REQUEST FOR COPIES OF TAX RETURNS 
                                                                                                                              Form 70-698 

Request may be rejected if the form is incomplete, illegible or any required line was blank.  Payment must be made prior to issuing copies. You may contact the Department 
of  Revenue at  601  923-7700  and ask for the Tax Area responsible for the administration of the tax type you are requesting copies from to determine how many pages your 
request will generate.  This will determine the cost.  The Account Number is the Social Security Number (SSN) for Individual Income Tax, the Federal Employer’s Identification 
Number (FEIN) for Corporate Income Tax and Withholding Tax, and the Sales and/or Use Tax Account Number for most other tax types.  For Individual Income Tax Returns that 
are filed jointly, both spouses SSNs and names are required before copies can be released. 
ACCOUNT NUMBER:  ______________________   TAX TYPE:  ____________________   TAX PERIOD:  ____________________ 

ACCOUNT NUMBER:  ______________________   TAX TYPE:  ____________________   TAX PERIOD:  ____________________ 

ACCOUNT NUMBER:  ______________________   TAX TYPE:  ____________________   TAX PERIOD:  ____________________ 

ACCOUNT NUMBER:  ______________________   TAX TYPE:  ____________________   TAX PERIOD:  ____________________ 

Name and address where to send the copies of the requested returns.  If you want these copies certified, please check here. 

Name:                              _____________________________________________________________________________________ 
Address:                           _____________________________________________________________________________________ 
City, State, Zip:                  _____________________________________________________________________________________ 
Phone Number:                      _____________________________________________________________________________________ 

The “Mississippi Public Records Act of 1983” requires the following charges be submitted before delivery of the reproduced documents.  Payments 
must be in the form of cash, a cashier’s check or money order.  We do not accept personal checks for copies.  We                             do not recommend you send 
cash through the mail.  The charge for copies is $2.50 for the first page and $.50 for each additional page.  We will return this document with 
the charge on it.  Please allow 7 days for processing.  Contact this office at 601-923-7 00 to7                    determine the cost of the copies.  Ask for the Tax 
Area responsible for the tax type of the return you have requested. 

Signature of Taxpayer(s):          Under penalties of perjury, I declare that I am either the taxpayer whose name is shown above or a person authorized 
to obtain the tax return requested.  If the request applies to a joint return, either spouse can sign.  If signed by a corporate officer, partner, guardian, 
executor, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to execute this form on behalf of the taxpayer. 

Taxpayer Signature: ______________________________________________________   Date:  ___________________ 
Spouse Signature: _________________________________________________________________________________ 
Title if officer, partner, trustee or party other than taxpayer:  _________________________________________________________ 
Contact Phone Number:  _____________________________________________________________________________________ 
                                                                            AFFIDAVIT 
STATE OF __________________________________                                                       COUNTY OF _____________________________________ 

Before me, the undersigned authority, on this day personally appeared ________________________________________________, 
known to me to be the person whose name is subscribed to the foregoing authorization and who, after being by me duly sworn, upon 
oath states that same was executed for the purpose therein expressed. 

SUBSCRIBED and SWORN to me, a Notary Public, on the _______________ day of ____________________________, 20______. 

My Commission Expires:_______________________________                                             ________________________________________________ 
                                                                                                                                     Notary Public 

NUMBER OF PAGES COPIED:  ___________   TOTAL COST:  $___________    DATE PAYMENT RECEIVED:  ________________ 

INITIAL AND DATE WHEN RETURNS WERE COPIED AND SENT:  ____________________________________________________