Form L-80 - Tracer Request For Net Income Tax printable pdf download

Form L-80 - Tracer Request For Net Income Tax

STATE OF HAWAII — DEPARTMENT OF TAXATION

FORM

L-80

TRACER REQUEST FOR NET INCOME TAX YEAR _____

(See back for Instructions)

(Rev. 2001)

General Information

Part I

(Complete Lines 1 through 5)

1. Taxpayer’s Name(s):

2. Social Security No(s). OR Federal Employer I.D. No.:

Primary Taxpayer

Spouse

3. Mailing Address on the Return

4. New Mailing Address (if different)

5. Daytime Telephone Number: Residence ( ______ ) __________________

Business ( ______ ) ____________________

Part II

Reason For Tracer Request

Did you receive the refund check?

Yes

If “No,” stop here, otherwise continue to line 2.

The refund check was received but was (check ONE of the following boxes):

Lost

Stolen

Destroyed

Other _____________________________________

AND

Was the check endorsed?

Yes

If “No,” stop here, otherwise continue to line 3.

The refund check was endorsed with (check ONE of the following boxes):

All required signatures

Husband’s signature only

Wife’s signature only

For Deposit Only

Pay to the Order of

NOTE:

A “STOP PAYMENT” will be issued on the original refund check upon receipt of this form. If you receive/find your original check after submitting

this form, DO NOT CASH THE ORIGINAL CHECK. You must return the check to the district tax office to which you submitted this form.

Declaration

Part III

I hereby declare, under the penalties provided by section 231-36, HRS, that I have examined this request and, to the best of my knowledge and belief, it

is true, correct, and complete.

Print or Type Your Name

Signature

Title (if applicable)

Date

For Office Use Only

Check/Warrant#

Amount

Issued Date

COMPT VO#

Period

Tax I.D.#

Tax Office VO#

Post Date

FORM L-80

Form L-80 - Tracer Request For Net Income Tax

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