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Get Tax Information Authorization Tax Disclosure

That this Tax Information Authorization Tax Disclosure form has been signed by the authorizing individual listed below. If your authorized representative changes, submit a new form to notify the Department. Check one (Required): q New q Update q Revoke q Revoke All Section I: Taxpayer Information *Required Fields (If the required fields are not complete, this form is VOID and the taxpayer's information will not be shared.) Name(s)* A. Tax Identification Number(s)* SSN: DBA Name(s) (I.

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