Form 673 Arizona 2019-2025

Form 673 Arizona: What You Should Know

All commercial requests must be notarized. If this is a commercial request, please PRINT the form, have it NOTARIZED, and SUBMIT VIA FAX to or . All commercial requests must be notarized. You must provide the following information to file this form: Full Social Security Number (Social Security numbers for individuals are not required.) Full name and mailing address of employer Date the work was performed Date the income was reported The date the wages were reported and paid to the employer The information needed to calculate the exemption. What is exempt? What do I need to file? All exemptions form must be completed, signed and dated by all parties. What do I sign “in support of my claim.” What do I sign under “in order to authorize the tax return preparer to prepare your tax return.” Your name and address. Your full address and city/state of residence. The name or trade name under which you perform the work. The date and place of performance of the work. (i.e. “work for WAC of Phoenix”) The name under which the business is listed. The name under which the partnership is listed. Your business identification number (BIN), if different from your social security number. “In order that your return may be filed and processed without delay, I hereby certify that the information given is true, correct and complete and that the information you provided is not the product of an improper or illegal search or an intentional misrepresentation of fact by you or anyone acting on your behalf. I further certify that under penalties of perjury, I am authorized to issue this return.” “I have received this form, which is signed, notarized and completed by me (as your representative) under penalty of perjury. I hereby certify that the information given on this form is true and complete.” “I have carefully examined this form and believe that it does not constitute a false, deceptive, or fraudulently fraudulent document.

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