Form 4506-A - Request For Public Inspection Or Copy Of Exempt Organization Tax Form


Request for Public Inspection or Copy
OMB No. 1545-0495
(Rev. September 1994)
of Exempt Organization Tax Form
Department of the Treasury
Internal Revenue Service
Exempt organization’s name and address (city and state). If a
Employer identification number of exempt organization (if known)
multiple request, please attach list of names, forms, and tax
5 Tax form requested
Form 990 or 990-EZ
Exemption application
Form 990-PF
Other (specify)
Type of request
For inspection of a return at an IRS district office, enter
Aperture card of
“Taxpayer Service” and the IRS district office address.
Form 990-PF
Tax year requested
Latest return on file
Date requested
Document locator number (if known)
Internal Revenue Service Center where tax form was filed
3 Requester’s name, address, and telephone number
IRS office where inspection will be made
IRS Use Only
For returns files:
Copy of requested tax form is attached.
We find no record of requested tax form.
13 The tax form requested above was inspected (name of requester)
15 IRS office where inspection was made
Signature of employee present at inspection
$.18 for each additional card. If your cost
Arizona, Colorado, Kansas,
is over $50, we will ask for payment in
New Mexico, Oklahoma,
Austin, TX 73301
Texas, Utah, Wyoming
Paperwork Reduction Act Notice.—We
ask for the information on this form to
Indiana, Kentucky,
There is no charge to inspect a return at
Michigan, Ohio,
Cincinnati, OH 45999
carry out the Internal Revenue laws of the
an IRS office. You may inspect the return
West Virginia
United States. We need the information to
at any IRS district office or at the IRS
Alaska, California, Hawaii,
gain access to the return you requested in
National Office in Washington, DC.
Idaho, Nevada, Oregon,
Fresno, CA 93888
our files and properly respond to your
Where To File.—If you want to inspect a
request. If you do not furnish the
Connecticut, Maine,
return or an approved exemption
information, we may not be able to fill your
Massachusetts, New
Holtsville, NY 00501
application or get a copy of an application,
Hampshire, New York,
send Form 4506-A to the District Director
Rhode Island, Vermont
The time needed to complete and file
(Attention: Disclosure Officer) of the district
Illinois, Iowa, Minnesota,
this form will vary depending on individual
Missouri, Montana,
in which you want to inspect the return or
Kansas City, MO 64999
circumstances. The estimated average time
Nebraska, North Dakota,
application or in which you reside. If you
South Dakota, Wisconsin
is: Recordkeeping, 7 min.; Learning
want to inspect the return or application at
Delaware, Maryland, New
about the law or the form, 2 min.;
the IRS National Office, send the request
Jersey, Pennsylvania,
Preparing the form, 17 min.; Copying,
to the Comissioner of Internal Revenue,
Virginia, District of
Philadelphia, PA 19255
assembling, and sending the form to the
Columbia, any U.S.
Attention: Freedom of Information Reading
IRS, 14 min. If you have comments
possession, foreign country
Room, 1111 Constitution Avenue, NW,
concerning the accuracy of these time
Washington, DC 20224. The office
Line 1.—Enter the organization’s official
estimates or suggestions for making this
handling your request will contact you
name (that is, the name under which
form simpler, we would be happy to hear
when the form or application is available
exempt status was approved). If you do
from you. You can write to the Internal
for inspection or you will receive the copy
not enter the official name, we may not be
Revenue Service, Attention: Tax Forms
by mail.
able to locate the requested return.
Committee, PC:FP, Washington, DC
For a copy of an organization’s return,
Lines 2 and 11.—To inspect a return at a
20224. DO NOT send this form to this
send Form 4506-A to the Internal
district office, complete line 2; do not
address. Instead, see Where To File.
Revenue Service Center for the place
complete line 11. To inspect a return or
Purpose of Form.—Use Form 4506-A to
where the organization’s principal office is
exemption application at the National
request a copy of or to inspect an exempt
Office or to inspect an exemption
organization’s return or approved
application at a district office, complete
exemption application. Also use it to
If the organization’s
Send your request
line 11; do not complete line 2.
request an aperture card (a type of
principal office
for copies of
Line 5.—If you are requesting a copy of a
is located in:
returns to:
microfiche) of Forms 990-PF.
form or other item not listed, check the
The cost for a copy of each return or
Alabama, Arkansas, Florida,
“Other” box and write in the form number
exemption application is $1.00 for the first
Georgia, Louisana,
Atlanta, GA 39901
or other item.
Mississippi, North Carolina,
page and $.15 for each additional page.
South Carolina, Tennessee
Line 7.—If a specific tax year is needed,
The cost for an aperture card for each
enter the year. If not, check the box for the
Form 990-PF is $1.00 for the first card and
latest return filed.
Printed on recycled paper
Cat. No. 41722P
(Rev. 9-94)


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