PDF document
- 1 -

Enlarge image
      0 0 0 1 1 1 1 0 
0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 6 6 6 6 6 6 6 6 6 6 7 7 7 7 7 7 7 7 7 7 8 8 8 8 8 80 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 6 6 6 6 6 6 6 6 6 6 7 7 7 7 7 7 7 7 7 7 8 8 8 8 8 80 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 6 6 6 6 6 6 6 6 6 6 7 7 7 7 7 7 7 7 7 7 8 8 8 8 8 80 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 6 6 6 6 6 6 6 6 6 6 7 7 7 7 7 7 7 7 7 7 8 8 8 8 8 80 
1 1 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 52 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 51 
      0 0 0  4 4 4 4 0 
      0 0 0  5 5 5 5 0                                 Form
      0 0 0  6 6 6 6 0                                             Request for Photocopy of Missouri Income 
      0 0 0  7 7 7 7 0       1937                                  Tax Return or Property Tax Credit Claim
      0 0 0  8 8 8 8 0 
      0 0 0  9 9 9 9 0 
      1 1 1  0  0  0  0  1 Social Security Number                                                                                  Spouse’s Social Security Number
      1 1 1  1 1 1 1 1 
      1 1 1  2 2 2 2 1                                           -               -                                                                 -              -
      1 1 1  3 3 3 3 1     Taxpayer Name                                                                                           Spouse’s Name
      1 1 1  4 4 4 4 1 
      1 1 1  5 5 5 5 1 
      1 1 1  6 6 6 6 1     Address on Return As Filed                                                                   City                                                      State         ZIP Code
      1 1 1  7 7 7 7 1 
      1 1 1  8 8 8 8 1 
      1 1 1  9 9 9 9 1     Present Address (If Different)                                                               City                                                      State         ZIP Code
      2 2 2  0 0 0 0 2 
      2 2 2  1 1 1 1 2 
      2 2 2  2 2 2 2 2     Tax Year(s) Requested
      2 2 2  3 3 3 3 2 
      2 2 2  4 4 4 4 2 
      2 2 2  5 5 5 5 2                                 All correspondence will be released to the person authorized below. Release of this information to a third party (such as 
      2 2 2  6 6 6 6 2                                 an  accountant)  at  the  request  of  the  taxpayer  does  not  give  the  third  party  authority  to  request  further  information,  from  the  
      2 2 2  7 7 7 7 2                                 Department. To obtain additional information or to represent the taxpayer before the Department, the taxpayer must execute a             Power of Attorney 
      2 2 2  8 8 8 8 2                                 Form 2827 designating the third party person as their representative. 
      2 2 2  9 9 9 9 2                                 Name of Person Authorized to Receive this Infomation        Title                                                          Telephone Number
      3 3 3  0 0 0 0 3 
      3 3 3  1 1 1 1 3 
      3 3 3  2 2 2 2 3                                 Street Address                                                   City                                                      State         ZIP Code
      3 3 3  3 3 3 3 3              Authorization
      3 3 3  4 4 4 4 3 
      3 3 3  5 5 5 5 3                                 Email Address
      3 3 3  6 6 6 6 3 
      3 3 3  7 7 7 7 3 
      3 3 3  8 8 8 8 3 
                                                                                 Under penalties of perjury, I declare that the above information is true, complete and correct. 
      3 3 3  9 9 9 9 3 
      4 4 4  0 0 0 0 4                                 Taxpayer Signature                                                          Date (MM/DD/YYYY)                              Telephone Number
      4 4 4  1 1 1 1 4 
      4 4 4  2 2 2 2 4 
      4 4 4  3 3 3 3 4              Signature          Spouse’s Signature (required if a joint tax return)                         Date (MM/DD/YYYY)                              Email Address
      4 4 4  4 4 4 4 4 
      4 4 4  5 5 5 5 4 
      4 4 4  6 6 6 6 4 
      4 4 4  7 7 7 7 4                                 Comments
      4 4 4  8 8 8 8 4 
      4 4 4  9 9 9 9 4 
      4 4 4  0 0 0 0 4 
      5 5 5  1 1 1 1 5 
      5 5 5  2 2 2 2 5 
      5 5 5  3 3 3 3 5 
                                    Department Use Only
      5 5 5  4 4 4 4 5 
      5 5 5  5 5 5 5 5 
                           The confidentiality provisions of the Missouri income tax law protect you by prohibiting other persons from obtaining information 
      5 5 5  6 6 6 6 5 
                           contained on your tax return or property tax credit claim(s). In compliance with these provisions, please complete this form to obtain a 
      5 5 5  7 7 7 7 5     copy of your tax return(s).
      5 5 5  8 8 8 8 5 
      5 5 5  9 9 9 9 5                                                                                                                                                            Form 1937 (Revised 12-2023)
      5 5 5  0 0 0 0 5     Mail to:  Missouri Department of Revenue                                 E-mail:  TaxForms@dor.mo.gov
                                                              Taxation Division 
      6 6 6  1 1 1 1 6                                                                                                                      Visitdor.mo.gov/faq/personal/indiv.php
                                                              P.O. Box 3022 
      6 6 6  2 2 2 2 6                                        Jefferson City, MO 65105-3022                                                        for additional information.
      6 6 6  3 3 3 3 6 
      6 6 6  4 4 4 4 6                                                                             *17354010001*
      6 6 6  5 5 5 5 6                                                                                                  17354010001
      6 6 666 6 6 6 






PDF file checksum: 1354072002

(Plugin #1/10.13/13.0)