Form AR4506 Fillable Request for Copies of Arkansas Tax Return(s)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

( 4506 1) ( 4506 10) ( 4506 11) ( 4506 2) ( 4506 3) ( 4506 4) ( 4506 5) ( 4506 6) ( 4506 7) ( 4506 8) ( 4506 9) (800) 882 9275 (Click Here to Clear the Work Sheet) Click Here to Clear Form Info (If you make your request in person you may pay with cash Bring exact change ) (You must be using Adobe Reader ver 6 or above ) Click Here to Print Document applicable) return(s) and/or W 2(s) you are requesting AR4506 AR4506 (R 10/11/13) attach an authorization document completed by a paid preparer he/she should be able to provide a copy of the return Your employer Copies are $2 00 per year Attach a check or money order DO NOT SEND CASH IN THE MAIL Current Mailing Address (City State & Zip) Date Secondary Signature (If Applicable) Date Daytime Phone Number In order to process your request signatures are required below For entities other than individuals you must Individual Income Tax 1816 W 7th Street Room 2300 INSTRUCTIONS Little Rock AR 72203 3628 (501) 682 1100 or Mail this form with your payment to the mailing address or deliver to the physical address at the top of this form Mail To: NOTE You may be able to get your tax information from other sources If you had your tax return OF ARKANSAS TAX RETURNS AND W 2S Or Bring To: P O Box 3628 Little Rock AR 72201 partner guardian tax matters partner executor receiver administrator trustee or party other than the taxpayer I certify that I have Primary Name On Return Primary Signature PRINT Print or type your name mailing information SSN FEIN (if applicable) Account ID spouse s information (if REQUEST FOR COPIES Return(s) Requested (List Tax Year(s)) Secondary Name On Return (If Applicable) should be able to provide a copy of your W 2 Signature of taxpayer(s) I declare that I am either the taxpayer whose name is shown above or a person authorized to obtain the SSN FEIN or ID Number SSN or ID Number STATE OF ARKANSAS State of Arkansas Joel Y Ledbetter Building tax information requested If the request applies to a joint return either husband or wife must sign If signed by a corporate officer the authority to execute Form AR4506 on behalf of the taxpayer Title (if primary name is a partnership or trust) W 2(s) Requested (List Tax Year(s))