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Get and Sign Wi Referral Form 2016-2022
Of birth
Employer identification number
Occupation
State Zip
What kind of business? (e.g., grocery store)
Marital status (check one)
Married
Single
Divorced
Separated
Head of household
Name of spouse, if applicable
1. Type of tax violation (check all that apply)
Income tax or withholding tax
Sales and use tax
Corporation franchise/ income tax
Other
2a. Amount of unreported income and tax years (fill in tax years and dollar amounts, if known; e.g., TY 2006,...
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