Form 12508 - Questionnaire For Non-Requesting Spouse
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1
2
3Questionnaire for Non-Requesting Spouse
Form 12508
(April 2005)
Name
Tax Year
Social Security Number
We recognize that some of these questions involve sensitive subjects. However, we need this information to evaluate the
circumstances of the claim and properly determine whether relief should be given. If this form is not completed and returned, the
claim will be considered based on the information available to us.
1. What is the current relationship between you and your (former) spouse with whom you filed the joint return(s) for
the year(s) relief is being requested?
[
]
Married and living together
[
]
Married and living apart
Provide date you started living apart (month, day, year)
/
/
[
]
Legally Separated
Provide date of legal separation (month, day, year)
/
/
[
]
Divorced
Provide date of divorce decree (month, day, year)
/
/
[
]
Widowed
Provide date of death of spouse (month, day, year)
/
/
Enclose a complete copy of the separation agreement, divorce decree, death certificate
and will, if applicable. If you are still married but living apart, provide documentation to
verify the date of your separation such as copies of your lease agreement or utility bills
in your individual name.
1a. During the year(s) in question, did you and your (former) spouse live together the full year?
If no, please list dates of separation.
2. Why did you file a joint return instead of your own separate return?
3.
What was your involvement in the preparation of the return(s)? For example, did you gather the receipts and cancelled
checks, or just provide your W-2's, etc.
4. Did your (former) spouse review the tax returns(s) before signing?
[
] Yes
[
] No
4a. If no, explain why not.
4b. If yes, did your (former) spouse ask you or the return preparer for an explanation of any items or amounts on the tax
returns?
Please list the questions asked, who responded and the response given.
5.
During the year(s) in question did you have your own separate bank account(s)?
[
] Yes
[
] No
If yes, indicate the type of account(s).
[
] Checking
[
]
Savings
[
] Other
12508
Catalog Number 28730P
Form
(Rev. 4-2005)
Page 1 of 3
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