Form Icb-2 - Offer Of Disposition Of A Proposed Assessment Or Claim Denial
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Illinois Department of Revenue
ICB-2
Offer of Disposition of a Proposed
Assessment or Claim Denial
Read this information first
Note: Do not complete this form if you are making an offer in
You should complete and submit this form if you are making an offer
of disposition with the Informal Conference Board (ICB) to settle a tax
compromise based on the inability to pay. If you are seeking relief
dispute with the department for a proposed assessment or claim
from your tax liability based only on your inability to pay, you should
denial. The ICB may accept an offer of disposition settling a tax
file a petition with the Board of Appeals after a final assessment of
the tax has been issued.
dispute only where the ICB finds that there is legitimate uncertainty
regarding the facts or law in the case and if it would be in the best
interests of the State for the ICB to resolve the matter at this time.
Step 1: Identify yourself, your business, or your organization
1
_________________________________
5
___ ___ - ___ ___ ___ ___ ___ ___ ___
Taxpayer’s name
FEIN
Federal employer identification number
2
_________________________________
6
___ ___ ___ ___ - ___ ___ ___ ___
Current address
IBT no.
Street address
Illinois business tax number
_________________________________
7
____________________________________
Excise Tax no.
City
State
ZIP
8
______________________________________
License no.
(____)____________________________
Daytime phone no.
9
Write the track number from the notice you received.
(____)____________________________
______________________________________________
Fax no.
3
___________________________________
10
Contact person
If someone will represent you during the informal conference
(For business or organization)
process, complete the following:
(____)____________________________
___________________________
Daytime phone no.
Representative’s name
4
___ ___ ___ - ___ ___ - ___ ___ ___ ___
SSN
Daytime phone no. (____)_________ Fax no. (____)__________
Social Security number
Step 2: Please provide the following information
1
Write the amount of your offer. (This amount must be a specific net dollar amount.) $______________________
2
Write the penalty type(s)._________________________________________
Write the amount of penalty. $____________________
3
Identify all issues to be conceded, in whole or in part, by the taxpayer or by the Illinois Department of Revenue. Include the total dollar
amount associated with each issue and the dollar amount being offered to settle that specific issue. Attach additional sheets, if necessary.
_________________________________________________________________________________________________________
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_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Disclosure of this information is VOLUNTARY. This form has been approved by the Forms Management Center. IL-492-3508
ICB-2 (R-06/07)
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