UNITED STATES TAX COURT SAMPLE FORM
Real forms can be found at www.ustaxcourt.gov.
(PLEASE TYPE OR PRINT)
COMMISSIONER OF INTERNAL REVENUE
1. Petitioner(s) hereby file(s) a (PLACE AN “X”
ON THE APPROPRIATE LINES):
Redetermination of a Deficiency X
Petition for Lien or Levy Action
Determination of Relief from Joint and Several Liability on a Joint Return
Petition for Redetermination of Employment Status(Worker Classification)__
2. Petitioner(s) disagree(s) with the
determination contained in the notice issued by the Internal Revenue
Service for the year(s) or period(s)
ending Dec 31, 2003, as set forth in such notice
dated March 31, 2006
A COPY OF WHICH IS ATTACHED. DO NOT ATTACH ANY OTHER DOCUMENTS TO
3. Petitioner(s)’ taxpayer identification (e.g.,
Social Security) number(s) is (are)
listed on form 4 Statement of Taxpayer Identification Number, attached.
4. Set forth the relief requested and the reasons why
you believe you are entitled to such relief.
I do not have any tax liability. I deny the figures and content in the Notice of Deficiency. I dispute the computations. In the year in question I had dependents, deductions, credits, business expenses, etc.
The 1099s and W-2 forms information and other statements of income on the NOD are incorrect, false, or appears that way to me. I do not have information to substantiate the income figures alleged by the IRS. This case is ready for settlement. I request a settlement conference with Appeals, etc. Petitioner request waiver and abatement on any and all penalties.
See Attachment incorporpated herein by reference.
Petitioner(s) request(s) that this case be conducted
under the “small tax case” procedures. The amount in dispute or
any overpayment claimed is $50,000 or less. A decision in a “small
tax case” is final and cannot be appealed to a Court of Appeals by
the Internal Revenue Service or the Petitioner(s). If you do NOT
want this case conducted as a “small tax case”, place an “X” on the following line X
SIGNATURE OF PETITIONER DATE
(PRINT) MALL1NG ADDRESS
ZIP CODE AREA CODE
SIGNATURE OF PETITIONER
DATE (Print) MAILING ADDRESS
(IF NAMED IN THE FINAL NOTICE)
STATE Z1P CODE
SIGNATURE, NAME, ADDRESS, TELEPHONE NO., AND TAX COURT BAR NUMBER OF
COUNSEL, IF RETAINED BY PETITIONER(S)
T .C. FORM 2 (REV 5/03)