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Get Louisiana Department Of Revenue R 60010 711 Form

17 North 3rd St., 5th Floor Baton Rouge, LA 70802-5428 (225) 219-2720 (225) 219-2740 Fax vda.ldr la.gov PLEASE PRINT OR TYPE. Representative s Name/ Title Representative s Telephone Number Representative s Firm Name Representative s Email Address Representative s Address Type of Legal Entity of Applicant City State ZIP Tax Type(s) for which a Voluntary Disclosure Agreement is Requested Please answer each question fully. Failure to disclose all relevant information could resu.

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