh Includes all attachments.
9 Year or period requested. Enter the ending date of the year or period, using the miniddly yyy formal. If you are requesting more than four
years or periods, you must attach another Form 45064. For requests relating to quarterly tax returns, such as Form 941, you must
enter each quarter or lax period separately. 12/31/2013 12/31/2012 12/31/2011 12/31/2010
Check this box if you have notified the IRS or the IRS has notified you that one of the years for which you are requestbg a
transcript Involved Identity theft on your federal lax return IM
Caution. Do not sign this form unless all applicable foes have been ©owlet ed.
Signature of taxpayer(s). I declare that I am either the taxpayer whose name Is shown on line la or 2a or a rson authorized to obtain the
lax Information requested. If the request apples to a joint return, at least ono spouse must sign. If signed a corporate officer, partner,
guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer. I rtify that I have the authority
to execute Form 4506-1- on behalf of the taxpayer. Note. For transcripts being tent to a third party, this form must be received within 120
days of the signature date.
...-
Phone number of taxpayer on
121.119
Mee'
Sign
Here line (4 brio to above Fs a orporabon, peen ersbn, eve to, or trust)
Spouses signature Dato
For Privacy Act and Paperwork Reducton Act Notice, see page 2. Cal. No. 3766714 Fpm 4689-T (Rev. 9.2013)
bolters Nowa Finnan Services W090457(1405)
CONFIDENTIAL SDNY_GM_00030258
EFTA_00140876
EFTA01279830
Form 4508.1(Rev. 9.2013)
Section references eve to me Internal Revenue Pam 2
Code unless otherwise noted. Chart for all other transcripts Partnerships. Goners y, Fern 45064 can be
signed by any person who was a member of the
Future Developments If you Med i Mall or fax to patio ershlp during any pad of the lax period
Foe Melded Informal:mahout Form 4506.1and your business requested on Ono 9.
es halm crions„go to was In:
vnwe .Irs.govIforrn45061 . Information about Al others. See section 8103(e)V the
any recent dovelopments allotting Font 4506.1 Alabama, Masks, taxpayer has riled, Is Intro/vent Is a dissolved
(such as bpi:station enacted seerwe rebated Arizona. Arkansas, corporation, or if n trustee, guardian, executor,
wit be posted on that page. deMo min, Colorado, receiver, or administrator Is acting for the
Florida, Hawai, Idaho, taxpayer.
General Instructions t mal .nn
Iowa, Kansas. LOWS13/10, laWri eaminn 'Service Documentation. For entitles other than
CAUTION. Do not sign this form unless tel Mrnnelait Mini"PP II individ oaks, you must attach the authorization
applicable tines have been completed. Missouri, Montana, P.O. Box 0941
Nebraska Nevada. Mel Stop 8734 document. For ex amok), ells could be the teller
Purpose of form Use Form 4508-1 to request New Mexico, North Ogden, UT 84409 from rho principal arbor outhoikkm an
tax return Informaron. You can also designate Dakota, Oklahoma, employee of the corpomfon or the tellers
(on Me 5)o third party to receive Oro information. Oregon. South Dakota, testamentary authorizing an Individual to oat for
Taxpayers using a tax year beginning in one Texas, Utah, an estate.
caMbdor yo or end ending In the following year
Vaishinta0l1i Wo Signature by a representative. A
(fiscal lax yew) must frio Form 4506-T to request a foreign country, or g' 80142043922
a return transat. A.P.O. or FRO. address representative can sign Form 45064 for a
taxpayer only if the taxpayer has specific ely
Note. If you are unsure of which typo of delegated Pits auth arty to the reprosentathe on
transcript you aced, request Pro Record of Connealat. Form 2848. Me 5, The representative mid
Account, as I provides the most detailed Delaware. 0;striol of
Information. Columba, Georgia, alta ch Form 2848 showing ran dcdogation to
Okla, Indiana, Form 4508-1.
lip. Use Form 4508, Request for ropy of Tax Kentucky. Matte,
Rdurn, fo request copies of tax returns. Marytand, Privacy Act and Paperwork Reduction Act
'Moral Revenue Service
Automated transcript request. You can Massachusetts, RAIVS Teem Notice. Inb ask for the information en this form
quickly request transcripts by 'sing our Michigan, New P.O. Box 146500 to ostab5sh your right to gab access to the
automated Solf•help servo fools. Pinto vis1 us Hampshko. New Jersey, Stop 2800 F requested lax informaten under the Internal
at IRSeor and click on 'Order a Return or Naw York. North ancinnall, OH 45250 Revenue Code. Wo need this Information to
Account Transcript* or can 14009084940. Camino, Ohio. property identify the tax Womsation end respond
Painsykania, Rhode to your request. You are not required to rennin,
Where to tile. Mall or fax Form 4506.T to m e Island, South Carolina,
address below for lho able you Wad In, or the Tennessee, Vermont, any tronscripl: if you do request a transcript,
slate your business was In, when that return was Verginb. Mal Virginia. 859469-3592 sections6103 and 8109 and their regulations
lied. Them aro two address charts: one for Vibcondri require you to provide this Jerome/ion, including
Ind/Moatranscripts (Form 1040 sodas and Form your SSN or DN. If you do not provide this
W.2) end one for tal other transcripts. Information, wo may not bo able to process your
Line lb. Enter your empbyer identirca ton request. Providing false or fraudulent Information
If you we request.ng more than ono transcript number (01/8 V your rawest relates to a business may subject you to Napkins.
or other product and the chart below shows Iwo return. Mends., enter to that social security
afferent addrossos, send your request to rho number (SSN) or your Individual taxpayer Routine uses of this information Include giving
address based on the address of your most Wont& align number OTIN) strewn on the return, to the Department of JUSG30 for civil end
recent return. For example. U you are requesting Form 1040 that minimal lag ation, and cabs, states, the District
Includes Schedule C (Form 1040), enter your SSN. of Columbia, and U.S. commonwealths and
Chart for individua transcripts possessions Larose In administering their tax
Line 3. Eater your current address. It you use a laws. We may also disclose ails hibernation to
m series and Fom W-2 P.O. box, Include It on this Eno. other countries under a lex treat', to federal end
a(Fornd Forn
10401099) Line 4. Enter the address shown on Pro last
stab oarlocks to enforce fedora' minas criminal
11 you tiled an return Ned a different from the address entered taws, or to federal law enforcement and
Mall or Fax to krieligence agencies to combat terrorism.
indigduat return on Me 3.
and lined in: You are not requited to provide the
Note. If the address on linos 3 and 4 are
Alabama, Kentucky. Internal Revenue defo rent and you have not changed your address kilo rrnalbn requested on a form that Is subject
Louisiana, Strube to the Paperwork Reduction Act Unless Pr o form
will the IRS, file Form 8822. Orange of Address. displays a yard CtAB control number. Books or
Mississippi, PAWS Team Fa a business address, no Form 8822.8, Change
Tennessee, Texas, a Stop 6716 AUSC records relating to a form or is instructions
of Address or Ftesponseb Party - Business. must bo retained as long as their contents may
foreign country. American A ustn , TX 73301
SWOOP, Puerto Rico, Line 6. Enter only ono tax form number per become material In the administration of any
Guam, rho request. Internal Rovenuo low. Generally, lax returns and
Conunenwealls of the Signature and date. Form 4506.7 must be return Information aro confidenlial as required
Northern Marian Islands, signed end dated by the taxpayer fated on Meta by section 6103.
the U,S. Web Islands, or or 2a. If you completed Inc 5 requesting the
A.P.O, or F.P.O. 512.460.2272 Tho Iune needed b complete and fie Fenn
address informaon be sent to a third party, the IRS must 45064 wit vary depondog on individual
receive Fern 4506-Twain 120 days of lb o date chow/W.1min. The estanatod average tine It:
Alaska, Arizona, Internal Revenue signed by the taxpayer or a will be winded. Learning about the taw or the form, 10
Arkansas, CaWomb, Service Ensure that al applcabb Ines wo completed mat: Preparing the form 12 min.; and
Colorado, Hayek. Idaho, RAIVS Team before signing. Copying,assembling and serving the form
book, Indiana, Iowa, Stop 37106 to the IRS, 20 min.
Kansas, Michigan, Fiosno. CA 03888 Individuals Tronsaipts of jointly red lax
Minnesota. Montana, returns may ho furnished to ether spouse. Only If you have comments corbelling the
Nebraska, Nevada, Nays ono egneleto Is required. Sign Form 4506.1 accuracy of these tine estimates or suggestions
Moxbo, North Dakota, coscly as your name appeared on the inland for making Form 4508.1simpler, wo would bo
Oklahoma, Oregon. South return. Ir you changed your name, mho sign your happy to hear from you. You can wrap to:
Dakota, Utah. current name.
Washington, Wsconsil, Internal Revenue Scribe
659456.7227 Corporations. General/. Form 4506:Fcon Tax Forms and Publbolons Division
Wyoming be signed by: (1) an oak or having legal 1111 Constitution Ave. NW, II24626
Connecticut, Delaware, Internal Revenue authority to bind the corporation, 12) any poison Washington, DC 20224
Mind of Columbia, Service designated by the board el directors or oiler
goveming body, or (3) any officer or employer. Do not send the form to this address Indeed,
Florida, Georgia. RAIVS Team see Where to rate on this page.
Mahe, Maryland, Slop 6705 P8 on wog° n request by any principal officer and
Massachusers 4999 CAY, MO ablated IO by the secretary or other olio er.
Kansas
Missouri, Now karrbe,
New Jersey. New YYork,
North Cambria, Ohio,
PennsyNanb, Rhode
Island, South Otrofna,
Vermont, Virginia, 816.2924102
West Virginia
Wolters Mower Financial Services
CONFIDENTIAL SONYSItto4M0141issi
EFTA_00I40877
EFTA01279831
ℹ️ Document Details
SHA-256
1d4c708bbcf6f5f47f9364bee7615596ed0bada45540d71070b006ff9a7a3550
Bates Number
EFTA01279830
Dataset
DataSet-10
Document Type
document
Pages
2
Comments 0