Form 4506A Form 4506A Request for Public Inspection or Copy of Exempt Politica

Form

Request for Public Inspection or Copy
of Exempt or Political Organization IRS Form

4506-A

(Rev. March 2009)
Department of the Treasury
Internal Revenue Service

TIP

©

OMB No. 1545-0495

Type or print clearly. Request may be rejected if the form is incomplete or illegible.

You may not have to complete Form 4506-A to get the copies you need.

● Internet. Form 8871, Political Organization Notice of Section 527 Status, and Form 8872, Political Organization Report of
Contributions and Expenditures, are available for inspection and printing from the Internet. The website address for both
forms is www.irs.gov/polorgs.
● Public disclosure by the organization. Exempt or political organizations must make their returns, reports, notices, and
exempt applications available for public inspection. You can visit the organization to inspect the material instead of requesting
it from the IRS. The organization may be able to mail the copies to you.
1 Exempt or political organization. If a multiple request, please attach list of names, forms, and tax years.
Name

Employer identification number (if known)

Address

City or town, state, and ZIP code

2 Requester
Name

Contact person

Address

Phone
(

)

Date

City or town, state, and ZIP code

3 Category of requester:
Commercial user
Non-commercial scientific institution
You must check a box.
Educational institution
Media
All others
4 Reason for request. All requesters except for commercial users must provide an explanation of how the records will be used to avoid being
charged the commercial rate. Attach additional sheets if necessary.

Lines 5–9. For each applicable form, check the box(es) for the item(s) you are requesting. You may request more than one form. For each form
requested, check either the copy, inspection, or CD/DVD box and enter the specific tax year(s), as indicated. If ordering a partial set on CD/DVD,
indicate the format, state(s), and month(s) requested.
CD/DVD Format:

5 Form 990, Form 990-EZ
Copy

Inspection

Tax year(s) requested:

;

;

.

6 Form 990-PF
Copy

Tax year(s) requested:

;

;

.

7 Form 990-T (501(c)(3) organizations filed after August 17, 2006)
Copy

Tax year(s) requested:

;

;

.

8 Form 5227 (for tax years beginning after December 31, 2006)
Copy

;

.

Months:

;

;

.

Copy
;

;

Raw

;

;

.

Months:

;

;

.

Alchemy

Raw

State(s):

;

;

.

Months:

;

;

.

;

.

9 Form 1023, 1024 or Determination Letter

Inspection

Tax year(s) requested:

Alchemy

State(s):

CD/DVD Format:

Inspection

Raw

;

CD/DVD Format:
Inspection

Alchemy

State(s):

.

Inspection

Tax year(s) requested:

;

IRS Use Only
The form requested above was inspected by (name of requester)

IRS office where inspection was made

Signature of employee present at inspection

Date

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 41722P

Form

4506-A

(Rev. 3-2009)