Free Form 6847 (Rev. 9-2008) - Federal

Form 6847 (Rev. September 2008)

Department of the Treasury ­ Internal Revenue Service

Consent for Internal Revenue Service to Release Tax Information

I authorize the IRS to release information returns (Forms 1099-DIV, INT, G, MISC, OID, PATR, R and 5498), filed electronically at the Enterprise Computing Center-Martinsburg (ECC-MTB) as part of the Combined Federal/State Filing Program, to the officers and employees of the State tax agencies charged with processing and handling this data in the course of their tax administration duties. Returns may be disclosed to the tax agency in the State shown on the file record. The State tax agency may use the information for any purpose permitted by State law. This consent is effective from the date signed and until the date the IRS/ECC-MTB Information Reporting Program receives a written revocation from me. This form does not have to be sent every year. Send Form 6847 to Internal Revenue Service, Enterprise Computing Center-Martinsburg, Information. Reporting Program, 230 Murall Drive, Kearneysville, WV 25430.
Business Name Taxpayer Identification Number (TIN)

Street Address

Transmitter Control Code (TCC)

City

State

ZIP Code

Telephone

E-mail

Signature (See instructions)

Date

Signature of Attesting Officer (If a corporation)

Date

Instructions:
The type of business entity filing the returns determines the individual authorized to sign this consent. The following is a list of business entities and persons authorized to sign consent on behalf of the entity. 1. Sole proprietorship­owner. 2. Partnership­any person who is a partner during any part of the period covered by the returns. 3. S corporation under Subchapter S or Chapter 1 of the Internal Revenue Code­any shareholder during any part of the period covered by the returns. 4. Corporation­any principal officer (the consent must also be attested to by the secretary or other corporate officer). Note: An attorney-in-fact for the filer may also sign consent, however, a written authorization from an appropriate person as described above must be attached.
Cat. No. 61524B Form 6847 (Rev. 9-2008)