Waiver Of Confidentiality Provisions Relating To Wisconsin Tax Return Information Form A-270

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WAIVER OF CONFIDENTIALITY PROVISIONS
RELATING TO WISCONSIN TAX RETURN INFORMATION
Date:
(This waiver will expire 6 months after the date
entered above.)
Wisconsin Department of Revenue – Custodian of Files:
I hereby authorize the Wisconsin Department of Revenue to furnish
,
(name)
a member of the Wisconsin State Senate or Assembly
a member of the United States Congress,
and his/her staff acting on the Legislator’s behalf, information from or pertaining to my
(Specify type of tax, for example: income, corporation/franchise or sales, and years. If related to the taxpayer’s business, please state the business name)
tax return for the year(s)
.
Name of Taxpayer*
Social Security Number or WTN
Name of Spouse*
Social Security Number or WTN
Address
Title (if corporate officer)
Signature of Taxpayer*
Signature of Spouse*
* If the information to be released is from a joint return, both spouses names, social security numbers and
signatures must be included.
A-270 (R. 7-12)
Wisconsin Department of Revenue

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