Form Dtf-4157 - Complaint About New York State Tax Return Preparer

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New York State Department of Taxation and Finance
DTF- 4157
Complaint About New York State
(10/13)
Tax Return Preparer
Return preparer information
(complete all known information; see instructions, Form DTF-4157-I)
1 Preparer’s professional status
(mark an X for all that apply)
Attorney
Registered tax return preparer
Certified Public Accountant (CPA)
Enrolled Agent
Other/unknown:
3 Preparer’s business name and address
2 Preparer’s name and address
(if different)
4 Preparer’s telephone number(s)
5 Preparer’s email address
(include area code)
6 Preparer’s Web site
7 Preparer’s electronic filing identification number (EFIN)
8 Preparer tax identification number (PTIN)
9 Preparer’s employer identification number (EIN)
10 Preparer’s NYTPRIN
11 Tax year(s) impacted
Nature of complaint
(complete all known information; see instructions)
12a Review the statements below and mark an X in the box for all that apply
False or overstated income or withholding amount on
Diverted refund to unknown account
Form W-2 or 1099
Incorrect filing status
Failure to sign a refund anticipation loan
Failure to explain refund anticipation loan
Misrepresentation of credentials
No PTIN, SSN, or NYTPRIN
Failure to provide copy of return
PTIN or SSN misuse
Failure to return records
Return filed does not match client’s copy
Failure to sign returns
Return filed without authorization or consent
False exemptions or dependents
False expenses, deductions, or credits
Theft of refund
False or altered documents
Unreported income
Other
(explain below)

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