Petition Form - United States Tax Court Page 7
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12UNITED STATES TAX COURT
This form can be filled-in and printed directly from
Acrobat Reader. However, please be aware that the
information you enter on a form cannot be saved to
disk unless you are using the full Adobe Acrobat
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software suite.
To begin, move your mouse pointer over the
_____________________________________________________
Petitioner(s) name field. Your pointer will turn into a
vertical beam, indicating that you are over an
(PLEASE TYPE OR PRINT)
Petitioner(s)
editable field. Simply click once and begin typing.
Docket No.
Use the Tab key to move forward through the form
v.
fields (Shift+Tab to move backwards).
COMMISSIONER OF INTERNAL REVENUE
Respondent
PETITION
1. Petitioner(s) hereby file(s) a (PLACE AN "X" IN THE APPROPRIATE BOX):
Petition for Determination of Relief from Joint and Several
G
G
Petition for Redetermination of a Deficiency
Liability on a Joint Return
Petition for Redetermination of Employment Status
G
G
Petition for Lien or Levy Action (Collection Action)
(Worker Classification)
2. Petitioner(s) disagree(s) with the determination contained in the notice issued by the Internal Revenue Service for the
year(s) or period(s) ____________________________________, as set forth in such notice dated ____________________________,
A COPY OF WHICH IS ATTACHED. DO NOT ATTACH ANY OTHER DOCUMENTS TO THIS PETITION.
3. Petitioner(s)' taxpayer identification (e.g., Social Security) number(s) is (are)
___________________________________________________________________________________________________________
4. Set forth the relief requested and the reasons why you believe you are entitled to such relief.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Petitioner(s) request(s) that this case be conducted under the "small tax case" procedures. The amount in dispute or any
overpayment claimed is $50,000 or less. A decision in a "small tax case" is final and cannot be appealed to a Court of Appeals by the
Internal Revenue Service or the Petitioner(s). If you do NOT want this case conducted as a "small tax case", place an "X" in the
following box.
______________________________________________
_________________________________________________________
SIGNATURE OF PETITIONER
DATE
(PRINT) MAILING ADDRESS
_______________________________(_____)___________________
CITY
STATE ZIP CODE
AREA CODE TELEPHONE NO.
______________________________________________
_________________________________________________________
SIGNATURE OF PETITIONER (e.g.,SPOUSE)
DATE
(PRINT) MAILING ADDRESS
(IF NAMED IN THE FINAL NOTICE)
_______________________________(_____)___________________
CITY
STATE ZIP CODE
AREA CODE TELEPHONE NO.
___________________________________________________________________________________________________________
SIGNATURE, NAME, ADDRESS, TELEPHONE NO., AND TAX COURT BAR NUMBER OF COUNSEL, IF RETAINED BY PETITIONER(S)
T.C. FORM 2 (REV 5/03)
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