Summary. Sixteen templates, in case order.
1. Notice triage worksheet
Do this the day the envelope arrives. Write the deadline on the envelope.
NOTICE TRIAGE
Notice date: ____/____/______ Received: ____/____/______
Notice number / title: ______________________
Tax year(s): ______________ Amount stated: $ ______________
WHAT KIND IS IT?
[ ] Balance due / first request for payment
-> Respond in writing if the number is wrong. Cheap moment to fix it.
Deadline: ________
[ ] Proposed changes to a filed return (income matching)
-> FREQUENTLY WRONG. It does not know your basis, your business
expenses, or income reported elsewhere. Respond with documents.
Deadline: ________
[ ] NOTICE OF DEFICIENCY / "90-DAY LETTER"
-> 90 DAYS to petition the U.S. Tax Court (150 if addressed abroad).
CANNOT BE EXTENDED BY ANYONE. Filing means you do NOT pay first.
HARD DEADLINE: ____/____/______
[ ] NOTICE OF FEDERAL TAX LIEN FILING
-> 30 DAYS for a CDP hearing under 26 U.S.C. § 6320.
HARD DEADLINE: ____/____/______
[ ] FINAL NOTICE OF INTENT TO LEVY / NOTICE OF YOUR RIGHT TO A HEARING
-> 30 DAYS for a CDP hearing under 26 U.S.C. § 6330.
HARD DEADLINE: ____/____/______
[ ] Levy notice sent to employer or bank
-> ACT TODAY. See Template 4.
[ ] State tax notice
-> Separate system, separate deadlines, often shorter. Check license
consequences.
Deadline: ________
[ ] Other: ______________________
ACTIONS
[ ] Deadline written on the envelope and on a calendar
[ ] Copy scanned and stored
[ ] Transcripts requested (Template 2)
[ ] Response drafted by ________
2. Transcript request and reading worksheet
TRANSCRIPT REQUEST — all four types, every year in question
Years needed: ______________________
[ ] Wage and income transcript (what third parties reported)
[ ] Account transcript (assessments, penalties, events)
[ ] Return transcript (what was filed)
[ ] Record of account (both combined)
Method: [ ] online account [ ] mail request [ ] representative pull
READING THE ACCOUNT TRANSCRIPT — one row per year
YEAR RETURN FILED BY ASSESSMENT TOTAL TOTAL SUSPENSIONS
you / IRS(SFR)/ DATE PENALTIES INTEREST (offers, CDP,
not filed bankruptcy,
abroad)
____ ______________ __________ $ _______ $ ______ ____________
____ ______________ __________ $ _______ $ ______ ____________
____ ______________ __________ $ _______ $ ______ ____________
____ ______________ __________ $ _______ $ ______ ____________
TOTAL PENALTIES ACROSS ALL YEARS: $ __________
<- this is your penalty abatement target
SUBSTITUTE FOR RETURN prepared for years: ______________________
<- these balances are probably inflated. File actual returns.
COLLECTION STATUTE EXPIRATION DATE
My own estimate (assessment + 10 years): ____/____/______
IRS's COMPUTED date (REQUEST THIS): ____/____/______
Requested on ________ Received ________
Note: the IRS date governs. Suspensions push it later, sometimes by
years. This date changes which resolution is right.
3. Emergency levy release request
[Date] DELIVER TODAY — BY FAX AND PHONE
Internal Revenue Service
[Office / revenue officer name from the notice]
[Fax number from the notice]
RE: REQUEST FOR IMMEDIATE RELEASE OF LEVY — ECONOMIC HARDSHIP
Taxpayer: ______________ SSN: xxx-xx-____
Tax years: ______________
Levy served on: [employer / bank name] on [date]
I request immediate release of the levy served on [employer/bank]. The
levy is creating an immediate economic hardship that prevents me from
meeting basic, reasonable living expenses.
CURRENT MONTHLY INCOME
Net wages after the levy: $ ______
Other income: $ ______
TOTAL: $ ______
NECESSARY MONTHLY LIVING EXPENSES
Rent or mortgage: $ ______
Utilities (electric, gas, water, phone): $ ______
Food: $ ______
Transportation to work: $ ______
Health insurance and medical: $ ______
Child care necessary for employment: $ ______
Court-ordered support: $ ______
TOTAL: $ ______
SHORTFALL: $ ______
SPECIFIC CONSEQUENCES
[State them concretely and truthfully:]
- I cannot pay [rent/mortgage] due on [date]. My landlord has [given
notice / stated they will file].
- My [medication/treatment] costs $____ and I cannot fill the
prescription.
- My utility service is scheduled for disconnection on [date].
- I have [__] dependents: [ages].
SIMULTANEOUS RESOLUTION REQUEST
I am concurrently requesting:
[ ] an installment agreement at $____ per month
[ ] currently not collectible status
[ ] an offer in compromise
[ ] a collection due process hearing (filed [date])
I understand levy action is generally prohibited while such a request is
pending, and I ask that the current levy be released on that basis as
well as for hardship.
ENCLOSED: [pay statement showing the levy · lease or mortgage statement ·
utility disconnection notice · medical documentation · bank statement]
I can be reached at [phone] at any time.
______________________ · [Address] · [Phone] · [Email]
FOR A BANK LEVY, ADD: The bank is holding these funds for the statutory
period ending on or about [date]. I ask for a determination before that
date so that the funds are not remitted.
4. Collection due process request — statement of issues
Attach this to the request form. Issues not raised are generally not preserved.
STATEMENT OF ISSUES — REQUEST FOR COLLECTION DUE PROCESS HEARING
Taxpayer: ______________ Tax years: ______________
Notice: [lien filing / final notice of intent to levy] dated ________
Request filed within 30 days: YES — on ________
1. COLLECTION ALTERNATIVE REQUESTED
I request that the proposed collection action be replaced with:
[ ] An installment agreement of $______ per month, beginning ________,
by direct debit.
[ ] Currently not collectible status. My income does not meet my
allowable living expenses; see the enclosed financial statement.
[ ] An offer in compromise of $______, based on doubt as to
collectibility. My reasonable collection potential is computed at
$______; see enclosed worksheet.
2. THE PROPOSED ACTION IS MORE INTRUSIVE THAN NECESSARY
Under 26 U.S.C. § 6330(c)(3)(C), Appeals must consider whether the
collection action balances the need for efficient collection against
the legitimate concern that it be no more intrusive than necessary.
[State concretely what the action does:]
- The levy would take $____ per month, leaving $____ against necessary
expenses of $____.
- I would be unable to [continue working / keep housing / obtain
medical care], which would reduce rather than increase what the
government ultimately collects.
- [Number] dependents rely on this income.
3. CHALLENGE TO THE UNDERLYING LIABILITY
[Include ONLY if you did not previously have an opportunity to dispute
it — for example, no notice of deficiency was received, or a substitute
return was assessed without your participation.]
I did not previously have an opportunity to dispute the liability for
[years] because [I never received a notice of deficiency at my address
of record / the assessment resulted from a substitute for return
prepared without my participation]. The liability is incorrect because
[the substitute allowed no business expenses against 1099 income / no
basis was allowed on securities sold / the filing status and dependents
are wrong]. Corrected returns for [years] are enclosed / were filed on
[date].
4. SPOUSAL DEFENSES
[If a joint return is involved:] I request relief from joint and
several liability under 26 U.S.C. § 6015. A separate request is
[enclosed / being filed on ________].
5. PROCEDURAL ISSUES
[ ] Required notices were not sent to my last known address
[ ] The assessment was not properly made
[ ] The collection period has expired for [years]
[ ] Other: ______________________
6. FILING COMPLIANCE
All required returns are filed through tax year ______.
[If not yet: they will be filed by ________ — note that Appeals will
not grant an alternative to a taxpayer with unfiled returns.]
ENCLOSED: financial statement · supporting documentation · RCP worksheet ·
corrected returns [as applicable]
______________________ Date: ________
5. Record reconstruction log
RECORD RECONSTRUCTION — TAX YEAR ______
INCOME (from wage and income transcript)
SOURCE FORM AMOUNT NOTES
____________________ _____ $ ______ ______________
____________________ _____ $ ______ ______________
TOTAL REPORTED INCOME: $ ______
SECURITIES SALES — the biggest substitute-return distortion
DESCRIPTION PROCEEDS BASIS GAIN/LOSS SOURCE OF BASIS
______________ $ ______ $ ______ $ ______ broker stmt dated __
______________ $ ______ $ ______ $ ______ ______________
[Request historical statements from the brokerage. They have them.]
BUSINESS EXPENSES (self-employment)
CATEGORY AMOUNT SOURCE
Vehicle / mileage $ ______ calendar + job log, ____ miles
Fuel $ ______ card statements, ____ transactions
Tools and equipment $ ______ card statements + vendor reprints
Materials and parts $ ______ supplier reprint dated ________
Insurance (liability) $ ______ policy + payment records
Phone / internet $ ______ bills, ____% business
Software / subscriptions $ ______ card statements
Continuing education $ ______ receipts / registration records
Rent (workspace) $ ______ lease + payments
Professional fees $ ______ invoices
Health insurance premiums $ ______ insurer records
Other: ______________ $ ______ ______________
TOTAL: $ ______
ITEMIZED DEDUCTIONS
Mortgage interest $ ______ Form 1098 on transcript
Property tax $ ______ county records
State income tax paid $ ______ state records / W-2
Charitable $ ______ receipts / bank records
Medical (above threshold) $ ______ provider statements
FILING STATUS AND DEPENDENTS (a substitute assumes SINGLE, none)
Correct status: ______________
Dependents: ______________________
Credits available: ______________________
WHERE A RECORD IS GONE
Item: ______________ Estimated: $ ______
METHODOLOGY: [state it plainly — e.g., "Fuel estimated from 11 months of
card statements averaging $412/month, extrapolated to 12 months. The
December statement is unavailable because the account was closed."]
SOURCES ORDERED
[ ] Bank statements, ____ years, requested ________ received ________
[ ] Credit card statements, requested ________ received ________
[ ] Brokerage historical statements, requested ________ received ______
[ ] Vendor reprints from ______________, requested ________
[ ] Prior year return located: ________
6. Reasonable collection potential worksheet
Complete this before anyone quotes you a fee.
REASONABLE COLLECTION POTENTIAL
Taxpayer: ______________ Date computed: ________
Total balance owed (all years): $ ____________
PART A — REALIZABLE VALUE OF ASSETS
REAL PROPERTY
Fair market value $ ________
x quick sale percentage $ ________
minus mortgage balance $ ________
EQUITY $ ________
VEHICLES (list each)
Vehicle 1: QSV $______ - loan $______ = $______
less equity allowance = $______
Vehicle 2: QSV $______ - loan $______ = $______
less equity allowance = $______
BANK ACCOUNTS
Balances $______ less allowance = $______
RETIREMENT ACCOUNTS
Value $______ net of tax and penalty = $______
LIFE INSURANCE (cash value) = $______
OTHER
Investments / securities = $______
Cryptocurrency = $______
Business assets = $______
Accounts receivable = $______
Other: ______________ = $______
TOTAL REALIZABLE ASSET VALUE = $________
PART B — FUTURE INCOME
Average monthly gross income (12-month average) $ ________
[Average seasonal or variable income over a
full year, not a good month.]
Allowable living expenses (Worksheet 7) $ ________
MONTHLY DISPOSABLE INCOME $ ________
x applicable number of months (depends on the
payment option chosen) x ________
FUTURE INCOME COMPONENT = $________
PART C — TOTAL
RCP = Part A + Part B = $________
DECISION
RCP $________ vs. BALANCE $________
[ ] RCP is FAR BELOW the balance
-> offer in compromise is realistic. Proceed.
[ ] RCP is NEAR OR ABOVE the balance
-> AN OFFER WILL NOT BE ACCEPTED. Anyone who says otherwise is
selling you a rejection. Choose an installment agreement.
[ ] Disposable income near zero, no assets
-> currently not collectible. Free to request. And note: THE
COLLECTION PERIOD KEEPS RUNNING in this status, while an offer
SUSPENDS it. Compare against your collection statute
expiration date before choosing.
[ ] Comfortable disposable income
-> direct debit installment agreement, then penalty abatement,
then lien withdrawal.
7. Allowable expense worksheet
ALLOWABLE LIVING EXPENSES
Household size: ____ County: ______________ Region: ______________
STANDARD CATEGORIES (published amounts by household size / geography)
Food, clothing, household supplies, personal care,
misc. $ ________
Housing and utilities (county standard) $ ________
Transportation — ownership (per vehicle) $ ________
Transportation — operating (regional) $ ________
Out-of-pocket health care (per person standard) $ ________
ACTUAL EXPENSES THAT MAY EXCEED OR SUPPLEMENT STANDARDS
— DOCUMENT AND CLAIM THESE. They are the most under-claimed items.
Health care above the standard:
Insurance premiums $ ________
Prescriptions $ ________
Ongoing treatment / therapy $ ________
Dental / vision $ ________
[Attach: EOBs, pharmacy printouts, provider statements]
Court-ordered payments ACTUALLY BEING PAID:
Child support $ ________
Spousal support $ ________
Judgment payments $ ________
[Attach: the order AND proof of payment]
Child care necessary for employment $ ________
[Attach: provider statement]
Current taxes:
Federal withholding / estimated payments $ ________
State withholding / estimated payments $ ________
[Do NOT omit these. They are allowable.]
Term life insurance premiums (within limits) $ ________
Delinquent state/local tax under an agreement $ ________
Secured debt payments (allowable portion) $ ________
Other necessary, documented: ______________ $ ________
TOTAL ALLOWABLE EXPENSES $ ________
GENERALLY NOT ALLOWED — do not build a plan on these
[ ] Unsecured credit card payments
[ ] Private school tuition
[ ] Charitable contributions
[ ] Voluntary retirement contributions
[ ] Expenses for people outside the household
[ ] Cable, streaming, entertainment beyond the standard
DOCUMENTATION ATTACHED
[ ] 3 months bank statements, every account
[ ] 3 months pay statements or P&L
[ ] Lease/mortgage + property tax
[ ] Vehicle registrations and loan statements
[ ] Utility bills
[ ] Health insurance and out-of-pocket documentation
[ ] Support orders + payment proof
[ ] Retirement and investment statements
[ ] Life insurance with cash value info
8. Installment agreement proposal letter
[Date]
RE: Proposal for Installment Agreement
Taxpayer: ______________ SSN: xxx-xx-____
Tax years and balances: ______________________
Total: $ ____________
I propose an installment agreement with the following terms:
Monthly payment: $ ________
First payment date: ____/____/______
Payment method: DIRECT DEBIT from account ending ____
[Direct debit reduces the user fee, prevents
default from a missed payment, and supports a
later request to withdraw the lien notice.]
BASIS FOR THE AMOUNT
Average monthly gross income: $ ________
Allowable living expenses (worksheet): $ ________
Monthly disposable income: $ ________
Proposed payment: $ ________
[If proposing less than full disposable income, explain: an upcoming
necessary expense, a variable income pattern, a documented obligation
beginning on a date certain.]
FILING COMPLIANCE
All required returns are filed through tax year ______.
ADDITIONAL REQUESTS MADE CONCURRENTLY
[ ] Penalty abatement (see separate request dated ________)
[ ] Withdrawal of the Notice of Federal Tax Lien, to be requested after
[__] months of on-time direct debit payments
[ ] Release of any levy currently in effect
I understand that penalties and interest continue to accrue during the
agreement, that I must remain current on all future filings and payments,
and that the agreement may be terminated for default.
ENCLOSED: financial statement · supporting documentation · direct debit
authorization
______________________ · [Address] · [Phone]
9. Currently not collectible request
[Date]
RE: Request for Currently Not Collectible Status
Taxpayer: ______________ SSN: xxx-xx-____
Tax years: ______________ Balance: $ ____________
I request that my account be placed in currently not collectible status
because collection would create an economic hardship, leaving me unable to
meet necessary living expenses.
FINANCIAL SUMMARY
Monthly gross income: $ ________
Sources: [Social Security $____ / pension $____ / wages $____ /
disability $____ / other $____]
Allowable living expenses: $ ________
MONTHLY SHORTFALL / DISPOSABLE INCOME: $ ________
ASSETS
Real property: [none / ______________ , equity $______]
Vehicles: [year, make, value $______, loan $______]
Bank accounts: $ ______
Retirement: $ ______
Other: ______________
TOTAL REALIZABLE: $ ______
CIRCUMSTANCES
[State them plainly: age, health, disability, fixed income, dependents,
caregiving obligations, employment prospects. Two or three paragraphs.]
FILING COMPLIANCE
All required returns are filed through tax year ______.
ADDITIONAL REQUESTS
[ ] Release of any levy currently in effect
[ ] Penalty abatement (separate request enclosed)
I understand that penalties and interest continue to accrue, that a Notice
of Federal Tax Lien may still be filed, and that the account will be
reviewed periodically if my circumstances change.
ENCLOSED: financial statement · bank statements · benefit award letters ·
medical documentation · lease or mortgage · utility bills
______________________ · [Address] · [Phone]
10. Penalty abatement request — first-time abatement
[Date]
RE: Request for First-Time Penalty Abatement
Taxpayer: ______________ SSN: xxx-xx-____
Tax year: ______
Penalties: failure to file $______ · failure to pay $______
estimated tax $______ · TOTAL $______
I request abatement of the penalties assessed for tax year ______ under
the first-time abatement administrative waiver.
I meet the criteria:
1. CLEAN COMPLIANCE HISTORY. I was not required to file a return, or had
no penalties assessed, for the three tax years preceding ______
(that is, ______, ______, and ______).
2. FILING COMPLIANCE. All currently required returns have been filed, or
a valid extension is in place. My most recent return, for tax year
______, was filed on ________.
3. PAYMENT COMPLIANCE. I have [paid the tax in full / entered an
installment agreement on ________ and am current on it, having made
____ payments totaling $______].
I request abatement of the penalties listed above and of the interest that
accrued on those penalties.
If first-time abatement is not available for this year, I request that
this be considered as a request for abatement based on reasonable cause,
and I will provide supporting documentation on request.
______________________ · [Address] · [Phone]
NOTE TO SELF: ask for FIRST-TIME ABATEMENT FIRST. It does not consume the
reasonable-cause argument, which remains available for other years.
11. Penalty abatement request — reasonable cause
[Date]
RE: Request for Abatement of Penalties — Reasonable Cause
Taxpayer: ______________ SSN: xxx-xx-____
Tax years: ______________
Penalties: $ ____________
I request abatement of the penalties assessed for the years above. I
exercised ordinary business care and prudence but was nevertheless unable
to comply because of circumstances beyond my control.
1. WHAT HAPPENED — with dates
[Be specific and chronological. "On March 4, 2022, I was hospitalized
at [hospital] following [event]. I remained hospitalized until May 19,
2022, and was under continuing treatment through November 2022,
including [treatments]. Records are at Exhibit A."]
2. HOW IT PREVENTED COMPLIANCE — the causal link, stated explicitly
["During this period I was unable to work, unable to manage my
financial affairs, and unable to gather the records required to prepare
a return. My records were located at [place], which I could not access.
My income during this period was $____, which was consumed by
[medical costs / housing]."]
3. WHEN IT ENDED AND WHAT I DID
["I was cleared to return to work on [date]. I engaged a preparer on
[date] and filed the return for [year] on [date] — within [__] weeks
of being able to do so." Prompt compliance after the impediment ended
is one of the strongest facts available.]
4. MY COMPLIANCE HISTORY
["I filed and paid on time for the [__] years before this event, and
have filed and paid on time in every year since."]
5. DOCUMENTATION ENCLOSED
[ ] Medical records with dates
[ ] Hospital admission and discharge summaries
[ ] Physician letter
[ ] Death certificate
[ ] Disaster declaration for [area and date]
[ ] Fire or police report
[ ] Correspondence with the tax professional relied upon
[ ] Insurance claim records
[ ] Employment termination records
[ ] Other: ______________________
I understand interest is generally not abatable except where it results
from an IRS error or delay, and I request abatement of the interest that
accrued on the penalties themselves.
______________________ · [Address] · [Phone]
COMMON REASONABLE CAUSE GROUNDS
serious illness or incapacity (yours or an immediate family member's)
death in the immediate family
natural disaster, fire, casualty
destruction or unavailability of records
inability to obtain records from a third party
reliance on a tax professional (fact-dependent)
erroneous written advice from the IRS
12. Innocent spouse declaration outline
DECLARATION IN SUPPORT OF REQUEST FOR RELIEF FROM JOINT AND SEVERAL
LIABILITY — 26 U.S.C. § 6015
I, ______________, declare under penalty of perjury:
RELIEF SOUGHT
[ ] Innocent spouse relief — an UNDERSTATEMENT attributable to my
spouse's erroneous items
[ ] Separation of liability — allocation of a DEFICIENCY (available if
divorced, legally separated, widowed, or living apart for the
required period)
[ ] Equitable relief — the catch-all, AND THE ONLY ROUTE FOR AN
UNDERPAYMENT (a correctly reported tax that was simply not paid)
1. THE MARRIAGE
Married [date]. Separated [date]. Divorced [date].
[Decree at Exhibit ___. NOTE: a decree assigning the tax debt to the
other spouse does NOT bind the IRS.]
2. HOW THE HOUSEHOLD'S FINANCES WORKED
[Who earned what. Who controlled the accounts. Whether I had access to
the business records. Whether I had my own account. Who paid which
bills. Whether I was given money or an allowance.]
3. THE RETURNS
[Who prepared them. Who chose the preparer. Whether I met the preparer.
Whether I was shown the return before signing. What I was told. Whether
I asked questions and what I was told in response. Whether I was
permitted to see supporting records.]
4. WHAT I DID NOT KNOW AND HAD NO REASON TO KNOW
[The specific items. Why nothing put me on notice: our lifestyle was
consistent with the reported income; I was not involved in the
business; the business records were kept at [place] and I did not have
access; I was told [what].]
5. MY INVOLVEMENT IN THE BUSINESS OR THE ITEMS AT ISSUE
[None / limited to ______. What I actually did.]
6. WHETHER I BENEFITED
[Whether unreported income was spent on me or on our household beyond
ordinary support. Be honest — an admission of ordinary benefit is
normal and expected.]
7. ABUSE OR FINANCIAL CONTROL — EXPRESSLY RELEVANT, AND IT CAN OUTWEIGH
A KNOWLEDGE FINDING
[If applicable: physical, emotional, or financial abuse. Control over
money and information. Threats. Isolation. Immigration-status threats.
What happened if I asked questions. Exhibits: protective orders, police
reports, medical records, counselor letters, shelter records, witness
statements.]
8. MY CURRENT FINANCIAL SITUATION — ECONOMIC HARDSHIP
[Income, expenses, dependents, what paying this liability would do.]
9. MY COMPLIANCE SINCE
[Filed and paid on time for tax years ______ through ______.]
10. THE OTHER SPOUSE'S SITUATION
[Whether they have paid anything. Whether they were ordered to.
Whether they are able to.]
I declare under penalty of perjury that the foregoing is true and correct.
______________________ Date: ________
TWO THINGS TO KNOW BEFORE FILING
1. The other spouse WILL be notified and given an opportunity to
participate. The statute requires it. Where abuse is involved, raise
the protections explicitly and ask about them.
2. Deadlines apply and differ by relief type. File promptly.
13. Lien withdrawal request
[Date]
RE: Request for Withdrawal of Notice of Federal Tax Lien
Taxpayer: ______________ SSN: xxx-xx-____
Notice of Federal Tax Lien filed [date] in [county/state],
recording number ______________
Tax years: ______________
I request withdrawal of the Notice of Federal Tax Lien on the following
ground(s):
[ ] I have entered into an installment agreement to satisfy the liability,
and the agreement provides for payment by DIRECT DEBIT. I entered the
agreement on [date] and have made [__] consecutive on-time payments
totaling $______. Account transcript and payment records enclosed.
[ ] Withdrawal will facilitate collection of the tax. Specifically:
[The lien notice is preventing me from [refinancing at a lower rate,
freeing $____ per month toward the liability / obtaining employment in
a field requiring a credit check / obtaining a business license].
Withdrawal would allow ______________, which would increase what I can
pay.]
[ ] Withdrawal is in the best interest of both me and the United States.
[Explain the mutual benefit concretely.]
[ ] The notice was filed prematurely or not in accordance with
administrative procedures. Specifically: ______________________
[ ] The liability has been satisfied and the lien released; I request
withdrawal of the notice as well.
FILING AND PAYMENT COMPLIANCE
All required returns are filed through tax year ______.
I am current on [the installment agreement entered ________ / all
estimated payments and withholding for the current year].
I request that notice of the withdrawal be provided to the credit
reporting agencies and to any other party I designate.
ENCLOSED: copy of the lien notice · installment agreement · payment record
· account transcript · [refinance quote / employment documentation]
______________________ · [Address] · [Phone]
14. Lien discharge or subordination request
[Date]
RE: Request for [ ] Certificate of Discharge [ ] Certificate of
Subordination of Federal Tax Lien
Taxpayer: ______________ SSN: xxx-xx-____
Property: [full legal description and street address]
Lien notice recorded [date], number ______________
TRANSACTION
[ ] Sale to ______________, closing scheduled ____/____/______
[ ] Refinance with ______________, closing scheduled ____/____/______
Contract price / loan amount: $ ____________
Closing date: ____/____/______
VALUE AND ENCUMBRANCES
Fair market value (appraisal enclosed): $ ____________
First mortgage payoff: $ ____________
Second mortgage / HELOC payoff: $ ____________
Other liens senior to the federal tax
lien (list with dates and amounts): $ ____________
Closing costs and commissions: $ ____________
NET PROCEEDS AVAILABLE: $ ____________
BASIS FOR THE REQUEST
DISCHARGE — select the applicable ground:
[ ] The proceeds attributable to the federal tax lien's position will be
paid to the United States: $______ will be remitted at closing.
[ ] The property is being sold for no more than the amounts owed to
senior lienholders, so the federal tax lien has no value in this
property.
[ ] The government's interest in the remaining property is adequate:
[describe remaining property and equity].
[ ] Other ground: ______________________
SUBORDINATION — select the applicable ground:
[ ] The refinancing will produce $______ that will be paid to the
United States.
[ ] Subordination will increase the amount ultimately realizable and
facilitate collection because [the new payment is $____ lower per
month, which I will apply to the liability under the installment
agreement entered ________].
ENCLOSED
[ ] Copy of the lien notice
[ ] Purchase agreement or loan commitment
[ ] Appraisal or valuation
[ ] Title report showing all encumbrances with recording dates
[ ] Payoff statements for each senior lien
[ ] Estimated closing statement
[ ] Escrow or closing agent contact information
TIMING
The closing is scheduled for ____/____/______. I understand this request
requires processing time and I have submitted it [__] weeks in advance.
Please contact me or the closing agent at [contact] with any questions.
______________________ · [Address] · [Phone]
LESSON: START THIS WHEN THE PROPERTY IS LISTED, NOT WHEN THE CLOSING DATE
IS SET. Requests filed ten days before closing do not make it.
15. Taxpayer Advocate hardship request
[Date]
Taxpayer Advocate Service
[Local office]
RE: Request for Assistance and for a TAXPAYER ASSISTANCE ORDER
Taxpayer: ______________ SSN: xxx-xx-____
Tax years: ______________
I request assistance from the Taxpayer Advocate Service and, if necessary,
a Taxpayer Assistance Order, because an IRS action is causing or is about
to cause significant hardship.
THE HARDSHIP
[ ] An immediate threat of adverse action: [levy scheduled / levy in
effect / lien filing / seizure]
[ ] A delay of more than [__] days in resolving my account
[ ] I will incur significant costs (including professional fees) if
relief is not granted
[ ] I will suffer irreparable injury or long-term adverse impact:
[eviction on [date] / utility disconnection on [date] / loss of
employment / inability to obtain medical treatment / loss of a
professional license]
SPECIFICS AND DATES:
______________________________________________________________
______________________________________________________________
WHAT I HAVE ALREADY DONE
Date ________ Action: ______________ Result: ______________
Date ________ Action: ______________ Result: ______________
Date ________ Action: ______________ Result: ______________
WHAT I AM ASKING FOR
[ ] Release of the levy served on [employer/bank] on [date]
[ ] A determination on my [installment agreement / offer / CNC request]
submitted on [date]
[ ] Correction of [specific error] on my account
[ ] Release or withdrawal of the lien notice
[ ] Other: ______________________
MY FINANCIAL SITUATION
Monthly income $______ · Necessary expenses $______ · Shortfall $______
Dependents: ______ Assets: ______________
ENCLOSED: notices received · correspondence · financial documentation ·
proof of the impending consequence
I can be reached at [phone] at any time.
______________________ · [Address] · [Phone] · [Email]
16. Response to a proposed change or notice of deficiency
[Date]
RE: Response to [Notice number] dated ________
Taxpayer: ______________ SSN: xxx-xx-____
Tax year: ______
Proposed additional tax: $ ____________
RESPONSE DEADLINE: ____/____/______
I disagree with the proposed changes, in whole or in part, for the reasons
below.
ITEM 1 — [The proposed change, quoted from the notice]
I disagree. [The notice treats the full proceeds of $______ reported on
Form 1099-B as income. My basis in the securities sold was $______,
established by the brokerage statements at Exhibit A. The correct gain
is $______.]
Correct amount: $ ______ Enclosure: ______
ITEM 2 — [The proposed change]
I disagree. [The notice treats $______ reported on Form 1099-NEC as
income with no offsetting expenses. This is self-employment income
against which I incurred deductible business expenses of $______,
itemized and documented at Exhibit B. Schedule C is enclosed.]
Correct amount: $ ______ Enclosure: ______
ITEM 3 — [The proposed change]
I agree with this item.
ITEM 4 — [The proposed change]
I disagree. [This income was reported on my return, on line ____, under
a different payer name. See the return at Exhibit C. This is a duplicate
assessment.]
REVISED COMPUTATION
Tax as proposed: $ ______
Tax as corrected: $ ______
Difference: $ ______
ENCLOSURES
A. ______________________
B. ______________________
C. ______________________
If additional information is needed, please contact me before making a
determination.
______________________ · [Address] · [Phone]
Sent by certified mail, return receipt requested, tracking ____________
IF THIS IS A STATUTORY NOTICE OF DEFICIENCY ("90-day letter"):
A response letter does NOT preserve your rights. To contest without
paying first, you must PETITION THE UNITED STATES TAX COURT within
90 DAYS (150 if the notice was addressed outside the United States).
THIS DEADLINE CANNOT BE EXTENDED BY ANYONE, INCLUDING THE IRS.
Petition deadline: ____/____/______
Free representation for Tax Court is available from Low Income
Taxpayer Clinics. Call one today.
Related documents
- Personal Income Tax Problems: Unfiled Returns, Liens, Levies, and Offers in Compromise
- Resolving a Tax Debt with the IRS
- Tax Problem Resolution Checklist
- Debt Collection and the FDCPA
- Consumer Debt Defense Toolkit
Templates only, not legal advice. Adapt to your facts and verify current forms, standards, and thresholds. Framework: liens 26 U.S.C. § 6321 · lien hearings § 6320 · levies § 6331 · levy hearings § 6330 · compromises § 7122 · joint liability relief § 6015 · refund limits § 6511 · penalties § 6651 · taxpayer rights § 7803.
