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Part 3: Tell us about you and your spouse for the years you want relief

6. Who was your spouse for the years you want relief? (On this form, we refer to your spouse for the years you want relief as that individual.)

That individual’s current name

Current home address

State

City

ZIP code

—

(

)

—

Social security number

Best daytime phone

What is the current marital status between you and that individual?

Married and still living together

Married and living apart since ________/_____/________

YYYY

Widowed since

________/_____/________

Attach a photocopy of the death certificate or will (if one exists).

YYYY

Legally separated since

________/_____/________

Attach a photocopy of your separation agreement.

YYYY

Divorced since

________/_____/________

Attach a photocopy of your entire divorce decree.

YYYY

Note: A divorce decree stating that your former spouse must pay all taxes does not necessarily mean you qualify for relief.

What was the highest grade completed in school when you filed the returns? If the answers are not the same for all the years, explain.

You That individual

Some high school or less

Explain, if necessary.

___________________________________________________

High school diploma or equivalent

___________________________________________________________________

Some college

College degree or higher

Were you a victim of spousal abuse for any of the years you want relief?

Yes. Attach a statement to explain the abuse and when it started. Provide photocopies of any documentation, such as police

reports, a restraining order, a doctor’s statement, or a notarized statement from someone who was aware of the situation.

10. When you signed any of the returns, did you have a mental or physical health problem or do you have a mental or physical health problem

now?

Yes. Attach a statement to explain the problem and when it started. Provide photocopies of any documentation, such as

medical bills or doctors’ statements.

Part 4: Tell us how you were involved with filing the returns and your financial situation for those years

11. How were you involved with preparing the returns? Check all that apply and explain, if necessary. If the answers are not the same for all the years,

explain.

You prepared or helped prepare the returns.

You gathered receipts and cancelled checks.

You gave tax documents (such as W-2s, 1099s, etc.) to the person who prepared the returns.

You reviewed the returns before you signed them.

You did not review the returns before you signed them.

Other

Explain how you were involved

_____________________________________________________________________________

_____________________________________________________________________________________________________

page 2 of 4

Form 8857 (Rev. 2006)

Catalog Number xxxxx

Form 8857 - Request For Innocent Spouse Relief, Separation Of Liability, And Equitable Relief Page 2

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