Form Ftb 914 - Taxpayer Advocate Assistance Request
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State of California
Franchise Tax Board
Taxpayer Advocate Assistance Request
Section 1 – Taxpayer Information
(See pages 2 and 3 for FTB 914 Filing Requirements and Instructions for completing this form.)
1a. Your name or business entity name as shown on tax return
1b. Taxpayer identifying number (SSN, FTBID, FEIN, Corp. Number)
2a. Spouse’s/RDP’s name as shown on tax return (if applicable)
2b. Spouse’s/RDP’s taxpayer identifying number (SSN, FTBID)
3a. Your current street address or business entity mailing address (number, street, and apt. number)
3b. City
3c. State (or foreign country) 3d. ZIP code
4. Fax number (if applicable)
5. Email address
6. Tax form(s) (540, 540NR, 100, 565, 568, etc.)
7. Tax period(s)
8. Person to contact
9a. Daytime phone number
9b.
Mark here if y
ou consent to
have confidential information
about your tax issue left on
10. Best time to call
your answering machine or
voice message at this number.
Mark if cell phone
11. Indicate the special communication needs you require
TTY/TDD Line
Interpreter (specify language other than English, including sign language) ________________________________________
Other (specify)
12a. Describe the tax issue you are experiencing and any difficulties it may be creating (If more space is needed, attach additional sheets.)
12b. Describe the relief/assistance you request (If more space is needed, attach additional sheets.)
Executive and Advocate Services employees or other Franchise Tax Board employees may contact third parties in order to respond to this
request. I understand that I may not receive further notice about these contacts. (Revenue and Taxation Code (R&TC) Section 19504.7)
13a. Signature of taxpayer or business entity designee, and title, if applicable
13b. Date signed
14a. Signature of spouse/RDP
14b. Date signed
Section 2 – Representative Information (
Attach FTB 3520, Power of Attorney Declaration, if not already on file with FTB.)
1. Name of authorized representative
2. Centralized authorization file (CAF) number
3. Current mailing address
4. Daytime phone number
5. Fax number
Mark if cell phone
6. Signature of representative
7. Date signed
FTB 914 (NEW 01-2015) PAGE 1
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