Income Verification Request

Associate's Market*

United States
Canada

How would the Associate prefer us to send them the information?*

Email
Fax
Mail

How would the Associate prefer us to send them the information?

Mail

In order to receive tax information electronically, the Associate must complete the US Income Verification Request Form. Exit out of this form and go to the US Income Verification Request Form in Ask USANA and send it to the Associate and have them send it back.

Mail form to:

Main Address on file
Other address

Please enter the email address*

Please enter the fax #*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Requesting DSR Name*

Associate ID#*

Associate Name*

Tax Year's Requested*

Is the Tax ID Currently on file?*

Yes
No

Entire Tax ID#*

Last 3 digits of Tax ID#*

Last 4 Digits of Tax ID#*

Please give a detailed reason why the Associate was unable to access the information online*

Income Verification Request

All time

This month

Today