Instructions For Completing The Third Party Contact Report Form 12175

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Instructions for completing the Third Party Contact Report Form 12175
ENTER ONLY (1) ONE THIRD PARTY CONTACT
PER FORM
1. Enter only (1) one Taxpayer TIN. This is an edited
TIN, enter the dashes where appropriate. Include
appropriate file source code.
2. Enter the four-letter name control for the taxpayer.
Ensure that it is the correct name control for the
Taxpayer TIN in Box 1.
3. Enter your Employee Identification Number. Enter
your badge number or enter your IDRS Number. Enter
your telephone number. Enter your mail stop number (if
applicable).
4. Secondary TIN should be entered for joint 1040
situations only.
5. Put a check mark on the appropriate line to signify
that the third party contact is for the Primary TIN, or the
Secondary TIN, or if it is for Both the Primary and
Secondary TINs. Both should only be checked in those
situations where there is a joint filing 1040. Do not check
more than one.
CONTACT INFORMATION
6. Enter the date the third party contact was made. Use
the following format (yyyy/mm/dd) to enter the date:
1999/01/19.
7. IF A FEAR OF REPRISAL HAS BEEN INDICATED,
THEN CHECK THE "REPRISAL" BOX. IF FEAR OF
REPRISAL HAS BEEN INDICATED, ONLY THE
FOLLOWING DATA SHOULD BE ENTERED ON THE
THIRD PARTY CONTACT FORM: TAXPAYER TIN,
NAME CONTROL, EMPLOYEE ID NUMBER,
TELEPHONE NUMBER, MAIL STOP NUMBER, DATE
OF CONTACT AND THE REPRISAL BOX SHOULD
BE CHECKED.
8. Provide a full name of the third party whenever
possible. If the name of the third party is not known but
the employee knows the relationship of the third party to
the taxpayer, write the term that describes the
relationship. Examples: wife, mother, brother, neighbor,
son etc. If the name or relationship is not known but the
occupation of the third party is known, write the
occupation. Examples: gardener; loan officer; etc. If a
business is identified as a third party contact, write the
complete business name. Example: First National Bank
of Richmond, Virginia. For a business contact,
employees are required to write only the name of the
business, not the name of the employee of the business.
In situations where the name of third party, the
relationship or the occupation is not known, employees
should write "Unknown Person" as the third party
name.
9. Employee Plans and Exempt Organizations Use Only.
If an Employee Plan, enter the three digit Employee Plan
Number, also if an Employee Plan, make sure to place a
P at the end of the Primary TIN. If an EP/EO
determination, enter the EP/EO Determination Case
Number (EDS) or if assigned to National Office, enter
Control Number, in the following format: 999999999X
where 999999999 = the EDS Case Number or National
Office Case Control Number; X = the type of case and
has the following values: E = EP Determination, O = EO
Determination, A = EP Division (Headquarters), B = EO
Division (Headquarters).
10. Enter all the (2) two digit Master File Tax Class
Codes and Tax Periods for the taxpayer whom theThird
Party Contact is related. Use this format: 30 1999 12;
where 30 = mft, 1999 = year, 12 = month. Please note: If
an EIN is entered in Box 1, do not enter Individual
Master File MFTs. If a SSN is entered in Box 1, do not
enter Business Master File MFTs. IT IS IMPORTANT
TO LIST ALL TAX PERIODS AND MFTs TO ENSURE
MAILING THIRD PARTY CONTACT LISTINGS TO
PeAs.
Privacy Act Notice
Internal Revenue Code section 7602(c), added by the Ins Restructuring and Reform Act of 1998, requires the Ins to provide a report to each taxpayer
of certain third party contacts made with respect to the determination or collection of the taxpayer's tax liability. The information on this form is used to
make such reports. The employee identification number is used to permit verification of the contact report information. Failure to provide this information
may result in discipline.
~'U.S. GPO: 1999---459-948

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