Form 13909 - Tax-Exempt Organization Complaint (Referral) Form
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1
2Department of the Treasury — Internal Revenue Service
13909
Form
Tax-Exempt Organization Complaint (Referral) Form
(August 2007)
1. NAME OF REFERRED ORGANIZATION:
Street Address:
City/State/Zip Code:
Date of Referral:
2. ORGANIZATION’S EMPLOYER IDENTIFICATION NUMBER (EIN):
3. NATURE OF VIOLATION:
Directors/officers/persons are using income/assets for personal gain
Organization is engaged in commercial, for-profit business activities
Income/assets are being used to support illegal or terrorist activities
Organization is involved in a political campaign
Organization is engaged in excessive lobbying activities
Organization refused to disclose or provide a copy of Form 990
Organization failed to report employment, income, or excise tax liability properly
Organization failed to file required federal tax returns and forms
Organization engaged in deceptive or improper fundraising practices
Other (describe):
4. DETAILS OF VIOLATION:
Name(s) of Person(s) Involved:
Organizational Title(s):
Date(s):
Dollar Amount(s) (if known):
Description of activities:
5. SUBMITTER INFORMATION:
Name:
Occupation or Business:
Street Address:
City/State/Zip Code:
Telephone:
I am concerned that I might face retaliation or retribution if my identity is disclosed.
6. SUBMISSION AND DOCUMENTATION: The completed form, along with any supporting documentation, may be
mailed to IRS EO Classification, Mail Code 4910DAL, 1100 Commerce Street Dallas, TX 75242-1198, faxed to
214-413-5415 or emailed to eoclass@irs.gov.
13909
Catalog Number 50614A
Form
(08-2007)
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