FORM                   ALABAMA DEPARTMENT OF REVENUE
                          INDIVIDUAL AND CORPORATE TAX DIVISION

4506-W4/2000               P. O. Box 327480 • Montgomery, AL  36132-7480
                  Request for Copy of Withholding Tax Forms
               IMPORTANT: Before completing this form, please read all instructions. Type or print all information.
1. Name, trade name, and address of employer as shown on return.               4. If name in third party’s records differs from Item 1 above, show here (see
                                                                                  instructions for Item 3).

2. Employee’s current name, address, and Social Security Number if W-2 is      5. Employer Federal Identification Number as shown on tax form.
   needed.

3. If information is to be mailed to someone else, show the third party’s name 6. Employer’s state withholding tax account number.
   and address.

7. Use the following table to compute the amount to submit with your request:

               Tax
   Period/Year    A-1      A-6                                               A-3   W-2                                            TOTAL
                                                                                                           X $15.00

                                                                                                           X $15.00

                                                                                                           X $15.00

                                                                                                           X $15.00

   Amount Due

NOTE:  Payment must be in the form of a money order or cashier’s check made payable to the Alabama Department of
Revenue. Full payment must accompany your request.

Your Signature                                                                     Date

Telephone number of requester (_________)_________________________________

           Instructions For Completing Form 4506-W

Fill out this form completely. Incomplete forms may         is different than the name shown in Item 1 or Item 2. If we
not provide enough information for processing.              cannot find a record of your return, we will notify the
                                                            third party directly that we cannot fill the request.
Please allow eight to ten weeks for your request to be
processed.                                                  ITEM 5.  The federal employer identification number
                                                            is written 00-0000000.
Use this form to request copies of Alabama withhold-
ing tax returns or employee wage and tax statements.        ITEM 6. The employers state withholding tax account
                                                            number is written 000000.
If you are not the employer shown in Item 1 or the
employee shown in Item 2, you must send a copy of your      ITEM 7.  Enter the tax period or tax year of the with-
authorization to receive the information. This will gener-  holding tax return you are requesting. Indicate the num-
ally be a power of attorney, tax information authorization, ber you need under the appropriate column. Calculate the
or evidence of entitlement (for Title II Bankruptcy or      total due and remit this amount.
Receivership Proceedings). If the employer/employee is
                                                            Write your Alabama withholding tax account number
deceased, you must send enough evidence to establish
                                                            or Federal employer identification number and “Form
that you are authorized to act for the taxpayer's estate.
                                                            4506-W Request” on your payment. Payment must be in
Corporations, Partnerships, Estates, and Trusts – For       the form of a money order or cashier’s check made
information about who may obtain tax information on the     payable to the Alabama Department of Revenue. If we
entity, see Internal Revenue Code section 6103.             cannot fill your request, we will refund your money.
ITEM 3.    If you have named someone else to receive        Mail to: Alabama Department of Revenue
the information (such as a CPA, scholarship board, or                Individual and Corporate Tax Division
mortgage issuer), you must include the name of the indi-             Withholding Tax Section
vidual along with the address in Item 3. Also, be sure and           P. O. Box 327480
write the name of the employer or employee in Item 4 if it           Montgomery, AL 36132-7480