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Authorization for One-Time Release of Confidential Tax Information
This form allows for a one-time authorization for disclosure of information only. If you would like to authorize an individual to represent you, use form FTB 3520, Power of Attorney. To request a copy of your personal income tax or fiduciary return, use form FTB 3516, Request for Copy of Personal Income Tax or Fiduciary Return. To: Disclosure Section Franchise Tax Board PO Box 1468, MS A181 Sacramento CA 95812-1468 Telephone number: (916) 845-3226 Fax number: (916) 845-4849
I,
(Print name of taxpayer)
(
(Social Security or TAX ID Number of taxpayer)
) of
(Taxpayer's Address)
hereby authorize and request the California State Franchise Tax Board to release confidential information Of my [
(Specific Tax Matter or Document)
for
(Tax periods)
] to:
at
(Print name of authorized representative/person/company) (Print company name, if applicable)
(Print address and phone number of authorized representative/person/company)
(Taxpayer signature)
(
)
(Taxpayer telephone number)
(Date)
FTB 3518 C1 (NEW 11-2005)