Schedule TDS — Taxpayer Disclosure Statement

Use Schedule TDS to make disclosures as required by law and DOR guidance. Enclose a separate Schedule TDS for each issue being addressed.
Further information about certain required disclosures may be found in taxpayer form instructions, TIR 06-5, DD 12-7 , and TIR 19-11.
Name of taxpayer Federal Identification or Social Security number For tax year beginning Ending
Type of tax return filed Schedule Line number Statement number
Massachusetts Department of Revenue

# Schedule TDS Taxpayer Disclosure Statement

Rev. 9/22