Self-Declaration of Non-Filing Tax Return Form

Self-Declaration of Non-Filing Tax Return Form
Form for individuals to formally declare non-filing of a tax return for a specified year. Please complete all sections accurately.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Tax Year for Non-Filing Declaration
Reason for Not Filing Tax Return
Did you have any taxable income or a filing requirement for the specified year?
Supporting Explanation (if any)
Date of Declaration
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
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