Federal Free Printable Form 12256 (Rev. 10-2012) for 2017 Federal Withdrawal of Request for Collection Due Process or Equivalent Hearing

It appears you don't have a PDF plugin for this browser. Please use the link below to download 2016-federal-form-12256.pdf, and you can print it directly from your computer.

Withdrawal of Request for Collection Due Process or Equivalent Hearing
Form 12256 (Rev. 10-2012)

Department of the Treasury - Internal Revenue Service Form 12256 (October 2012) Withdrawal of Request for Collection Due Process or Equivalent Hearing Taxpayer name(s) Taxpayer address City State Zip code Type of tax/tax form* Tax period(s)* Social Security/Employer Identification Number(s)* *Note: You may attach a copy of your Collection Due Process notice to this form instead of listing the tax type/form number/period and identification number in the spaces above. I've reached a resolution with the Internal Revenue Service (IRS) regarding the tax and tax periods that my hearing request concerned or I am otherwise satisfied that I no longer need a hearing with the Office of Appeals (Appeals). Therefore, I withdraw my hearing request under (check all that apply): IRC Section 6320, notice and opportunity for a hearing upon the filing of a Notice of Federal Tax Lien IRC Section 6330, notice and opportunity for a hearing before a levy Both IRC Section 6320 and 6330 notices Equivalent Hearing I understand that by withdrawing my request for a Collection Due Process hearing under Section 6320 and/or 6330: • I give up my right to a hearing with Appeals. I understand that Appeals will not issue a Notice of Determination with respect to the tax and tax periods subject to the hearing request. As part of a CDP determination, Appeals verifies that all legal and administrative requirements were met. I understand that by withdrawing my hearing request, Appeals will not conduct this verification. • I give up my right to seek judicial review in the Tax Court of the Notice of Determination that Appeals would have issued as a result of the CDP Hearing, as Appeals will not issue a Notice of Determination. • I give up my right to have Appeals retain jurisdiction with respect to any determination that it would have made as a result of the CDP Hearing. • The suspension of levy action and the suspension of the statute of limitations on the period of collection, as required under the provisions of IRC Sections 6320 and 6330, are no longer in effect upon the receipt by the IRS of this withdrawal. • I do not give up any other appeal rights that I am entitled to, such as an appeal under the Collection Appeals Program (CAP). I understand that by withdrawing my request for an equivalent Hearing: • I give up my right to a hearing with Appeals. I understand that Appeals will not issue a Decision Letter with respect to the tax and tax periods subject to the hearing request. • I do not give up any other appeal rights that I am entitled to, such as an appeal under the Collection Appeals Program (CAP). Taxpayer's signature Date Spouse's signature (if applicable) Date Authorized Representative signature (if applicable) Date For privacy Act information please refer to Notice 609 Catalog Number 27779K www.irs.gov Form 12256 (Rev. 10-2012)
Extracted from PDF file 2016-federal-form-12256.pdf, last modified October 2012

More about the Federal Form 12256 Other TY 2016

We last updated the Withdrawal of Request for Collection Due Process or Equivalent Hearing in May 2017, so this is the latest version of Form 12256, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 12256 directly from TaxFormFinder. You can print other Federal tax forms here.

Other Federal Other Forms:

TaxFormFinder has an additional 774 Federal income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 8962 Premium Tax Credit
Form 12277 Application for Withdrawal of Filed Form 668(Y), Notice of Federal Tax Lien (Internal Revenue Code Section 6323(j))
Form 433-D Installment Agreement
Form W-4V Voluntary Withholding Request
Form 8283 Noncash Charitable Contributions

Download all  tax forms View all 775 Federal Income Tax Forms


Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 12256 from the Internal Revenue Service in May 2017.

Show Sources >

Historical Past-Year Versions of Federal Form 12256

We have a total of four past-year versions of Form 12256 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 12256

Form 12256 (Rev. 10-2012)

Withdrawal of Request for Collection Due Process or Equivalent Hearing 2015 Form 12256

Form 12256 (Rev. 10-2012)

Withdrawal of Request for Collection Due Process or Equivalent Hearing 2012 Form 12256

Form 12256 (Rev. 10-2012)

Withdrawal of Request for Collection Due Process or Equivalent Hearing 2011 Form 12256

Form 12256 (Rev. 2-2007)


TaxFormFinder Disclaimer:

While we do our best to keep our list of Federal Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.

** This Document Provided By TaxFormFinder.org **
Source: http://www.taxformfinder.org/federal/form-12256