Form Boa-1 - Board Of Appeals Petition Page 2
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Are you requesting that the Board Chairman issue a temporary restraining order (TRO), to stop the department from
enforcing collection, until the board has reviewed your petition and made a decision in your case? (Please note, the issu-
ance of a TRO is at the discretion of the Chairman of the Board).
yes
no
If you answered “yes,” have you paid the tax portion of the specific assessments at issue?
yes
no
5
Have you previously petitioned the Board of Appeals for relief?
yes
no
6
Outline the reasons why you think this petition is appropriate and should be decided in your favor. (Attach additional pages
if necessary.)
7
Tell us if you have been contacted by any of the following program areas within the Illinois Department of Revenue and if
you are involved in any of the following proceedings. (Check all that apply.)
Administrative hearings
Collections
(Department hearing before administrative law judge)
Bankruptcy no. _____________
Collections with Attorney General’s Office
Audit
Revocation of liquor license
100 percent penalty
Revocation of certificate of registration
Garnishment of wages
Revocation of professional license
Bank levy
8
You must answer this question only if this petition is on behalf of a business.
When did you first begin business activity in Illinois?
___ ___/___ ___/___ ___ ___ ___
Month
Day
Year
Describe your principal business activity.
BOA-1 (R-1/01)
Page 2
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