SVOG 4506-T Request for Transcript of Tax Return

Summary

An SVOG sample of IRS Form 4506-T, Request for Transcript of Tax Return (March 2019), OMB No. 1545-1872, filled in with example entries for a fictional shuttered venue applicant. The sample shows how an applicant names the U.S. Small Business Administration Office of Disaster as the third party to receive the transcript, with a customer file number. The form explains that Form 4506-T orders a transcript or other return information free of charge, while Form 4506 is used to get a copy of a return for a fee. It warns not to sign until all applicable lines are completed and closes with signature lines and the Privacy Act notice reference.

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SVOG
Form 4506 -T Request for Transcript of Tax Return
(

March 2019) > Do not sign this form unless all applicable lines have been completed. OMB No. 1545-1872
Department of the Treasury > Request may be rejected if the form is incomplete or illegible.
Internal Revenue Service > For more information about Form 4506-T, visit www.irs.gov/form4506t.

Tip. Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can quickly request transcripts by using our automated
self-help service tools. Please visit us at IRS.gov and click on “Get a Tax Transcript...” under “Tools” or call 1-800-908-9946. If you need a copy of your return, use Form 4506,
Request for Copy of Tax Return. There is a fee to get a copy of your return.

la Name shown on tax return. If a joint return, enter the name 1b First social security number on tax return, individual taxpayer identification
shown first. number, or employer identification number (see instructions)
Jane Doe 555555555
2a If a joint return, enter spouse’s name shown on tax return. 2b Second social security number or individual taxpayer identification
number if joint tax return

3 Current name, address (including apt., room, or suite no.), city, state, and ZIP code (see instructions)
SVOG Shuttered Venue Corp. 123 Shuttered Ave., Performing, VA 12345
4 Previous address shown on the last return filed if different from line 3 (see instructions)

5a If the transcript or tax information is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address,
and telephone number.

U. S. Small Business Administration Office of Disaster, 14925 Kingsport Rd, Fort Worth, TX 76155: ODApdc02

5b Customer file number (if applicable) (see instructions)
123456789

Caution: If the tax transcript is being mailed to a third party, ensure that you have filled in lines 6 through 9 before signing. Sign and date the form once you have
filled in these lines. Completing these steps helps to protect your privacy. Once the IRS discloses your tax transcript to the third party listed on line 5a, the IRS has
no control over what the third party does with the information. If you would like to limit the third party’s authority to disclose your transcript information, you can
specify this limitation in your written agreement with the third party.

6 Transcript requested. Enter the tax form number here (1040, 1065, 1120, etc.) and check the appropriate box below. Enter only one tax form number
per request. > 1120

a__ Return Transcript, which includes most of the line items of a tax return as filed with the IRS. A tax return transcript does not reflect changes made
to the account after the return is processed. Transcripts are only available for the following returns: Form 1040 series, Form 1065, Form 1120, Form
1120-A, Form 1120-H, Form 1120-L, and Form 1120S. Return transcripts are available for the current year and returns processed during the prior 3
processing years. Most requests will be processed within 10 business dayS............0- 22 ee eee LI

b Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penalty assessments,
and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liability and estimated tax
payments. Account transcripts are available for most returns. Most requests will be processed within 10 business days. ........ Oo

c Record of Account, which provides the most detailed information as it is a combination of the Return Transcript and the Account Transcript.
Available for current year and 3 prior tax years. Most requests will be processed within 10 businessdays . . . . . 2... eee

7 Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Current year requests are only available after June
15th. There are no availability restrictions on prior year requests. Most requests will be processed within 10businessdays. . . . . . . . CJ

8 Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data from these
information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this transcript information for
up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS. For example, W-2 information for 2011,
filed in 2012, will likely not be available from the IRS until 2013. If you need W-2 information for retirement purposes, you should contact the Social Security
Administration at 1-800-772-1213. Most requests will be processed within 10 businessdays ...............24.- L]

Caution: If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099 filed
with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.

9 Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than four years or
periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you must enter
each quarter or tax period separately. | 12/31/2019

Caution: Do not sign this form unless all applicable lines have been completed.

Signature of taxpayer(s). | declare that | am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the tax information
requested. If the request applies to a joint return, at least one spouse must sign. If signed by a corporate officer, 1 percent or more shareholder, partner, managing
member, guardian, tax matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, | certify that | have the authority to execute
Form 4506-T on behalf of the taxpayer. Note: This form must be received by IRS within 120 days of the signature date.

Signatory attests that he/she has read the attestation clause and upon so reading declares that he/she has the Phone number of taxpayer on line 1a
authority to sign the Form 4506-T. See instructions. or 2a
—

Sign&tUre (see instructions) Date
Sign President
Here Title (if line 1a above is a corporation, partnership, estate, or trust)

Spouse’s signature Date

For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 37667N Form 4506 -T (Rev. 3-2019)

File and source

File: 2021-05_4506-T-Example-508.pdf
Size: 631,392 bytes
SHA-256: 72ef2158089177a90a4f15824a415bcf318d04620e9ac13d7ec171924d65934c
Our copy: 2021-05_4506-T-Example-508.pdf
Original: www.sba.gov