Form 4506-A
(October 2018)
Department of the Treasury
Internal Revenue Service
Request for Public Inspection or Copy
of Exempt or Political Organization IRS Form
▶
Type or print clearly. Request may be rejected if the form is incomplete or illegible.
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Information about Form 4506-A and its separate instructions is at www.irs.gov/form4506.
OMB No. 1545-0495
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 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.
• Form 990-N (e-Postcard) annual electronic notice is available for inspection on IRS.gov using Tax Exempt Organization Search (see instructions).
• Amazon Web Services (AWS). Efiled Forms 990, 990-EZ and 990-PF are available on AWS in a machine readable format.
1
Exempt or political organization. Complete a separate Form 4506-A for each organization.
Name Employer identification number
Address
City or town, state or province, country, and ZIP or foreign postal code
2
Requester
Name
Address
City or town, state or province, country, and ZIP or foreign postal code
Contact person
Phone
Date
3
Category of requester:
You must check a box.
Commercial user Non-commercial scientific institution Media
Name of Media Outlet Educational institution 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 5–8. 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, DVD, or Sample DVD box and enter the specific tax year(s), as indicated. If ordering a partial set on DVD
or Sample DVD, indicate the format, state(s), and month(s) requested.
Line 9. Check the box(es) for the item(s) you are requesting. You may request more than one item. If you check “other,” you must indicate the specific
item(s) you are requesting on the line provided or on an attachment. See instructions for more information.
Note. DVD and Sample DVD are not available for individual exempt organizations.
5 Form 990, Form 990-EZ:
a Paper request:
Copy Inspection
Tax year(s) or period(s) requested:
YYYYMM
;
YYYYMM
;
YYYYMM
.
b Digital data request: Yearly Sample
State(s):
; ; .
Calendar year(s):
; ; .
6 Form 990-PF:
a Paper request: Copy Inspection
Tax year(s) or period(s) requested:
YYYYMM
;
YYYYMM
;
YYYYMM
.
b Digital data request: Yearly Sample
State(s):
; ; .
Calendar year(s): ; ; .
7 Form 990-T (501(c)(3) organizations filed after August 17, 2006):
a Paper request: Copy Inspection
Tax year(s) or period(s) requested:
YYYYMM
;
YYYYMM
;
YYYYMM
.
b Digital data request: Yearly Sample
State(s):
; ; .
Calendar year(s): ; ; .
8 Form 5227 (for tax years beginning after December 31, 2006):
Paper request: Copy Inspection
Tax year(s) or period(s) requested:
YYYYMM
;
YYYYMM
;
YYYYMM
.
9
Application for exemption (Form 1023, 1023-EZ,
Form 1024, etc.)
Exemption determination letter only
Affirmation letter
Other
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. 10-2018)
