Looking for a New York State Tax Forms And Templates? Download it for free!

Page 2 of 2 DTF-911 (1/10)

Instructions

Business contact person — If a business entity is filing

The Office of the Taxpayer Rights Advocate (OTRA) is

an independent organization within the New York State

this form, enter the name of the person to contact about

Department of Taxation and Finance. OTRA was created

the request. This may be the corporate officer signing

to safeguard taxpayer rights and to assist taxpayers who

the request, or another person authorized to discuss the

are experiencing problems with the Tax Department.

matter.

When to use this form

Power of attorney

If you choose to have a representative act on your behalf,

Use this form if you are experiencing any of the following

you must complete a power of attorney form.

problems:

• You are facing a threat of immediate adverse action

Businesses: use Form POA-1, Power of Attorney

(e.g., seizure of an asset) for a debt you believe is not

Individuals: use Form POA-1-IND, Power of Attorney

owed or where the action is, in your view, unwarranted,

for Individuals

unfair, or illegal.

Estates: use Form ET-14, Estate Tax Power of Attorney

• You are experiencing undue economic harm or are

about to suffer undue economic harm because of your

You can get these forms from our Web site at

tax problem.

• You believe there has been an undue delay by the Tax

Include the power of attorney form when you submit this

Department in providing a response or resolution to

form.

your problem or inquiry.

Describe the tax problem you are experiencing

• You believe the tax laws, regulations, or policies are

being administered unfairly or have impaired (or will

Enter any detailed information necessary to describe

impair) your rights.

the tax problem you are experiencing. If you have

been involved with a Bureau of Conciliation and

• You believe a Tax Department system or procedure has

Mediation Services conference, a small claims hearing,

failed to operate as intended, or has failed to resolve

the Tax Appeals Tribunal, a courtesy conference, an

your problem or dispute.

administrative law judge, an Offer in Compromise, or an

• You believe that the unique facts of your case or

audit or other collection action, include the dates of such

compelling public policy reasons warrant assistance.

activity, as well as the following information (if applicable):

When not to use this form

• BCMS number

• DTA number

• If you haven’t exhausted all reasonable efforts to obtain

timely relief through normal Tax Department channels.

• audit case number

• To seek legal or tax return preparation advice.

• assessment or collection case number

• To seek review of an unfavorable administrative law

• formal or informal protest number

judge, Tax Appeals Tribunal, or judicial determination.

Where to file

Specific instructions

Send your completed Form DTF-911 and any required

attachments to:

Taxpayer information

E-mail address — We may contact you by e-mail if we’re

By mail —

NYS TAX DEPT

unable to reach you by telephone. We won’t use your

OTRA

e-mail address to discuss the specifics of your case.

W A HARRIMAN CAMPUS

Taxpayer identification — Enter your taxpayer

ALBANY NY 12227

identification number if this request involves a business

By fax — (518) 435-8532

or non-individual entity (e.g., a partnership, corporation,

trust, or self-employed individual).

Tax type — Enter the tax type (for example, personal

income tax, corporation tax, sales tax, etc.) that relates to

Privacy notification — The Commissioner of Taxation and Finance may collect and maintain

personal information pursuant to the New York State Tax Law, including but not limited to,

this request.

sections 5-a, 171, 171-a, 287, 308, 429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and

may require disclosure of social security numbers pursuant to 42 USC 405(c)(2)(C)(i).

Tax form(s) — Enter the form number(s) that relates to

This information will be used to determine and administer tax liabilities and, when authorized

this request. For example, an individual taxpayer with an

by law, for certain tax offset and exchange of tax information programs as well as for any other

lawful purpose.

income tax issue might enter Form IT-201.

Information concerning quarterly wages paid to employees is provided to certain state agencies

for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain

Tax period(s) — Enter the quarterly, annual, or other tax

employment and training programs and other purposes authorized by law.

period(s) that relates to this request. For example, if this

Failure to provide the required information may subject you to civil or criminal penalties, or both,

request involves an income tax issue, enter the calendar

under the Tax Law.

or fiscal year; if an employment tax issue, enter the

This information is maintained by the Manager of Document Management, NYS Tax

Department, W A Harriman Campus, Albany NY 12227; telephone (518) 457-5181.

calendar quarter.

Form Dtf-911 - Request For Assistance From The Office Of The Taxpayer Rights Advocate Page 2

Related Articles

Related forms

Related Categories