Form Dtf-664 - Tax Shelter Disclosure For Material Advisors

DTF-664

New York State Department of Taxation and Finance

Tax Shelter Disclosure for

Material Advisors

Tax Law - Article 1, Section 25(b)(1)

Material advisor’s name

Employer identification number (EIN) or social security number

Mailing address of material advisor

( number and street or rural route )

City, village, town, or post office

State

ZIP code

Telephone number

(

)

Material advisor’s e-mail address

Aggregate material advisor’s fees

Attach a copy of the statement or return filed with the Internal Revenue Service (IRS) pursuant to Internal Revenue Code (IRC)

section 6111 (currently federal Form 8918, Material Advisor Disclosure Statement) . Also include all documentation submitted to the

IRS in connection with the statement or return and mail to the address shown below. For more information, see the instructions on

the back of this form.

Tax shelter information

Type of business organization

( mark an X in all that apply )

Partnership

( including a limited partnership )

Trust

S corporation

Federal Schedule C or Schedule F activity

Other

( specify )

Enter the tax shelter’s six-digit NAICS business code number

..............................................

( from the federal tax return )

Certification: I certify that this disclosure and any attachments are to the best of my knowledge and belief true, correct, and complete.

Signature

Official title

Date

Firm’s name

Firm’s EIN

Preparer’s PTIN or SSN

(or yours if self-employed)

Paid

preparer

Signature of individual preparing this disclosure

Address

City

State

ZIP code

use

only

E-mail address of individual preparing this disclosure

Preparer’s NYTPRIN

Date

(see instr.)

Instructions

General information

Commissioner of Taxation and Finance if any of the following conditions

apply:

The Tax Law provides for reporting requirements with respect to the

A the person is organized in this state;

disclosure of information relating to transactions that present the

potential for tax avoidance (a tax shelter). These requirements are

B the person is doing business in this state;

similar to the tax shelter disclosure requirements for federal income tax

C the person is deriving income in this state; or

purposes. The Tax Law also imposes penalties for nondisclosure and

D (i) the list, required to be maintained by this person pursuant

the underpayment of taxes due to participation in these transactions

to IRC section 6112, identifies, or is required to identify, a

and extends the statute of limitations for assessments relating to these

taxpayer subject to tax under Tax Law Article 9, 9-A, 22, 32, or

transactions. For more information, see TSB-M-05(2)C or TSB-M-05(4)I,

33, and (ii) this person is a material advisor, as defined in IRC

Disclosure of Certain Transactions and Related Information Regarding

section 6111, who provides any material aid, assistance, or

Tax Shelters, and TSB-M-05(2.1)C or TSB-M-05(4.1)I, Supplement to

advice with respect to organizing, managing, promoting, selling,

the Disclosure of Certain Transactions and Related Tax Shelters.

implementing, or carrying out any reportable transaction.

Who must file

Exception: A material advisor who is required to file a duplicate of the

statement or return submitted to the IRS pursuant to IRC section 6111

Every person (material advisor) required to make and file a statement

may file an abbreviated disclosure statement if:

or return pursuant to IRC section 6111 on or after April 12, 2005, and

• the material advisor has designated one person as the designated

prior to July 1, 2015, must file a duplicate of that statement or return

(currently federal Form 8918), including all documentation submitted

material advisor for federal income tax purposes (a designation

agreement); and

to the IRS in connection with the statement or return, with the

• the designated material advisor elects collective disclosure by

supplying a list of names, addresses, and tax identification numbers

for each of the material advisors included in the IRS designation

agreement.

For more information concerning collective disclosure elections

664001140094

and abbreviated disclosure statements, refer to TSB-M-05(2.1)C or

TSB-M-05(4.1)I.

Form Dtf-664 - Tax Shelter Disclosure For Material Advisors - 2014

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