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

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DTF-505 (12/01)
Authorization for Release of Photocopies of Tax Returns
and/or Tax Information
To:
Disclosure Officer
NYS Department of Taxation and Finance
Disclosure & Government Exchange Section
Building 9 Room 381
WA Harriman Campus
Albany NY 12227
I,
(
) of
(Print name of taxpayer)
(social security or employer identification number)
(Address)
hereby authorize and request the New York State Department of Taxation and Finance to release a photocopy / information
of my [
tax return for
] to:
(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)
of
(Print firm name, if applicable)
(Telephone number of authorized representative)
(Print address of authorized representative)
Taxpayer signature
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.

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