Form 28249 Request For Copies Of Tax Returns - Office Of State Tax Commissioner
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1STATE OF NORTH DAKOTA
OFFICE OF STATE TAX COMMISSIONER
STATE CAPITOL, 600 E. BOULEVARD AVE., DEPT. 127, BISMARCK, NORTH DAKOTA 58505-0599
701-328-2770
FAX 701-328-3700
Hearing/Speech Impaired 800-366-6888
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ONG
C
OMMISSIONER
Request For Copies Of Tax Returns
The Offi ce of State Tax Commissioner retains tax returns for three years. The copies that you request will be provided
within 10 working days from the date of your request. You will receive a complete copy of your return(s) that we have on
fi le for you. There is no charge for this service. A photo ID is required if the return(s) will be picked up in our offi ce.
Date Requested
Daytime Phone Number
Hours that you can be reached at this number
Year(s)
____ Will Pick Up
____ Please Mail
Taxpayer’s Name: (last name, fi rst name, middle initial)
Social Security No.
Spouse’s Name (last name, fi rst name, middle initial)
Social Security No.
Mailing address
If you want a copy of your return(s) mailed to or picked up by someone other than yourself, provide that person’s name
and address.
PLEASE
SIGN
____________________________________________________________________________
HERE
Signature of Taxpayer
Date
(Do not print)
For Offi ce Use Only
_____ Enclosed is a copy of your tax return(s) for the year(s) requested.
_____ From our available information, we fi nd no record of a state return fi led under the above
social security number or name for the year(s) requested.
_____ We have not completed the processing of the current tax year’s returns.
_____ Return(s) for the following year(s) are unavailable. ________________________
We are only requested to keep tax returns on fi le for 3 years.
Return(s) were picked up by:
_______________________________________________
____________________
Signature
Date
28249
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