Looking for a Irs Form 13750 Templates? Download it for free!

Page 2 of 4

Section III

Ineligible Taxpayer Special Request for Inclusion

I am ineligible to participate in the Announcement 2005-80 settlement initiative because – (Check all that apply)

I am a promoter as outlined in Section 2, paragraph 1 of the Announcement

I am a person related to a promoter as outlined in Section 2, paragraph 2 of the Announcement

I am a TEFRA partner or promoter as outlined in Section 2, paragraph 3 of the Announcement

Despite my ineligibility, I request that the Service permit settlement under this initiative for the following reason(s)

Section IV

Penalties

I may qualify for a 0% penalty under IRC § 6662 for the following reasons (Check all that apply)

I filed a disclosure under Announcement 2002-2

I obtained a written tax opinion by an independent tax advisor (If box is checked, please complete a separate

Form 13750, Schedule B for each issue to which the opinion applies and attach it to your election).

Under penalties of perjury, I declare that I have examined these statements, accompanying

schedules, and attachments, and to the best of my knowledge and belief, they are true, correct,

and complete.

Signature of Taxpayer

Date

Taxpayer

Attestation

Signature of Taxpayer

Date

Instructions

Send your completed Form 13750 and all required

If you are under examination (or in Appeals) or if any

•

attachments to:

TEFRA partnership in which you are a partner is under

examination (or in Appeals), please send a copy of this

INTERNAL REVENUE SERVICE

Election to the IRS examiner (or IRS Appeals Officer).

Attn: Announcement 2005-80

MS1505

•

For additional information, please refer to the IRS website

24000 Avila Road

at A link to Announcement 2005-80 will be

Laguna Niguel, CA 92677

displayed on the main page.

Privacy Act Statement

The Privacy Act of 1974 says that when we ask you for information, we must first tell you our legal right to ask for the information, why we are asking for it, and how it will be

used. We must also tell you what could happen if you do not provide it and whether or not you must respond under the law.

This notice applies to tax returns and any papers filed with them. It also applies to any questions we need to ask you so we can complete, correct, or process your return;

figure your tax; and collect tax, interest, or penalties.

Our legal right to ask for information is found in Internal Revenue Code sections 6001, 6011, and 6012(a) and their regulations. They say that you must file a return or

statement with us for any tax you are liable for. Your response is mandatory under these sections.

Code section 6109 and its regulations say that you must show your social security number, employer identification number or individual taxpayer identification number on

what you file. Section 6109 also requires return preparers to provide their identifying numbers on the return. You must also fill in all parts of the tax form that apply to you. This

is so we know who you are and can process your return and papers.

We ask for tax return information to carry out the U.S. tax laws. We need it to figure and collect the right amount of tax. We may give the information to the Department of

Justice and to other federal agencies, as provided by law. We may also give it to cities, states, the District of Columbia, and U.S. commonwealths or possessions to carry out

their tax laws. And we may give it to certain foreign governments under tax treaties they have with the United States. We may also disclose this information to federal and

state agencies to enforce federal non-tax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

If you do not file a return, do not give us the information we ask for, or provide fraudulent information, the law says that we may have to charge you penalties and, in certain

cases, subject you to criminal prosecution. We may also have to disallow the exemptions, exclusions, credits, deductions, or adjustments shown on your tax return. This could

make your tax higher or delay any refund. Interest may also be charged.

Catalog No. 47521K

13750

Form

(10-2005)