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Taxpayer's name and address, an "In reply refer to" box, the tax year, the last four digits of the Social Security number and the principal place of employment.
9214
Moving Expenses Questionnaire
Form 9214, Moving Expenses Questionnaire, is an Internal Revenue Service form used in the examination of a return. The form says: "To assist us in the examination of your return, provide the following requested information and documentation." If more than one move was made in the year, it asks for a separate questionnaire for each move.
The one page form asks for the date and tax year of the move, where the taxpayer moved to and from, whether expenses are claimed in more than one tax year, whether the move was between foreign countries, how long the taxpayer worked at the new location, and how the employer reimbursed the move, including Form 4782 and Form W-2 amounts. It also asks for copies of receipts for all expenses claimed on Form 3903, Moving Expenses.
The taxpayer signs a certification under penalties of perjury, and the spouse signs if a joint return was filed. You can fill out the PDF free in your browser on this page and download it without an account.

Taxpayer's name and address, an "In reply refer to" box, the tax year, the last four digits of the Social Security number and the principal place of employment.
Date of move, tax year of move, where the taxpayer moved to and from, and whether expenses for the move are claimed in more than one tax year.
Whether the move was between foreign countries, and the period the taxpayer was employed at the new location.
Whether the employer reimbursed moving expenses, whether it provided Form 4782, Employee Moving Expense Information, or an equivalent statement, its name and address, and whether reimbursements were on the Form W-2.
A note asking for copies of receipts for all expenses claimed on Form 3903, then the certification with the taxpayer's and spouse's signatures and the date.
Use a separate questionnaire for each move made in the year, and enter the date and tax year of the move.
Enter where the move went to and from. If expenses for the move are claimed in more than one tax year, the form asks for a copy of the tax return for the other year.
If the move was between foreign countries, the form asks for a schedule of income earned in each country for the year of the move. Enter the period employed at the new location.
Answer the reimbursement questions. If the employer provided Form 4782 or an equivalent statement, the form asks for a copy. If reimbursements were on the Form W-2, it asks for a reconciliation to the return and an explanation of any differences.
Attach copies of receipts for all expenses claimed on Form 3903. The form says original documents, if submitted, will be returned at the conclusion of the examination.
Sign and date the certification. The spouse signs too if a joint return was filed.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The form says it is to assist the IRS ("us") in the examination of your return. It prints no mailing address.
The form prints no due date.
Copies of receipts for expenses claimed on Form 3903, a copy of Form 4782 or an equivalent statement if provided, a Form W-2 reconciliation, and the other-year return or foreign income schedule when those questions apply.
If original documents are submitted, the form says they will be returned to you at the conclusion of the examination.
The header holds the name and address, the tax year, the last four digits of the Social Security number and the principal place of employment.
The form asks for a separate questionnaire for each move made in the year.
The form says to furnish the requested information and documentation even if no deduction for moving expenses is shown on the return.
Several questions cover employer reimbursement, Form 4782 and the Form W-2. The form has no employer signature line.
A spouse's signature line is marked for use if a joint return was filed.
The form is addressed to the taxpayer whose return is being examined. The taxpayer completes it and returns it with copies of the documents it asks for to the IRS, which the form calls "us".
The agency’s own page for Form 9214.
The official blank form, to print or fill by hand.
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An IRS questionnaire about moving expenses. The form says it is to assist in the examination of your return.
The form asks for a separate questionnaire for each move made in the year.
The form says to furnish the requested information and documentation even if no deduction for moving expenses is shown on the return.
The form says original documents, if submitted, will be returned to you at the conclusion of the examination.
The form names it Form 4782, Employee Moving Expense Information, and asks for a copy if the employer provided it or an equivalent statement.
The taxpayer, and the spouse if a joint return was filed.