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4506-T

Request for Transcript of Tax Return

Form

Do not sign this form unless all applicable parts have been completed.

(January 2004)

OMB No. 1545-1872

Read the instructions on page 2.

Request may be rejected if the form is incomplete, illegible, or any required

Department of the Treasury

part was blank at the time of signature.

Internal Revenue Service

TIP: Use new Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can also call 1-800-829-1040

to order a transcript. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return. There is a fee to get a copy of your return.

Name shown on tax return. If a joint return, enter the name shown first.

First social security number on tax return or

employer identification number (see instructions)

If a joint return, enter spouse’s name shown on tax return

Second social security number if joint tax return

Current name, address (including apt., room, or suite no.), city, state, and ZIP code

Address, (including apt., room, or suite no.), city, state, and ZIP code shown on the last return filed if different from line 3

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 telephone number. The IRS has no control over what the third party does with the tax information.

CAUTION: Lines 6 and 7 must be completed if the third party requires you to complete Form 4506-T. Do not sign Form 4506-T if the third

party requests that you sign Form 4506-T and lines 6 and 7 are blank.

Product requested. Most requests will be processed within 10 business days. If the product requested relates to information from a return

filed more than 4 years ago, it may take up to 30 days. Enter the return number here and check the box below.

Return Transcript, which includes most of the line items of a tax return as filed with the IRS. Transcripts are generally available for the

following returns: Form 1040 series, Form 1065, Form 1120, Form 1120A, Form 1120H, Form 1120L, and Form 1120S. Return transcripts

are available for the current year and returns processed during the prior 3 processing years

Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penalty

assessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax

liability and estimated tax payments. Account transcripts are available for most returns

Record of Account, which is a combination of line item information and later adjustments to the account. Available for current year

and 3 prior tax years

Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year

Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data from

these information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this transcrpit

information for up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS. For example,

W-2 information for 2003, filed in 2004, will not be available from the IRS until 2005. If you need W-2 information for retirement purposes, you

should contact the Social Security Administration at 1-800-772-1213

CAUTION: If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099

filed with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.

Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than four

years or periods, you must attach another Form 4506-T.

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

information requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner,

guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to

execute Form 4506-T on behalf of the taxpayer.

Telephone number of taxpayer on

line 1a or 2a

(

)

Signature (see instructions)

Date

Sign

Here

Title (if line 1a above is a corporation, partnership, estate, or trust)

Spouse’s signature

Date

4506-T

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Cat. No. 37667N

Form

(1-2004)

Form 4506-T - Request For Transcript Of Tax Return, Authorization To Release Information

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