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This document serves as a legal affidavit to report the forgery of a signature on a refund check issued by the Louisiana Department of Revenue.
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How to fill out Affidavit of Louisiana Department of Revenue Refund Check Endorsement Forgery for Single Filing Status

01
Obtain the Affidavit of Louisiana Department of Revenue Refund Check Endorsement Forgery form.
02
Fill in your personal information, including your name, address, and Social Security Number.
03
Indicate your filing status as 'Single' on the form.
04
Describe the circumstances of the endorsement forgery clearly and concisely.
05
Gather any supporting documents, such as a copy of the forgery, bank statements, or police reports if applicable.
06
Sign and date the affidavit, certifying that the information provided is true and accurate.
07
Submit the completed affidavit along with any accompanying documents to the Louisiana Department of Revenue.

Who needs Affidavit of Louisiana Department of Revenue Refund Check Endorsement Forgery for Single Filing Status?

01
Individuals who have had their Louisiana tax refund check fraudulently endorsed and cashed without their permission, specifically those filing as single.
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A person who moves into Louisiana after the start of the succeeding year, and who files his federal income tax return for the prior taxable year using a Louisiana address, will receive the letter of inquiry from the department concerning Louisiana income tax liability, even though the person was not a resident of
A person who moves into Louisiana after the start of the succeeding year, and who files his federal income tax return for the prior taxable year using a Louisiana address, will receive the letter of inquiry from the department concerning Louisiana income tax liability, even though the person was not a resident of
If you owe a tax debt to the Louisiana Department of Revenue and cannot afford to pay the balance in full, you may request an installment agreement to pay your debt over time.
The Internal Revenue Service (IRS) administers and enforces U.S. federal tax laws.
The Louisiana Department of Revenue (LDR) is responsible for fairly and efficiently collecting state tax revenues to fund public services, to regulate charitable gaming and the sale of alcoholic beverage and tobacco, and to support state agencies in the collection of overdue debts.
If one of you is not a resident of Louisiana, you may file as a resident (Form IT-540) or a nonresident (Form IT-540B), whichever is more beneficial to you and your spouse.
To verify your tax liability for individual income tax, call LDR at (225) 219-0102. To verify your tax liability for business taxes, you can review your liabilities online using the Louisiana Taxpayer Access Point (LaTAP) system.

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It is a legal document used to declare that a refund check issued by the Louisiana Department of Revenue has been fraudulently endorsed or cashed without the rightful owner's consent, specifically for individuals who filed their taxes under a single filing status.
Any individual who has received a Louisiana refund check that has been forged or improperly endorsed is required to file this affidavit to report the forgery to the authorities.
To fill out the affidavit, individuals must provide their personal information, details about the forged check, explanation of the forgery, and any relevant documentation, then sign and date the form.
The purpose of the affidavit is to formally report the forgery of a tax refund check, seek restitution, and prevent further fraudulent activities related to tax refunds.
The affidavit must report the individual's name, social security number, the amount of the forged check, the check number, details of the forgery, and any additional relevant information or evidence supporting the claim.
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