Fillable Form Ret-001 - Taxpayer Return Request Form printable pdf download

Form Ret-001 - Taxpayer Return Request Form

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RET-001 (Rev. 05/04)

GEORGIA DEPARTMENT OF REVENUE

Taxpayer Return Request Form

Clear Form

Print Form

PLEASE PRINT CLEARLY

Fill In Form

Taxpayer Name:

_______________________________________________________

Address On Return:

_______________________________________________________

City/State/Zip:

_______________________________________________________

Current Address (if different):_______________________________________________________

City/State/Zip:

_______________________________________________________

Phone Number (Day):

________________________________

Social Security Number:

________________________________

Spouse’s Social Security

Number (if applicable):

________________________________

Year(s) of Return:

________________________________

Date Return(s) Filed:

________________________________

mm/dd/yy

Signature:________________________________________________ Date: _________________

mm/dd/yy

FEE - $1.00 PER PAGE DO NOT MAIL CASH

Please Check the Appropriate Box(es):

Georgia 500 ( )

Federal Attachments ( )

W-2 Forms ( )

Front Page Only ( )

Please mail completed form to:

Georgia Department of Revenue

P.O. Box 49512

Atlanta, GA 30359-1512

Form Ret-001 - Taxpayer Return Request Form

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