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                                               Utah State Tax Commission
                                                                                                                                      TC-880
                                               Request for Tax Records                                                                Rev. 3/12

Utah State Tax Commission, Taxpayer Services, 210 N 1950 W, SLC, UT 84134. For questions, call 801-297-2200 or 1-800-662-4335 outside Salt Lake area.
Name of person requesting records                                                                                      Daytime telephone number

Current mailing address                                                 City                                     State ZIP Code

Check box if you are a member of:                                       If you are a member of a special interest group, please indicate the group
     the media                    a special interest group

Description of the Records Requested
Name of the taxpayer or entity shown on records

Social security number / account number / employer identification number on record   Tax or filing period

Description of records

                                                                                                                ICN number

     Number of records requested at $6.50 per record                                                                      Total amount
     (additional expenses may be incurred if research is required)                  $                                     received

                                                                                                                          Office Use Only
If the name on the records differs from the name of the person requesting the records, please indicate 
which of the following apply:
 1.  The requester is the parent or legal guardian of the subject of the record who is 17 years or younger 
     and unmarried.

  2. The requester is the legal guardian of the subject of the record who is a legally incapacitated individual.

  3. The requester is an officer, director, member or general partner of the entity.
If you check either box below, you must attach a copy of the power of attorney or notarized release to this form.
  4. The requester has a power of attorney from the subject of the record.

 5.  The requester has a notarized release from the subject of the record or his legal representative dated no more than 90 days before the date 
     the request for records is made.

Under penalties of perjury, I declare to the best of my knowledge and belief, this request, including accompanying documents, is true, correct and complete.
Signature of requester                                                       Title                                        Date

Utah law requires proof of requester’s identity prior to release of private, controlled or protected information. If this form is mailed in, the requester’s 
signature should be notarized in the space provided. If this form is presented in person, the requester must  present proof of identification to the 
authorized examiner.
Place notary stamp in this space                                        Authorized examiner signature
                                                                        X
                                                                        Date

                                                                        Tax Commission/County Office

Notary public signature                                                 A driver’s license is the preferred identification. Indicate the form of 
                                                                        identification and the identification number used for proof.
X
Date subscribed and sworn 

If you need an accommodation under the Americans with Disabilities Act,                         Office Use Only
contact the Tax Commission at (801) 297-3811 or Telecommunication       Date request was filled                   USTC employee initials
Device for the Deaf (TDD) (801) 297-2020. Please allow three working 
days for a response.
IMPORTANT: To protect your privacy, use the "clear form" button when you are finished.                     Click here to clear form