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. November 1991)
of Exempt Organization Tax Form
Expires: 11-30-94
Department of the Treasury
Internal Revenue Service
Name and address of exempt organization. (If a multiple
Employer identification number of exempt organization (if known)
request, please attach list of names, forms, and tax years.)
5 Tax form requested
Date requested
Form 990 or 990EZ
Form 990-PF
Document locator number
Mail copies to (show Taxpayer Service, and district or local IRS
(if known)
office address)—For inspection requests only
Type of request
IRS service center where tax
form was filed
Aperture card of
Form 990-PF
3 Requester (name, address, and telephone number)
Tax year requested
IRS office where inspection
will be made
Latest return on file
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
The cost for a copy of each return is
Arizona, Colorado, Kansas,
$1.00 for the first page and $.15 for each
New Mexico, Oklahoma,
Austin, TX 73301
Paperwork Reduction Act Notice.— We
Texas, Utah, or Wyoming
additional page. The cost for an aperture
ask for the information on this form to
card for each Form 990-PF is $1.00 for the
Indiana, Kentucky,
carry out the Internal Revenue laws of the
Michigan, Ohio, or West
Cincinnati, OH 45999
first card and $.18 for each additional card.
United States. We need the information to
If the cost to you is over $50, we will ask
Alaska, California, Hawaii,
gain access to the return you requested in
for payment in advance.
Idaho, Nevada, Oregon, or
Fresno, CA 93888
our files and properly respond to your
There is no charge to inspect a return at
request. If you do not furnish the
an IRS office. You may inspect the return
Connecticut, Maine,
information, we may not be able to fill your
at any IRS district office or at the IRS
Massachusetts, New
Holtsville, NY 00501
National Office in Washington, DC.
Hampshire, New York,
Rhode Island, or Vermont
The time needed to complete and file
Where To File.—Requests for inspection
Illinois, Iowa, Minnesota,
this form will vary depending on individual
should be sent to the District Director
Missouri, Montana,
circumstances. The estimated average time
(Attention: Disclosure Officer) of the district
Kansas City, MO 64999
Nebraska, North Dakota,
is: Recordkeeping, 7 min.; Learning
in which you want to inspect the return or
South Dakota, or Wisconsin
about the law or the form, 2 min.;
application. If you want to inspect the
Delaware, Maryland, New
Preparing the form, 17 min.; Copying,
return or application at the IRS National
Jersey, Pennsylvania,
Virginia, District of
Philadelphia, PA 19255
assembling, and sending the form to the
Office, send the request to the
Columbia, any U.S.
IRS, 14 min.
Comissioner of Internal Revenue, Attention:
possession, or foreign country
Freedom of Information Reading Room,
If you have comments concerning the
Item 1—Enter the organization’s official
1111 Constitution Avenue, NW.,
accuracy of these time estimates or
name (that is, the name under which
Washington, DC 20224. The office
suggestions for making this form more
exempt status was recognized). If you do
handling your request will contact you
simple, we would be happy to hear from
not enter the official name, we may not be
when the form or application is available
you. You can write to both the Internal
able to locate the requested return.
for inspection.
Revenue Service, Washington, DC 20224,
Attention: IRS Reports Clearance Officer,
Requests for a copy of an organization’s
Item 5—If you are requesting a copy of an
T:FP; and the Office of Management and
return should be sent to the Internal
exemption application, check the “Other”
Budget, Paperwork Reduction Project
Revenue Service Center for the place
box and write in “exemption application.”
(1545-0495), Washington, DC 20503. DO
where the organization’s principal office is
For a copy of forms not listed in item 5,
NOT send this form to either of these
located. See the chart on this page for the
check the “Other” box and write in the
offices. Instead, see Where To File.
form number.
If the organization’s
Send your request
Purpose of Form.—Use Form 4506-A to
Item 7—If a specific tax year is needed,
principal office
for copies of
request a copy of or to inspect an exempt
enter the year. If not, check the box for the
is located in—
forms to—
organization’s return. Also use it to request
latest return filed.
an aperture card (a type of microfiche) of
Alabama, Arkansas, Florida,
Forms 990-PF.
Georgia, Louisana,
Mississippi, North Carolina,
Atlanta, GA 39901
South Carolina, or Tennessee
Cat. No. 41722P
(Rev. 11-91)


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