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Federal Free Printable Form 13711 (Rev. 10-2017) for 2019 Federal Request for Appeal of Offer in Compromise

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Request for Appeal of Offer in Compromise
Form 13711 (Rev. 10-2017)

Service employee - Staple the taxpayer's envelope here Form 13711 (October 2017) Department of the Treasury - Internal Revenue Service Request for Appeal of Offer in Compromise Provide the information required in the spaces below. You must sign and date this form. Taxpayer name Taxpayer Identification Number Taxpayer name Taxpayer Identification Number Mailing address Tax form number City State ZIP Code Tax period(s) ended Taxpayer's current daytime telephone number Name of authorized representative Mailing address City State Telephone number of authorized representative ZIP Code Best time to call (during normal business hours) If you disagree with a specific item shown on the Income and Expense Table and Assets and Equity table you received with your rejection letter, identify the specific item(s). In the space next to the disagreed item, provide a brief statement indicating why you don't agree with our determination (if the disagreed item is the value of future income, indicate that under "Disagreed Item," and provide an explanation under "Reason for Disagreement"). There is room for more entries on the back of this form, and you may use additional pages, if necessary. Attach supporting documents for each disagreed item you identify and indicate on them which issue they apply to. If you disagree with a reason for the rejection stated in our letter but not discussed on the Table, identify what statement you disagree with, the reason you disagree and attach any supporting documentation. Additional pages may be attached. If you do not agree with the Service's analysis of economic hardship or Effective Tax Administration, please provide an explanation with documentation. If possible, attach a copy of the rejection letter to this form. Disagreed item Reason for disagreement (attach supporting documentation) Certification of Taxpayer: Under penalties of perjury, I declare that to the best of my knowledge, the information contained herein is true, correct, and complete. Signature of Taxpayer Date signed Signature of Taxpayer Date signed Certification for authorized representative: Check the box that applies depending on whether you have personal knowledge. I declare that I have submitted the protest and accompanying documents and to the best of my knowledge, the facts stated in the protest and accompanying documents are true, correct, and complete. I declare that I have submitted the protest and accompanying documents, but have no personal knowledge concerning the facts stated in the protest and the accompanying documents. Signature of authorized representative (Attach a copy of your completed Form 2848, Power of Attorney and Declaration of Representative.) Signature of authorized representative Catalog Number 40992F Date signed www.irs.gov Scan this QR Code with your smartphone or other device with a QR reader, or go to the website url shown, to view more information about completing this form and other Appeals www.irs.gov/appeals processes online. Form 13711 (Rev. 10-2017) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Disagreed item Reason for disagreement (attach supporting documentation) Catalog Number 40992F www.irs.gov Form 13711 (Rev. 10-2017)
Extracted from PDF file 2018-federal-form-13711.pdf, last modified October 2017

More about the Federal Form 13711 Other TY 2018

We last updated the Request for Appeal of Offer in Compromise in February 2019, so this is the latest version of Form 13711, fully updated for tax year 2018. You can download or print current or past-year PDFs of Form 13711 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 13711 from the Internal Revenue Service in February 2019.

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Historical Past-Year Versions of Federal Form 13711

We have a total of six past-year versions of Form 13711 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2018 Form 13711

Form 13711 (Rev. 10-2017)

2017 Form 13711

Form 13711 (Rev. 10-2017)

2016 Form 13711

Form 13711 (Rev. 3-2013)

Request for Appeal of Offer in Compromise 2015 Form 13711

Form 13711 (Rev. 3-2013)

Request for Appeal of Offer in Compromise 2012 Form 13711

Form 13711 (Rev. 6-2009)

Request for Appeal of Offer in Compromise 2011 Form 13711

Form 13711 (Rev. 6-2009)


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