Catalog Number 68889B www.irs.gov
14767 (Rev. 6-2020)
Instructions for Form 14767, Consent to Disclose Tax Compliance Check
Purpose of Form
The purpose of the tax compliance report is to provide the appointee
federal tax information necessary for use in conducting a background
investigation or determining one or more of the following:
• Suitability for government employment or appointment,
• Eligibility for access to federally controlled facilities and information
• Authorization to be issued a federal credential or receive sensitive
• Access to classified information,
• Contractor or federal employee fitness,
• Monitoring tax compliance, if required as a condition of employment, or
• Other purposes authorized by Federal law
The purpose of this form is to authorize the Internal Revenue Service
(IRS) to prepare a tax compliance report that discloses confidential tax
information to a third-party appointee. The appointee is the federal
agency identified on the form which may be your current or prospective
employing or contracting agency or a federal investigative service
provider agency for example, the Defense Counterintelligence and
Security Agency (DCSA) which conducts background investigations for
Federal agencies. This form may also be used to request a tax
compliance report for other authorized uses. Without a valid consent, the
IRS is prohibited by law from disclosing any of this information to third
parties. Pursuant to this consent, only your tax compliance report and
limited details from your tax account will be disclosed.
If you timely filed and paid your taxes, the report will state that you are
compliant with your tax obligations. The report will only address facts of
filing and your compliance status on all authorized tax periods. If you
have a delinquent Federal tax liability (i.e. unpaid tax debt), we will only
disclose limited information sufficient to explain the specific delinquency.
If there are overdue filings or payments the report will state that you are
non-compliant or identify the compliance issue if there are extenuating
circumstances (e.g. litigation, combat zone, installment agreement) and provide
an explanation along with the current status of your account. For
example, if you owe taxes for 2018 and are repaying through an
approved installment agreement, we will report the amount owed and the
fact that you have a current installment agreement.
We will report an assessment of a civil tax fraud penalty or fraudulent
failure to file penalties whether paid or unpaid. These penalties relate to
the non-filing or non-payment of income, excise and employment tax
returns (for example the trust fund recovery penalty; frivolous filing penalty; willful
failure to pay, evade or defeat the stamp tax; sanctions awarded by the Tax Court).
Generally, these penalties are assessed in addition to any income tax
liability under your Social Security Number (SSN).
Your authorized appointee will use your tax records for purposes allowed
by federal law which may include redisclosure to others during the
maintenance and processing of your suitability or eligibility determination.
Contact your appointee to obtain additional information about routine
uses of your tax compliance report.
Do you own a business? If you own a business as a sole proprietor, we
will research and report any delinquent excise or employment tax
liabilities associated with your business. You would report the income
and expenses of your business on Schedules C or F attached to your
individual income tax return. This only applies if you have employees or
are subject to excise taxes for which you are personally responsible for
paying even though these taxes are assessed using the business’s
Employer Identification Number (EIN). The employment or excise tax
returns are not reported on your individual income tax return but are filed
separately with the IRS (for example, Form 940, 941,720). If you do not have
employees or are not required to pay these taxes, you would not file any
of these business returns.
Enter your name, Social Security Number (SSN) and address in the
spaces provided. If you used the IRS online tax check service, enter the
Online Code you received when you were unable to verify your identity.
Leave the Online Code blank if you did not use the IRS online tax check
The Federal agency that will receive your confidential tax information
should have provided the information for this section. They will identify
the name of the agency, assigned agency code, the agency’s mailing
address and contact telephone number. If they did not provide this
information, ask them to add it before you sign. Do not sign this consent
if this information is blank.
Signature of Taxpayer
You must sign and date the consent in order for the IRS to disclose your
tax information to the Federal agency appointee named on the consent.
The signature and date must be handwritten. When signing the
document, you are authorizing the release of specific tax information
from IRS records.
Privacy Act Notice
We ask for the information on this form to carry out the Internal Revenue laws of the United States. This form authorizes the IRS to disclose your confidential tax information to
the federal agency you appoint. This form is provided for your convenience and its use is voluntary. The information is used by the IRS to determine what confidential tax
information your appointee can receive. Internal Revenue Code section 6103(c) and its regulations require you to provide this information if you want to designate an
appointee to inspect and/or receive your confidential tax information. Under section 6109, you must disclose your identification number. If you do not provide all the
information requested on this form, we may not be able to honor the authorization. Providing false or fraudulent information may subject you to penalties.
Routine uses of this information include disclosure to the Department of Justice for civil or criminal litigation and to other federal agencies, as provided by law. We may
disclose this information to cities, states, the District of Columbia, and U.S. commonwealths and possessions to administer their laws. We may also disclose this information to
other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat
terrorism. We may disclose this information to persons for purposes of collecting debts through salary and administrative offsets and to the news media as described in IRS
Policy Statement 11-94. We may also disclose this information to appropriate persons to assist in responding to compromises of information.