Form Ar4506 - Request For Copies Of Arkansas Tax Returns And W-2s

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AR4506
STATE OF ARKANSAS
REQUEST FOR COPIES
OF ARKANSAS TAX RETURNS AND W-2S
Click Here to Clear Form Info
Mail To:
Or Bring To:
Click Here to Print Document
State of Arkansas
Joel Y. Ledbetter Building
Individual Income Tax
1816 W 7th Street, Room 2300
P.O. Box 3628
Little Rock, AR 72201
Little Rock, AR 72203-3628
(501) 682-1100 or
(800) 882-9275
Primary Name On Return
SSN, FEIN, or ID Number
SSN or ID Number
Secondary Name On Return (If Applicable)
PRINT
Daytime Phone Number
Current Mailing Address (City, State, & Zip)
OR
TYPE
Return(s) Requested (List Tax Year(s))
W-2(s) Requested (List Tax Year(s))
NOTE - You may be able to get your tax information from other sources. If you had your tax return
completed by a paid preparer, he/she should be able to provide a copy of the return. Your employer
should be able to provide a copy of your W-2.
INSTRUCTIONS
1. Print or type your name, mailing information, SSN, FEIN (if applicable), Account ID, spouse’s information (if
applicable), return(s) and/or W-2(s) you are requesting.
2. Copies are
$2.00 per year.
Attach a check or money order. DO NOT SEND CASH IN THE MAIL.
(If you make your request in person, you may pay with cash. Bring exact change.)
3. Mail this form with your payment to the mailing address or deliver to the physical address at the top of this form.
In order to process your request, signatures are required below. For entities other than individuals, you must
attach an authorization document.
Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown above, or a person authorized to obtain the
tax information requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer,
partner, guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have
the authority to execute Form AR4506 on behalf of the taxpayer.
Primary Signature
Date
Secondary Signature (If Applicable)
Date
Title (if primary name is a partnership or trust)
AR4506 (R 10/11/13)

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