Fillable Form 14157 - Complaint: Tax Return Preparer (Page 2 of 4) in pdf

Page 2

11b. Provide facts and other information related to the complaint

(attach additional sheets if necessary).

Yes

Section C - Taxpayer’s Information

Are you the taxpayer?

(We never share this information with the person or business you are reporting)

This information may be necessary to process your complaint. If you are the taxpayer complete section C only. If you are not the

taxpayer, complete sections C and D.

12. Name of individual or business

13. Mailing address (street, city, state, ZIP code)

14. Telephone number(s)

(include area code)

15. Email address

16. Taxpayer’s signature

17. Date of complaint

Section D - Your Information

(do not complete if you are the taxpayer)

(We never share this information with the person or business you are reporting)

This information is not required to process your complaint but is helpful if we need to contact you for additional information.

18. Name (Last, First, MI)

19. Date of complaint

20. Mailing address (street, city, state, ZIP code)

21. Telephone number(s)

(include area code)

22. Email address

23. Your relationship to Preparer

Client

IRS employee

Return preparer working for a different firm*

Other (specify)

Return preparer working for the same firm*

* Taxpayers’ information and any information relating to another professional are confidential. Please obtain your client’s consent before sharing any

protected tax information, even with the IRS.

The completed form along with all supporting information can be filed by fax or regular mail.

If faxing Form 14157 send to:

855-889-7957

If mailing Form 14157 send to:

Attn: Return Preparer Office

401 W. Peachtree Street NW

Mail Stop 421-D

Atlanta, GA 30308

Privacy Act and Paperwork Reduction Act Notice

We ask for the information on this form to carry out the Internal Revenue laws of the United States. We need it to ensure that preparers are complying with these laws and to

allow us to figure and collect the right amount of tax.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number.

Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law.

Generally, tax returns and return information are confidential, as required by Internal Revenue Code section 6103.

The time require to complete this form will vary depending on individual circumstances. The estimated average time is 15 minutes. The primary purpose of this form is to

report potential violations of the Internal Revenue laws by tax return preparers. We are requesting this information under authority of 26 U.S.C. § 7801 and § 7803. Providing

this information is voluntary, and failure to provide all or part of the information will not affect you. Providing false or fraudulent information may subject you to penalties. We

may disclose this information to the Department of Justice to enforce the tax laws, both civil and criminal, and to cities, states, the District of Columbia, and U.S.

commonwealths or possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce

federal non-tax criminal laws, and to federal law enforcement and intelligence agencies to combat terrorism.

14157

Catalog Number 55242M

Form

(Rev. 2-2017)