Free DR-841 - Florida

Request for Copy of Tax Return

DR-841 R. 05/98

The taxpayer, or authorized representative, must complete this request to obtain a copy of any tax return filed with the Florida Department of Revenue. An authorized representative must attach a Power of Attorney (DR-835) to this request.

Taxpayer Information
Name of Taxpayer Street or Mailing Address City FEIN, SSN or Sales Tax Certificate Number Type of Return State Florida Identification Number Tax Period ZIP Telephone Number Number of Copies

Authorized mailing address. The authorized mailing address need only be completed if the copies of the return(s) requested are to be mailed to an address different from that of the taxpayer.

Authorized Mailing Address
Name Street or Mailing Address City State ZIP

I hereby certify that I authorize the release of the above described return(s) and the information contained therein and the mailing thereof.

Signature of Taxpayer or Authorized Representative

Date

Department of Revenue Authorized Signature

Title

Date

Please keep a copy for your records and send original to: Florida Department of Revenue Attn: Records Management 168-C Blountstown Hwy Tallahassee, Florida 32304