Federal Free Printable Form 12509 (Rev. 01-2005) for 2017 Federal Statement of Disagreement

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Statement of Disagreement
Form 12509 (Rev. 01-2005)

Form 12509 (January 2005) Statement of Disagreement Purpose of form: You can use this form to explain why you disagree with the Internal Revenue Service (IRS) Determination concerning relief from joint and several liability for a joint return under Internal Revenue Code sections 6013(e), 6015(b), 6015(c), or 6015(f) in the letter you received with this form. Note: You can use the back of this page or attached additional pages if you need more space. CHECK HERE IF YOU ALSO WISH TO GO TO APPEALS Taxpayer Name: Social Security Number Statement of Disagreement I, , disagree with the Internal Revenue Service determination because Under penalties of perjury, I declare that I have examined this statement, and to the best of my knowledge and belief, it is true, correct and complete. My Signature Date Daytime phone number Best time to Call Form 12509 (Rev. 1-2005) www.irs.gov Catalog Number 28731A Department of the Treasury-Internal Revenue Service
Extracted from PDF file 2016-federal-form-12509.pdf, last modified May 2005

More about the Federal Form 12509 Other TY 2016

We last updated the Statement of Disagreement in May 2017, so this is the latest version of Form 12509, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 12509 directly from TaxFormFinder. You can print other Federal tax forms here.


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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 12509 from the Internal Revenue Service in May 2017.

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Historical Past-Year Versions of Federal Form 12509

We have a total of four past-year versions of Form 12509 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 12509

Form 12509 (Rev. 01-2005)

Statement of Disagreement 2015 Form 12509

Form 12509 (Rev. 1-2005)

Statement of Disagreement 2012 Form 12509

Form 12509 (Rev. 1-2005)

Statement of Disagreement 2011 Form 12509

Form 12509 (Rev. 1-2005)


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