Form Dr-1 - Appeals Form
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2Rev. 1/04
Massachusetts
Form DR-1
Department of
Appeals Form
Revenue
Taxpayer name
Social Security or Federal Identification number
Mailing address
City/Town
State
Zip
Name and telephone number of contact person
Attorney-in-fact (attach completed Form M-2848, Power of Attorney)
Tax amount in dispute
Tax year(s)
Tax Type(s)
Individual income tax
Corporate excise
Sales/use
Other:
Type of Request
Pre-assessment. Are you requesting:
Conference pursuant to G.L. c. 62C, sec. 26(b);
Settlement consideration pursuant to G.L. c. 62C, sec. 37C; or
Both
If you have answered “Both,” please indicate which process you wish to pursue first:
Post-assessment. Are you requesting:
Hearing pursuant to G.L. c. 62C, sec. 37;
Settlement consideration pursuant to G.L. c. 62C, sec. 37C; or
Both
If you have answered “Both,” please indicate which process you wish to pursue first:
Note: If you wish to request a post-assessment hearing, you must first file an Application for Abatement/Amended Return, Form CA-6.
Issues in Dispute
Please state the facts and legal issues involved. Explain why you believe the tax amount in question is excessive or in error. Include any
relevant legal references. Attach additional sheets and exhibits if helpful.
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Parent category: Financial