Document

Form 15293 (Rev. 4-2024)

ICR 202403-1545-014 · OMB 1545-2324 · Object 141360401.

Document Viewer [pdf]

Status: Original and derived artifacts are available for this document.

Download: pdf

Primary: pdfSource: application/octet-stream
Loading document viewer…

Document Metadata

Record metadata
application/octet-stream
Form 15293 (Rev. 4-2024)
Consent for Disclosure of Non-Tax IRS Records Protected under the Privacy Act
OS:P:PPC:PPKM
2024-04-02
2024-04-02
complete