Fillable Dr 5714 2/21/08 - Request For Copy Of Tax Returns - Colorado Department Of Revenue printable pdf download

Dr 5714 2/21/08 - Request For Copy Of Tax Returns - Colorado Department Of Revenue

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DR 5714 (02/21/08)

COLORADO DEPARTMENT OF REVENUE

CENTRAl DEPARTMENT oPERATIoNS DIvISIoN

TAx fIlES

DENvER, Co 80261

REQUEST FOR COPY OF TAX RETURNS

(SEE REVERSE SIDE FOR IMPORTANT INFORMATION)

MAIL COPIES TO:

Date Prepared

Name

Prepared By

Address

Section

City/State/ZIP:

IN ACCoRDANCE WITH THE PRovISIoNS of C.R.S. 39-21-113, I HEREBY REQUEST THAT THE DEPARTMENT of

REvENUE PREPARE:

TAX RETURN (FORM NUMBER)

FOR PERIOD BEGINNING

PERIOD ENDING

A Copy of:

A Certified Copy of:

Amount

Period Beginning

Period Ending

A Copy of a Cashed Refund Check

Name of Taxpayer:

Current Mailing Address (street, rte.#, box#):

City

State

ZIP

Social Security or Account Number(s)

Phone

Your requested copies will be forwarded upon receipt of remittance:

The State may convert your check to a one time electronic bank-

ing transaction. Your bank account may be debited as early as the same day received by the State. If converted, your check will not be returned. If your check is

rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account electronically.

SIGNATURE REQUIRED TO PROCESS REQUEST

I declare under the penalty of perjury in the second degree that I subscribed and filed said tax return(s) either for myself or for the taxpayer

named above as an officer of the company or an authorized representative thereof and that the signature which appears on the tax return

and the one that appears below are both my signatures.

Signature of Requestor

Spouse's Signature (if joint)

Date

# OF COPIES

DESCRIPTION

UNIT PRICE

TOTAL

Subscribed and sworn to or affirmed before me this __________________