REQUEST FOR COPIES OF TAX RETURNS
                            OFFICE OF STATE TAX COMMISSIONER
                            SFN 28249 (12-2020)

A complete copy of the requested tax return(s) we have on file  will be mailed within 10 business days from the date we
receive the request.  There is no charge for this service.  A photo I.D. is required if the return(s) will be picked up in our
office.  If the return(s) will be picked up by someone other than the taxpayer or authorized representative, that
individual must be identified on this form.
Taxpayer's Name: (Last, First, MI)                                                                       Social Security Number/FEIN

Spouse's Name: (Last, First, MI)                                                                         Social Security Number
Year(s)
Mailing Address                                                  City                                    State                   ZIP Code

Tax Year(s)                                                                Telephone Number
                                                                                                                 Will Pick Up            Please Mail

If you want a copy of your return(s) mailed to or picked up by someone other than yourself, provide that person's name
and address.
Name of Individual (or Firm)

Mailing Address                                                  City                                    State                   ZIP Code

                                                     PRIVACY ACT NOTIFICATION
In compliance with the Privacy Act of 1974, disclosure of a social security number or Federal Employer Identification Number (FEIN) on this form is required
under N.D.C.C. §§ 57-01-02, 57-01-14, and 57-01-15, and will be used for tax reporting, identification, and administration of North Dakota tax laws.
Disclosure is mandatory.  Failure to provide the social security number or FEIN may delay or prevent the processing of this form.
PLEASE SIGN HERE
Taxpayer Signature (Do not print)                                                                        Date

For Office Use Only
Enclosed is a copy of your tax return(s) for the year(s) requested.
From our available information, we find no record of a state return filed under the above
social security number or name for the year(s) requested.
We have not completed the processing of the current tax year's returns.
Return(s) for the following year(s) are unavailable. _________________________

Return(s) were picked up by:
Signature                                                                                                Date

Instructions:
North Dakota state law prohibits our office from releasing a tax return or any information on a tax return unless the taxpayer or
authorized representative provides written authorization.
This form must be completed and signed before the Office of State Tax Commissioner can release any return(s). The form, along with a
copy of a photo I.D. may be mailed to:  Office of State Tax Commissioner
                                         600 E. Boulevard Ave., Dept. 127
                                         Bismarck, ND 58505-0599

The form and photo I.D. may also be emailed to individualtax@nd.gov or faxed to our office at 701.328.1942. If you have questions on 
this form, please contact our office at 701.328.1243.

The return(s) can either be mailed to the most recent address we have on file or picked up at our Bismarck office, located in the State 
Capitol Building on the 8th floor. The individual picking up the return(s) will be required to produce a photo I.D., such as a driver’s 
license.  If someone other than the taxpayer or authorized representative will be picking up the return(s), that person’s name needs to 
be identified on the front of the form. In addition, that person will need to provide a photo I.D. and signature.

If the most recent address on file is not your current address, please complete a Change of Address Form and submit it with this form. 
The Change of Address Form can be found at www.nd.gov/tax/genforms.