Request For Copy Of Tax Form - Comptroller Of Maryland

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I
COT/RAD-029
Comptroller o f Maryland
Revenue Administration Division
for Copy of Tax Form
Request
1. PRINT Name & address of taxpayer(s) as shown on tax form for the requested year(s)
2. Tax ear(s) requested
3. Taxpayer's S Social Security number as shown on tax form
5.
4. PRINT current address if different from above
Spouse's Social Security number as shown on tax form
6.
If
you are requesting certified copies
please check here
7.
Mail copies to
8. Release copies to
9. Requester's telephone number
10. WRITTEN Signature of taxpayer
11. WRITTEN Signature of spouse
Date
OFFICE USE ONLY
Tax Year(s)
Account No.(s)
Taxpayer's Signature(s) verified by:
Photocopied by:
Reviewed by:
Researcher's Initials
Date
Date copies released
I
Mail to:
Comptroller of Maryland
Rev. 11/01
Revenue Administration Division
PS 2719
Taxpayer Service Section
MD
Annapolis,
21411

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