Form 4549-E - Income Tax Discrepancy Adjustments - Internal Revenue Service

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Department of the Treasury-Internal Revenue Service
4549-E
Form
Income Tax Discrepancy Adjustments
Page
of
(Rev. 12-2004)
Name and Address of Taxpayer
SS or EI Number
Return Form No.:
Person with whom
Name and Title:
examination
changes were
discussed.
Period End
Period End
Period End
1. Adjustments to Income
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
p.
2. Total Adjustments
3. Taxable Income Per Return or as Previously Adjusted
4. Corrected Taxable Income
Tax Method
Filing Status
5. Tax
6. Additional Taxes / Alternative Minimum Tax
7. Corrected Tax Liability
8. Less
a.
Credits
b.
c.
d.
9. Balance (Line 7 less total of Lines 8a thru 8d)
10. Plus
a.
Other
b.
Taxes
c.
d.
11. Total Corrected Tax Liability (Line 9 plus Lines 10a thru 10d)
12. Total Tax Shown on Return or as Previously Adjusted
13. Adjustments to:
a. Special Fuels Credit
b.
c.
14. Deficiency-Increase in Tax or (Overassessment Decrease in Tax)
(Line 11 less 12 adjusted by 13a thru 13c)
15. Adjustments to Prepayment Credits
16. Balance Due or (Overpayment) (Line 14 adjusted by Line 15) (Excluding
interest and penalties)
The Internal Revenue Service has agreements with state tax agencies under which information about federal tax, including increases or decreases, is
exchanged with the states. If this change affects the amount of your state income tax, you should amend your state return by filing the necessary
forms.
You may be subject to backup withholding if you underreport your interest, dividend, or patronage dividend, or patronage dividend income you earned
and do not pay the required tax. The IRS may order backup withholding (withholding of a percentage of your dividend and/or interest payments) if the
tax remains unpaid after it has been assessed and four notices have been issued to you over a 120-day period.
Catalog Number 13383E
publish.no.irs.gov
Form 4549-E

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