Department of Revenue Services
State of Connecticut                                           LGL-002
(Rev. 11/22)                                           Request for Disclosure of
                                        Tax Returns or Tax Return Information
        Complete and attach LGL-002 through myconneCT at portal.ct.gov/DRS-myconneCT. See instructions on Page 2.

Part 1  —  Taxpayer Return Information
Taxpayer name                                                                                              Social Security Number

Business name                                                                                              CT Tax Registration Number

Street address                             City                State                    ZIP Code           Federal Employer ID Number

Taxpayer is: (Check a box)
  Individual             Estate          Sole Proprietorship                 Limited Liability Company            Partnership
  Corporation            Trust (other than a business trust)  Business Trust             Other (Specify.)
Part 2  —  Return Information Requested:
                                                       For Tax Period(s):  _________________________________________
  Income tax                             Form W-2/1099                                          Gift tax
  Sales and Use tax                      Corporation Business tax                               Other return type  ______________________
Part 3  —  Check the Box to Indicate Your Relationship to the Taxpayer Listed in Part 1.

 Sole Proprietor                          Partner (Check box for partnership in                 Guarantor (Attach guaranty.)
  (Check box in Part 1.)                               Part 1; attach partnership agreement.)
 Receiver                                 Trustee (Check appropriate box for                    Other (Specify.)
  (Attach certificate of appointment.)                 trusts in Part 1; attach trust agreement.)
 Successor                                Assignee                                              Individual
  (Attach agreement.)                                  (Attach assignment.)
 Authorized Representative                Executor or Administrator                             Principal Officer (Check box for corporation
  (Attach LGL-001, Power of Attorney.)                 (Check box for estate in Part 1;                   in Part 1; attach last annual report filed
                                                       attach Certificate of Appointment.)                with Secretary of the State.)
 Member of a limited liability company that is not managed by managers        Manager of a limited liability company that is managed by managers. 
  (Check box for limited liability company in Part 1.)                         (Check box for limited liability company in Part 1.)
Part 4  —  Requester’s Name and Mailing Address
Name of person making request                          Telephone number                          Email address

Street address                                         City                                      State                             ZIP Code

Part 5  —  Request for Information to be Mailed to a Third Party  
           Check here if you wish to have the tax return(s) or tax return information mailed to a third party           
           (a person other than the requester named in Part 4)
Name                                                   Telephone number                          Email address

Street address                                         City                                      State                             ZIP Code

Part 6  —  Declaration
I declare that if I am not the taxpayer identified above, I have been authorized by that taxpayer to execute this request on behalf of the taxpayer, and 
I am permitted by the instructions on this form to make this request. (Attach LGL-001, Power of Attorney.)
I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my 
knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return to DRS is a fine of not more than 
$5,000, or imprisonment for not more than five years, or both. The declaration of a paid preparer other than the taxpayer is based on all information 
of which the preparer has any knowledge.

Signature                                                                      Title                               Date

                                        Visit us at portal.ct.gov/DRS for more information.

                                                 InstructionsInstructions

Use LGL‑002, Request for Disclosure of Tax Returns or Tax        Part 1:  Taxpayer Return Information
Return Information, to request copies of tax returns, tax return Provide the taxpayer’s name, business name (dba), address, 
information, or certain other information, such as Form W2       Social Security Number, Connecticut Tax Registration 
or 1099, from the Department of Revenue Services (DRS).          Number, and Federal Employer Identification Number, if 
Complete and attach LGL-002 through        myconneCT at          applicable. 
portal.ct.gov/DRS‑myconneCT.                                     Check the box that indicates the type of taxpayer for which a 
To attach LGL-002 through a secure message in myconneCT:         tax return or tax return information is being requested. 
•  Log into myconneCT.
•  Open the More… menu.                                          Part 2:  Return Information Requested
•  Locate the Correspondence group and click the Send a          Check the tax type and enter the tax periods or tax years 
  Message link.                                                  for which you are requesting a tax return or tax return 
•  Select the account, period, message area (e.g. account,       information. The terms years and periods can indicate various 
  return, refund), and category.                                 time frames. For example, a tax year may be a calendar year 
•  Type your subject, message, and attach your LGL-002.          of 1/1/15 through 12/31/15 or a fiscal year of 7/1/15 through 
                                                                 6/30/16 for corporation business tax. A tax period may have 
To request by mail:
                                                                 one or more monthly or quarterly periods. For example, a 
Complete the form, and include the caption Request for Tax       sales and use tax period of 1/1/13 through 12/31/15 may 
Returns or Tax Return Information on the envelope. Mail to:      contain 36 monthly or 12 quarterly periods. Please be specific.
       Contact Service Center 
       Department of Revenue Services                            Part 3:  Check the Box to Indicate Your Relationship 
       450 Columbus Blvd, Ste 1                                          to the Taxpayer Listed in Part 1.
       Hartford CT 06103-1837                                    Check the box that indicates your relationship to the taxpayer 
                                                                 for whom you are requesting a copy of a tax return or tax 
Who Can Make This Request?                                       return information. You must also attach the requested 
• Any individual, if the request is for an income tax return     documentation to support the status that entitles you to make 
  filed by that individual (or filed by that individual and      this request. 
  his or her spouse if the request is for a joint income tax 
                                                                 Part 4:  Requester’s Name and Mailing Address
  return). (Check the applicable box in Part 1 and Part 3.);
                                                                 Provide the requested information so a DRS representative 
• A limited liability company (LLC) member, if the taxpayer 
                                                                 can contact you if additional information is needed.
  is an LLC and has no manager, or a manager, if the 
  taxpayer is an LLC and has managers;                           Part 5:  Request for Information to be Mailed to a 
• The sole proprietor, if the taxpayer is a sole proprietorship;         Third Party 
• A general partner, if the taxpayer is a partnership or a       Check the box if you wish to have the tax return or tax return 
  limited partnership;                                           information mailed to a third party (a person other than the 
• The administrator or executor, if the taxpayer is an estate;   requester named in Part 4). If you are not the individual or 
• The trustee, if the taxpayer is a trust;                       business that the tax return or tax return information pertains 
• If the taxpayer is a corporation, a principal officer or       to, you must attach documentation to support the status that 
  corporate officer who has legal authority to bind the          entitles you to make this request. 
  corporation; any person who is designated by the board         This request is for a one-time use only. Any subsequent 
  of directors or other governing body of the corporation;       requests must be made by submitting a new LGL‑002. Any 
  any officer or employee of the corporation upon written        request that DRS mail tax returns or tax return information 
  request signed by a principal officer of the corporation and   to a third party will not change the taxpayer’s address of 
  attested by the secretary or other officer of the corporation; record with DRS.
  or any other person who is authorized to receive or inspect 
  the corporation’s return or return information under           Part 6:  Declaration
  IRC § 6103(e)(1)(D);                                           You must sign the declaration section of LGL-002. Only 
• The successor, receiver, guarantor, or any assignee of the     the taxpayer listed in Part 1 or an authorized representative 
  taxpayer; or                                                   listed in Part 4 can sign this section. For example, if the 
• The authorized representative of any of the above.             taxpayer is other than a natural person (an estate), DRS 
                                                                 requires the signature of the individual who is the authorized 
                                                                 representative of the taxpayer. The person signing this request 
                                                                 must attach a copy of a valid form of identification such as 
                                                                 a driver’s license, passport, or state issued identification.
LGL-002 Back (Rev. 11/22)