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DO NOT SEND CASH.
Send a signed copy of this form with a check or money order payable to Minnesota Department of Revenue to:
Minnesota Department of Revenue
MailStaon7703
600N.RobertSt.
St.Paul,MN55146-7703
Ifyouhavequesons,call651-296-3781or1-800-652-9094.
(Rev.11/19)
Form M100, Request for Copy of Individual Tax Return
TaxpayerName SocialSecurityNumberorITIN
StreetAddressorPOBox MinnesotaorFederalEmployerIdenfcaonNumber(FEIN) (Sole Proprietors)
Apt. or Suite City State ZIP Code
PhoneNumber FaxNumber EmailAddress(Oponal)
Taxpayer
Informaon
Type of Tax Return
Type of Tax Return You are Requesng Tax Form Name or Number (If known) Tax Year or Period Cered Copy
Signature
This form is not valid unl signed and dated by the taxpayer.
Parent, Guardian, Conservator: I cerfy that I have the legal authority to sign this form.
Signature Date Address,IfDierentfromTaxpayer
PrintNameandTitle,IfApplicable PhoneNumber City State ZIPCode