Pa Form 8857 - Request For Relief From Joint Liability

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Request for Relief from Joint Liability
PA 8857
(10-09)
(Relief from Understatement of Tax, Separation of Liability and Relief by Income Allocation)
PA Department of Revenue
Do not file with your tax return.
See instructions.
START
Your name:
Your Social Security Number:
Your current address:
Apt. number
City, town or post office, state, and ZIP code. If a foreign address, see instructions
Daytime phone number
(
)
• You may not claim relief from an understatement of Tax, separation of liability or relief by income allocation unless you filed a joint return with
your spouse during the year for which you are claiming relief.
• Do not file this form if you filed a joint return showing an overpayment of tax and all or part of the overpayment is expected to be applied
against your spouse’s past-due Pennsylvania Personal Income Tax or child support liability(ies). Instead, file Form PA 8379, Injured Spouse
Claim and Allocation, to have your share of the overpayment refunded to you.
TIP
The Department can help you with your request by calling 717-772-9347.
If you have been a victim of domestic abuse and fear that filing a claim for relief from joint liability
will result in retaliation, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part I
1
Enter the year(s) for which you are requesting relief from liability of tax . . . . . . . . . . . . . . . . . . .
2
Information about your spouse (or former spouse) with whom you filed a joint return for the tax year(s) listed on Line 1.
Name
Social Security Number
See
Spousal
Current home address (number and street). If a P.O. box, see instructions.
Apt. number.
Notification
on page 3.
City, town or post office, state, and ZIP code. If a foreign address, see instructions.
Daytime phone number (if known)
(
)
3
Do you have an Understatement of Tax (that is, the Department of Revenue determined there is a difference
between the amount of tax shown on your return and amount of the tax that should have been shown)?
Yes. Go to Part II.
No. Go to Part IV.
Part II
4
Are you divorced from the person listed on Line 2 (or has that person died)?
Yes. Go to Line 7.
No. Go to Line 5.
5
Are you legally separated from the person listed on Line 2?
Yes. Go to Line 7.
No. Go to Line 6.
6
Have you lived apart from the person listed on Line 2 at all times during the 12-month period prior to
filing this form?
Yes. Go to Line 7.
No. Go to Part III.
7
If Line 4, 5, or 6 is Yes, you may request Separation of Liability. If the understatement of tax on the joint return is due in
part, to an item of your spouse, you may request relief by submitting an election packet.
Otherwise check here
and go to Part III below.
Part III
8
Is the understatement of tax due to the erroneous items of your spouse (see Page 4)?
Yes. You may request Relief from an Under-
No. If Line 6 is Yes, you may request Relief by Income
statment of Tax by submitting an election packet.
Allocation. Check here and submit an election packet.
Part IV
9
If you were not a member of your spouse’s household for an entire year before filing this form and you have an
Underpayment of Tax (that is, tax that is properly shown on your return but not paid), check here.
You may request Relief by Income Allocation by submitting an election packet. Otherwise you cannot file this form unless
Line 3 is Yes.
Under penalties of perjury, I declare that I have examined this form and any accompanying schedules and statements, and to the best of my knowledge and belief,
they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign Here
MM/DD/YY
Your signature
Date
Please sign this form after printing
Keep a copy
of this form for
your records.
Preparer’s
Date
Check if
Preparer’s SSN or PTIN
signature
self-employed
Paid
Firm’s name (or yours
EIN
Preparer’s
if self-employed) and
ZIP code
address
Use Only
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