Form Dtf-664 - Tax Shelter Disclosure For Material Advisors - 2014

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DTF-664
New York State Department of Taxation and Finance
Tax Shelter Disclosure for
Material Advisors
Tax Law - Article 1, Section 25(b)(1)
Material advisor’s name
Employer identification number (EIN) or social security number
Mailing address of material advisor
( number and street or rural route )
City, village, town, or post office
State
ZIP code
Telephone number
(
)
Material advisor’s e-mail address
Aggregate material advisor’s fees
Attach a copy of the statement or return filed with the Internal Revenue Service (IRS) pursuant to Internal Revenue Code (IRC)
section 6111 (currently federal Form 8918, Material Advisor Disclosure Statement) . Also include all documentation submitted to the
IRS in connection with the statement or return and mail to the address shown below. For more information, see the instructions on
the back of this form.
Tax shelter information
Type of business organization
( mark an X in all that apply )
Partnership
( including a limited partnership )
Trust
S corporation
Federal Schedule C or Schedule F activity
Other
( specify )
Enter the tax shelter’s six-digit NAICS business code number
..............................................
( from the federal tax return )
Certification: I certify that this disclosure and any attachments are to the best of my knowledge and belief true, correct, and complete.
Signature
Official title
Date
Firm’s name
Firm’s EIN
Preparer’s PTIN or SSN
(or yours if self-employed)
Paid
preparer
Signature of individual preparing this disclosure
Address
City
State
ZIP code
use
only
E-mail address of individual preparing this disclosure
Preparer’s NYTPRIN
Date
(see instr.)
Instructions
General information
Commissioner of Taxation and Finance if any of the following conditions
apply:
The Tax Law provides for reporting requirements with respect to the
A the person is organized in this state;
disclosure of information relating to transactions that present the
potential for tax avoidance (a tax shelter). These requirements are
B the person is doing business in this state;
similar to the tax shelter disclosure requirements for federal income tax
C the person is deriving income in this state; or
purposes. The Tax Law also imposes penalties for nondisclosure and
D (i) the list, required to be maintained by this person pursuant
the underpayment of taxes due to participation in these transactions
to IRC section 6112, identifies, or is required to identify, a
and extends the statute of limitations for assessments relating to these
taxpayer subject to tax under Tax Law Article 9, 9-A, 22, 32, or
transactions. For more information, see TSB-M-05(2)C or TSB-M-05(4)I,
33, and (ii) this person is a material advisor, as defined in IRC
Disclosure of Certain Transactions and Related Information Regarding
section 6111, who provides any material aid, assistance, or
Tax Shelters, and TSB-M-05(2.1)C or TSB-M-05(4.1)I, Supplement to
advice with respect to organizing, managing, promoting, selling,
the Disclosure of Certain Transactions and Related Tax Shelters.
implementing, or carrying out any reportable transaction.
Who must file
Exception: A material advisor who is required to file a duplicate of the
statement or return submitted to the IRS pursuant to IRC section 6111
Every person (material advisor) required to make and file a statement
may file an abbreviated disclosure statement if:
or return pursuant to IRC section 6111 on or after April 12, 2005, and
• the material advisor has designated one person as the designated
prior to July 1, 2015, must file a duplicate of that statement or return
(currently federal Form 8918), including all documentation submitted
material advisor for federal income tax purposes (a designation
agreement); and
to the IRS in connection with the statement or return, with the
• the designated material advisor elects collective disclosure by
supplying a list of names, addresses, and tax identification numbers
for each of the material advisors included in the IRS designation
agreement.
For more information concerning collective disclosure elections
664001140094
and abbreviated disclosure statements, refer to TSB-M-05(2.1)C or
TSB-M-05(4.1)I.

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