Form 4506-A Request for Public Inspection or Copy

of Exempt Organization IRS Form OMB No. 1545-0495 (Rev. August 1997)

Department of the Treasury

Internal Revenue Service

1 Exempt organization’s name and address (city and state). If a multiple request, please attach list of names, forms, and tax years.

3 Employer identification number of exempt organization (if known) ©

4 IRS form requested:

7 Date requested

Exemption application Form 990-PF

8 Document locator number (if known)

Other (specify) ©

5 Type of request: Copy Aperture card of

Form 990-PF

2 Requester’s name, address, and telephone number

6 Tax year requested © or Latest return on file

IRS Use Only

9 For returns files: Copy of requested form is attached We find no record of requested form

10 The form requested above was inspected by (name of requester) 11 IRS office where inspection was made

12 Signature of employee present at inspection 13 Date

General Instructions

Purpose of Form

Form 4506-A (Rev. 8-97)

Inspection

Cat. No. 41722P

Form 990 or 990-EZ

Use Form 4506-A to request:

How Much Will It Cost?

You may inspect a return or exemption application at

an IRS office free of charge. If you want a copy of an

● A copy of an exempt organization’s return or

exemption application,

● An inspection of an exempt organization’s return or

exemption application, at an IRS district office or the

IRS National Office.

● An aperture card (a type of microfiche) of Forms

990-PF, or

● $1.00 for the first page and

● $ .15 for each additional page

IF you want ... THEN the cost is ...

A copy of a return or

an exemption

application

An aperture card ● $1.00 for the first card and

● $ .18 for each additional card

Note: If your cost is over $50, we will ask for payment

in advance.

For Paperwork Reduction Act Notice, see back of form.

item or an aperture card, use the following chart to

determine the cost.
Form 4506-A (Rev. 8-97)

Line 1

Line 6

Line 4

Enter the organization’s official name (that is, the name

under which exempt status was approved). If you do

not enter the official name, we may not be able to

locate the requested form.

If you are requesting a copy of a form or other item

not listed, check the “Other” box and enter the form

number or other item.

If a specific tax year is needed, enter the year. If not,

check the box for the latest return filed.

Paperwork Reduction Act Notice. We ask for the

information on this form to carry out the Internal

Revenue laws of the United States. We need the

information to gain access to the return you requested

in our files and properly respond to your request. If you

do not furnish the information, we may not be able to

fill your request.

The time needed to complete and file this form will

vary depending on individual circumstances. The

estimated average time is:

Recordkeeping 7 min.

If you have comments concerning the accuracy of

these time estimates or suggestions for making this

form simpler, we would be happy to hear from you.

You can write to the Tax Forms Committee, Western

Area Distribution Center, Rancho Cordova, CA

95743-0001. DO NOT send the form to this address.

Instead, see Where To File on this page.

Learning about the law or the form 3 min.

Preparing the form 13 min.

Copying, assembling, and

sending the form to the IRS 14 min.

You are not required to provide the information

requested on a form that is subject to the Paperwork

Reduction Act unless the form displays a valid OMB

control number. Books or records relating to a form or

its instructions must be retained as long as their

contents may become material in the administration of

any Internal Revenue law. Generally, tax returns and

return information are confidential, as required by the

Internal Revenue Code section 6103.

Specific Instructions

IF you want ... THEN file Form 4506-A with the ...

To inspect a return or

an exemption

application at an IRS

district office*

District Director of that district

Attention: Disclosure Officer

Where To File

Use the following chart to determine where to file Form

4506-A.

To inspect a return or

an exemption

application at the IRS

National Office*

Commissioner of Internal

Revenue

Attention: Freedom of Information

Reading Room

1111 Constitution Avenue, NW

Washington, DC 20224

A copy of an

exemption application

A copy of a return

Customer Service

Ohio Key District Office

P.O. Box 2508, Room 4010

Cincinnati, OH 45201

Internal Revenue Service Center

Ogden, UT 84201

Internal Revenue Service Center

11601 Roosevelt Blvd.

Philadelphia, PA 19154

An aperture card

* The office handling your request will contact you when the

item is available for inspection.

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