Division of Revenue

Statutory Authority: 30 Delaware Code, Section 354 (30 Del.C. §354)


Delaware's Voluntary Tax Compliance Initiative (VTCI) (September 1, 2009 - October 30, 2009)

To be considered for the tremendous benefits of the VTCI program you will need to register by completing the information below. Mail in this form with your payment or complete via phone or online.


Name :_______________________________________ (please print)

1. Home Phone:______________________________

2. Alternative Phone:__________________________

3. TaxPayerID#:______________________________

4. Status (circle one)

1 First Time Filer in Delaware

2 Return(s) may be missing

3 Return(s) may need correction

5. Repayment(circle one)

1 NOT currently paying a liability

2 In current Repayment plan

3 Current Wage Garnishment or lien

6. If you are planning to file a non-filed or amended return for returns that were previously filed, you must complete this section.

(Non-filed or amended returns for the VTCI must be received no later than October 30, 2009 to qualify).

TAX Type


If New/Amended Return, Estimated Tax Amount

Personal income tax


Withholding tax


Gross receipts tax


Estate tax


Income tax on estates and trusts


Corporation income tax


Occupational license fees and tax


Contractors’ license fees and tax


Manufacturers’ license fees and tax


Tobacco product license fees and tax


Realty Transfer tax


Public Utilities tax


Lodging tax


Retail and Wholesale Merchants’ license fees and tax


Use tax and gross receipts tax on leases of tangible personal property


(The above-listed taxes due from partners, shareholders or members of pass-through entities filing a voluntary tax return are also eligible.)

7. Confirm your existing reported liabilities below that you would like to register into the VTCI program

– make changes/additions where needed. (These are amended return claim liabilities)

Tax Type


Amt Reported Due




(use additional space below if needed)

Authorized Signature ___________________________ Date ______________________

Telephone Number _______________________ Email ___________________________

Tax Payer Name : ____________________________

Business Name: _____________________________

Address : _______________________________


13 DE Reg. 517 (10/01/09)