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

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Authorization for Release of Photocopies
DTF-505
(5/05)
of Tax Returns and/or Tax Information
To:
Disclosure Officer
NYS Tax Department
Office of Budget and Management Analysis
Disclosure & Government Exchange
W A Harriman Campus
Albany NY 12227
Telephone number: (518) 485-8594
Fax number:
(518) 485-0243
I,
(
) of
(Print name of taxpayer)
(Social security or employer identification number)
(Address)
hereby authorize and request the New York State Tax Department to release a photocopy / information
of my [
] to:
tax return for
(Type of tax)
(Tax period(s))
(The area within the brackets on the line above may be altered to suit your request for information or copies.)
(Print name of authorized representative/person/company)
(Print firm name, if applicable)
(Print address of authorized representative/person/company)
(Taxpayer signature)
(Telephone number of authorized representative/person/company)
(Taxpayer telephone number)
Please note: There will be a charge of twenty-five cents per page for copies unless you are a participating
member in a reciprocal agreement.
Please file this original scannable
5061050094
form with the Tax Department.

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