California Form 3534 Tax Information Authorization

Confidential Tax Information Authorization

I authorize the Department of Revenue to share my confidential tax information as indicated.

Use this form to authorize the Department of Revenue to share your confidential tax information with a third party. You can also use this form to authorize the Department to send confidential tax information using regular (unsecure) fax or email.

1. My information (This information will not be used to update your business record.*)

Taxpayer or business name

*To update your business record, go to http://dor.wa.gov and log in to your account.

2. Share my confidential tax information with the individual(s)/company listed below.

If you are not authorizing a third party, go to step 3. If you are authorizing an entire company or a Legislator’s office, add the words “and staff.” If authorizing specific people, add additional name(s) in the Authorized names/email section.

Individual or company name

Place an X in the appropriate box below:

3. Send my confidential tax information by regular email or fax.

I am aware of the Department’s secure message system described on page 2. I know regular email and fax are not as secure, and confidential information may be intercepted by unauthorized persons. I accept these conditions and waive any violation of the Secrecy Clause resulting from use of unsecured email or fax. (RCW 82.32.330)

By checking this box, I authorize the Department to send my confidential tax information using regular email or fax.

4. My signature

I declare, under penalty of perjury, that I am authorized to sign this form. I am listed as the real property owner or as the business owner, partner, corporate officer, or LLC member or manager in official records held by Washington State, or I have attached documentation (e.g., power of attorney, annual report, executor) that grants me the authority to sign.

This authorization remains in effect until revoked in writing by either party. Keep a copy for your files. To revoke this authorization, write “Revoke” across the front of this form and return it to the Department as indicated in step 5.

5. Fax to (360) 705-6175, email to DORTAAFaxIn@dor.wa.gov or mail to address on back.

For tax assistance or to request this document in an alternate format, visit http://dor.wa.gov or call 360-705-6705. Teletype (TTY) users may use the Washington Relay Service by calling 711.

ATTN:

Authorization for Confidential Tax Information - Page 2

Confidential tax information

Tax information is confidential and cannot be shared with anyone without express permission. By completing this form, you are authorizing the Department to share your confidential tax information with the person(s) you name. This request may cover all confidential tax information or it may be limited to certain information and/or reporting periods. In section 2, please describe the specific information you want the Department to share and the periods covered by this authorization.

Secure messaging

Secure messaging is offered through the Department’s online My DOR section. Taxpayers that have an online account can access secure messaging when logged in. On the More Options tab, click Send a Message and follow the instructions.

Taxpayers that don’t have an online account can register at dor.wa.gov. To create an account, provide your name, email, and phone number; create a logon ID and password; then choose a security question.

If you want to add your business to your online account, enter your UBI/Account ID number and your letter ID. Your letter ID can be found on the upper right corner of the letter you received from the Department when you first opened your business. It is also on mailed tax returns and at the bottom of balance due notices.

Only people authorized to access your online account can see secure messages.

ATTN: (If you are working with a Revenue employee)

If you are working with a Revenue employee, write the employee’s name on the ATTN: line on the bottom of page 1 of this form and return the form as instructed.

Otherwise, send this form to:

Fax 360-705-6175

Email DORTAAFaxIn@dor.wa.gov

Mail Dept. of Revenue
Taxpayer Account Administration - ICAP
PO Box 47476
Olympia, WA 98504-7476

Questions? Call the Department at 360-705-6705