Utah State Tax Commission
Rev. 12/07 EIN or Social Security Number
Get forms online - tax.utah.gov
Tax Shelter Disclosure for Material Advisors
Material advisor's name
Attach a copy of the statement or return filed with the Internal Revenue Service (IRS) pursuant to section 6111 of the Internal Revenue Code (IRC), currently IRS Form 8264, Application for Registration of a Tax Shelter. Also, include all documentation submitted to the IRS in connection with the statement or return and mail to the address shown below.
Certification: I certify that this return and any attachments are to the best of my knowledge and belief true, correct and complete. Signature Signature of person preparing this return Paid preparer use only Address Mail form to: Utah State Tax Commission Attention: Auditing Division 210 N 1950 W SLC UT 84134 Official title Firm's name (or yours if self-employed) City State ZIP code ID number Date signed Date signed