Form 0853c - Penalty Waiver Or Abatement Disallowed/appeals Procedure Explained - Sample

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Department
|Transmittal Number|Date of Issue
of the
|
12-04
|
04/02/2012
Treasury
--------------------------------------------
|Originating Office|Form Number
|
SE:S:E:EP:SP
|
0853C
IDRS
--------------------------------------------
CORRESPONDEX
Internal
Revenue
Service
---------------------------------------------------------------------------
Title:
Penalty Waiver or Abatement Disallowed/Appeals Procedure Explained
(for use with AMS/RCA applications only!)
---------------------------------------------------------------------------
Number of Copies
|
Distribution to:
|
Former Letter
Original and 1
|
2 to T/P
|
0853C (Rev. 06-11)
---------------------------------------------------------------------------
OMB Clearance Number
|
Expires
|
-
|
|
IMF
---------------------------------------------------------------------------
Letters Considered in Revision:
Taxpayer Identification Number: _________
A
Tax Period: _________
B
Tax Periods: _________
__________
C
_________
D
_________
__________
E
Form: _________
E
Kind of Penalty(s): _________
E
E
WE ARE SORRY THAT WE COULD NOT GRANT YOUR REQUEST
E
E
In this letter, we will explain why we could not grant your request to
E
remove the penalty charges to your account.
E
Dear
WHY WE ARE CONTACTING YOU
F
This is in response to the inquiry __________________________, from
F
________________. We have no record that you authorized ______________________
F
________________________________________________________ that we have replied
F
directly to you. If you wish to authorize a third party to represent
F
you, please complete Form 2848, Power of Attorney and Declaration of
F
Representative. If you wish an appointee to inspect and/or receive
F
confidential tax information, please complete Form 8821, Tax
F
Information Authorization. For more information about these forms,
F
visit our website at or call the telephone number listed
F
at the end of this letter.
F
G
Thank you for your inquiry ______________ asking us to remove ________________
G
_____________________________________________________________________________.

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