Form Cs-001 - Request For Certified Copy
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1GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
OFFICE OF TAX AND REVENUE
REQUEST FOR CERTIFIED COPY
Date: _________________
NOTE: Tax returns for 2011 and prior years are no longer available. However, if a return was filed for those
years, you will receive a letter of acknowledgment.
To Be Mailed
For Pick-Up at Customer Service Center
INDIVIDUAL INCOME TAX RETURNS:
Tax Period (s):
_________________________________________________________________________________
Name(s) as shown on Return (s)
(1) _____________________________________ (2)_____________________________________
Last
First
Middle
Last
First
Middle
Social Security Number: (1) _______-_______-_______
(2) _______-_______-_______
Current Address: ____________________________________________________________________
Approximate date return was filed: ___________________________________
Signature: ___________________________________ Daytime Phone Number: ( ) _____________
BUSINESS TAX:
FRANCHISE TAX RETURN ( D20 or D30)
SALES TAX RETURN
( monthly annual)
WITHOLDING TAX RETURN
–
(monthly annual Reconciliation)
PERSONAL PROPERTY
OTHER, Please specify _____________________________
Tax Period (s): _________________________ Name of Business: ___________________________
D.C. Business Tax Number (EIN/SSN): _________________ Approximate Date Filed: __________
Signature/Title: __________________ Daytime Phone Number ( ) _______-_______
th
Mail to: Office of Tax and Revenue, Customer Service Administration, 1101 4
Street, SW, Washington, DC 20024
CS-001. Rev. 01/17
Official
Type of I.D. _____________________________________
Use
Verified By: _____________________________________
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