Ted Patriot
South Daytona, Fl 32119
SSN: 12345

November, 20th 2006

Area Director of IRS
400 Bay Street
Jacksonville, Fl 32202

Attn: Compliance Technical Support Manager

RE: Administrative Claim For Unauthorized Collection Actions Under IRS 7433 & 26CFR 301. 7333.1

To: Compliance Technical support Manager:

This is an administrative claim for civil damages for Unauthorized Collection Actions under IRC 7433 and CFR 301.7433-1.

Under said law in section (d) (1) and said regulation in section (d) (2), I am required to exhaust my administrative remedies. This letter is my method of doing that. I will file a civil action in US District Court under IRC 7433 for the wrongful and illegal collections actions against me.

Under CFR 301.7433-1 (e)(2) Form , The administrative claim shall include; I must inform you of the following:

  1. My Name and address is above as is my telephone number and identification number. The best time to call is normal business hours, and my phone will also take your message.
  2. The grounds for my claim for demands include:

    The IRS has unlawfully, since April of 2006 levied and Seized my entire Social Security Benefits check. (Exhibit A). After repeated personal visits to both the Social Security office and the IRS. The Social Security tells me in writing see Exhibit (B) that they must follow what the IRS tells them. According to the IRS web site the law allows the IRS to levy and seize only up to 15% of my Social Security Benefits if my benefit is under $750.00 a month, which it is. See Exhibit C

  3. The damages to me include:

    My ability to purchase necessary and essential items for living . I can not purchase those things that are essential for healthy living. Such things as good grades of meat and fresh vegetables are out of my reach. My daily concern over the loss of income has caused sever emotional distress, leaving me unable to sleep and causing hypertension and sweating . I am losing weight and for an adult male over 70 years old this is very dangerous and damaging to my mind and body. Because of Levy , I have no income. The IRS has levied my Entire social security benefits check. They have stopped any payments to me since March of 2006.

  4. The dollar amount of this claim includes:
    1. $7,500.00 from the loss of Social Security Benefits
    2. $100,00 minimum statutory damages

In conclusion, this is my claim for damages for wrongful actions of IRS employees. Under federal law, I am entitled to compensation.

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Ted Patriot