Arizona Form 450 - Request For Certified Copies Of Documents
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1REVENUE USE ONLY.
ARIZONA FORM
Do not mark in this area.
Request for Certifi ed Copies of Documents
450
No. ________________________
Read instructions on reverse side before completing this form. Please print or type.
1 Name(s) as shown on document:
2 SSN and/or ID number as shown on document:
A.
A.
B.
B.
3 Tax return for period(s):
4 Tax type. Check only one:
Individual Income Tax
Corporate Income Tax
Transaction Privilege & Use Tax
Withholding
When fi led:
Other. Please specify:
6 Mail copies to:
5 Current address:
7 Signature:
8 Instructions:
• FEE is $1.00 for front page (per period),
10¢ for each additional page.
• Check or money order only. Your canceled
check is your receipt.
PRINT OR TYPE NAME OF REQUESTOR
• Mail completed form to:
Arizona Department of Revenue
Copy Desk
SIGNATURE OF REQUESTOR
1600 West Monroe
Phoenix, AZ, 85007-2650
TITLE (if applicable)
• Please allow thirty (30) days for
processing.
DATE
DAYTIME PHONE (with area code)
DEPARTMENT OF REVENUE USE ONLY
DOCUMENT NUMBER(S)
Serial Number:
Amount Received:
Postmark Date:
Date Received:
Date Mailed:
Billed:
Comments:
Print Form
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ADOR 10582 (10)
Previous ADOR 91-5391
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Parent category: Financial