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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
MailStaon7703
600N.RobertSt.
St.Paul,MN55146-7703
Ifyouhavequesons,call651-296-3781or1-800-652-9094.
(Rev.11/19)
Form M100, Request for Copy of Individual Tax Return
TaxpayerName SocialSecurityNumberorITIN
StreetAddressorPOBox MinnesotaorFederalEmployerIdenfcaonNumber(FEIN) (Sole Proprietors)
Apt. or Suite City State ZIP Code
PhoneNumber FaxNumber EmailAddress(Oponal)
Taxpayer
Informaon
Type of Tax Return
Type of Tax Return You are Requesng Tax Form Name or Number (If known) Tax Year or Period Cered Copy
Signature
This form is not valid unl signed and dated by the taxpayer.
Parent, Guardian, Conservator: I cerfy that I have the legal authority to sign this form.
Signature Date Address,IfDierentfromTaxpayer
PrintNameandTitle,IfApplicable PhoneNumber City State ZIPCode