Sd Eform-1365 V3 - Information Release Authorization - 2010
Download a blank fillable Sd Eform-1365 V3 - Information Release Authorization - 2010 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Sd Eform-1365 V3 - Information Release Authorization - 2010 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Complete and use the button at the end to print for mailing.
SD EForm -
1365
V3
HELP
evenue
Information Release Authorization
South Dakota law prohibits the department from releasing taxpayer information to anyone but the taxpayer or
the taxpayers’ duly appointed designee. The appointment of a designee must be done in writing.
I wish to have tax information and returns mailed to the
Yes _________ No ___________
following designee (includes employees if a firm):
I am authorizing you to discuss my account with the
Yes _________ No ___________
Individual/company named below:
Designee’s name: _______________________________________________________________
EIN or SSN:
_______________________________________________________________
Mailing Address: _______________________________________________________________
_______________________________________________________________
Daytime Phone:
_______________________________________________________________
E-Mail Address: _______________________________________________________________
The Taxpayer to whom the above authorization applies is shown below:
South Dakota Tax License Number: _________________________________________________
Name (owner/partnership/corporation): _______________________________________________
Mailing Address: ________________________________________________________________
________________________________________________________________
Responsible Person (Please Print): __________________________________________________
Title: __________________________________________________________________________
Signature: _________________________________________ Date: _______________________
Mail form to:
South Dakota Department of Revenue
445 East Capitol Avenue
Pierre, SD 57501
1-800-829-9188
RV 139 (01/10)
PRINT FOR MAILING
CLEAR FORM
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial