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FORM
Nebraska Tax Return Copy Request
23
NAME AND ADDRESS OF TAXPAYER
AUTHORIZED MAILING ADDRESS FOR TAX RETURN
Name
Name
Street or Other Mailing Address
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
Social Security Number
Nebraska ID Number
Type of Tax Return
Tax Period or Taxable Year Beginning
I hereby certify that I authorize the release of the tax return specified above, the information contained in the return, and the mailing of this
information to the above address.
sign
(
)
here
Signature of Taxpayer or Authorized Representative
Title
Date
Telephone Number
(
)
Department of Revenue Authorized Signature
Title
Date
Telephone Number
INSTRUCTIONS
WHO MUST FILE. A taxpayer or authorized representative must complete Form 23 to obtain a copy or transcript of any tax
return filed with the Nebraska Department of Revenue (Department). Taxpayers who request copies of e-filed tax returns will
be provided a transcript of the tax return information. Sales tax filers can print a PDF copy of tax returns directly from the
NebFile for Business program.
An authorized representative must have a power of attorney on file with the Department before requesting taxpayer information.
A person who signs a tax return as preparer of the return may request a copy of the return. This person is considered to have a
limited power of attorney with regard to the information contained on the return.
AUTHORIZED MAILING ADDRESS. Only complete the authorized mailing address section if the copy of the original tax
returns requested should be mailed to an address different than that of the taxpayer.
Mail this request to: NEBRASKA DEPARTMENT OF REVENUE, PO BOX 94818, LINCOLN, NE 68509-4818
7-136-1977 Rev. 6-2012 Supersedes 7-136-1977 Rev. 12-2007