Form Dtf-505 - Authorization For Release Of Photocopies Of Tax Returns And/or Tax Information

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DTF-505
New York State Department of Taxation and Finance
Authorization for Release of Photocopies of
(11/12)
Tax Returns and/or Tax Information
Part A – Taxpayer and tax form information
Name of taxpayer(s) as shown on return
Current name
(if different from name on return)
Street address as shown on return
Current street address
(if different than on return)
City, state, and ZIP code as shown on the return
Current city, state, and ZIP code
(if different than on return)
Primary social security number shown on return
Joint taxpayer’s social security number
Employer ID number (EIN) shown on return
If taxpayer is deceased, list date of death
Sales tax Certificate of Authority number Vehicle ID number (if requesting Form DTF-802)
Form number
Form title/tax type
Tax year or period
requested
Reason for request:
Part B – Authorized representative/person/company to receive copy of form(s)
(Complete only if information is to be sent to an individual/entity other than the one listed in Part A)
Print name of authorized individual
Print firm’s name, if applicable
Street address
City, state and ZIP code
Telephone number
(including area code)
Part C – Certification
I declare that I am either the taxpayer whose name is shown on the return, or a person authorized to obtain the tax return requested. If
the request applies to a joint return, only one spouse is required to 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
DTF-505 on behalf of the taxpayer.
Printed name
Title
Signature
Date
Telephone number
506001120094

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