Rhode Island Request For Letter Of Good Standing Page 5
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7CONTACT INFORMATION
(only if different from the information listed on page 1)
Person to contact for Additional Information. By completing this section you are authorizing the Division
of Taxation to review and disclose any state tax information that may be required to complete this request
for good standing to the individual listed below. If you do not want the division to share any information, do
not complete this section and all requests for information will be sent to the company name listed on page 1.
Name
Telephone Number
Mailing Address
Email Address
MAILING INFORMATION
(only if different from the information listed on page 1)
The Division of Taxation will not share any tax information with the individual listed below. This is only if
you want the Letter of Good Standing mailed to an address other than the address listed on page 1.
Name
Telephone Number
Address
SIGNATURE
A Letter of Good Standing may only be requested by an authorized representative of the entity listed
as the applicant on the front of this request. An authorized representative is a member or officer of
the company that is authorized to handle tax matters or a power of attorney (POA). If the Letter of
Good Standing is being requested by a POA, a signed POA must accompany the request. The letter
will not be issued if the following section is not completed.
Name of Authorized Representative
Title
Signature
Date
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