Form Icb-1 - Request For Informal Conference Board Review - Illinois Page 2
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2Step 4: Provide the grounds for your request
1
Please state below the specific reasons for your objection to the proposed assessment or denial of claim for refund (additional sheets may
be attached, if necessary). Please describe the specific issue(s) in the audit with which you disagree and provide in detail the legal
authority which supports your position. If you are disputing the calculation of a tax proposed to be assessed, you also must show why this
calculation is incorrect. Attach any additional information or documentation in support of your position.
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2
The ICB will decide your case based on your written request and supporting documentation. The ICB also will grant you a conference to
discuss your case if you so desire.
yes
no
Are you requesting an in-person conference with the ICB?
Chicago
Springfield
If you answered “yes,” indicate where you are requesting the conference be held.
Are you requesting a telephone conference?
yes
no
3
yes
no
Are you submitting an offer to settle the tax dispute?
If you answered “yes,” you must complete and attach Form ICB-2, Offer of Disposition of a Proposed Assessment or Claim Denial.
Step 5: Taxpayer or taxpayer’s representative must sign below
If signing as a corporate officer, partner, fiduciary, or individual on behalf of the taxpayer, I certify that I have the authority to execute this
request on behalf of the taxpayer.
____________________________________________
_____/_____/_____
______________________________________________
Taxpayer’s signature
Title, if applicable
Date
Print taxpayer’s name (if corporation, print duly authorized officer’s name)
____________________________________________
_____/_____/_____
Taxpayer’s representative’s signature*
Title, if applicable
Date
* Representative must be duly authorized under a valid power of attorney. (Form 2848, Power of Attorney, must be attached.)
Step 6: Sign the waiver of statute of limitations
The following waiver of statutes of limitations must be signed by the taxpayer, a duly authorized corporate officer, partner, or fiduciary of the
taxpayer, or by the taxpayer’s representative under a valid power of attorney.
In order to allow the ICB time to review this proposed assessment or claim denial, the undersigned expressly agrees to extend the running
of any and all statutes of limitations regarding the assessment of any tax, penalty, or interest or claims for refund for the tax periods at issue
to which the request is directed. This waiver shall run from the date this request for review is received and accepted by the ICB until six
months after the ICB issues its action decision or memorandum in the matter. This waiver applies only to the tax periods at issue, and has
no effect on closed tax periods or tax periods for which assessments have been issued and for which the liability is final.
__________________________________________
___________________
_____/_____/_____
Taxpayer’s signature
Title, if applicable
Date
____________________________________________
____________________
_____/_____/_____
Taxpayer’s representative’s signature*
Title, if applicable
Date
____________________________________________
_____/_____/_____
Director of Revenue
Date
* Representative must be duly authorized under a valid power of attorney.
Please send this form and all supporting documentation (including Form IL-2848, Power of Attorney, and Form ICB-2, Offer of Disposition of a
Proposed Assessment or Claim Denial, if applicable) to:
Informal Conference Board
Illinois Department of Revenue
100 W. Randolph, #7-341
Chicago, IL 60601
Page 2 of 3
ICB-1 (R-03/07)
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