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Federal Free Printable Form 211A (3-1989) for 2023 Federal State or Local Law Enforcement

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State or Local Law Enforcement
Form 211A (3-1989)

State or Local Law Enforcement Application for Reimbursement for Original Information 1. Requesting Agency Name 2. Address 3. Contact Person (Name & Title) 4. Telephone Number ( ( ) ) Individual involved in illegal drug related activities (or money laundering in connection with such activities). 5. Name 6. Address 7. SSN (If Known) 8. Summary of Information provided to the IRS (attach additional sheets, if necessary): 9. Summary of costs incurred in your investigation (including but not limited to reasonable expenses, Per diem, and overtime). Attach additional sheets if necessary. 10. Have any other reimbursements been received, or applied for, for expenses incurred in the investigation of the individual named in (2) above under any other program or arrangement including, but not limited to, Federal or state forfeiture programs, state revenue laws, i.e., Federal and state equitable sharing arrangements. NO YES If yes, please attach copies of DAG-71, IRS Form 9061 or other claim for an equitable share of asset forfeitures 11. Name of IRS employee to whom violation was reported 12. Title 13. Date Violation reported (Month, Day, Year) 14. Certification: The requesting certifies that the above information is true and accurate Signature Title Date The following is to be completed by the Internal Revenue Service Allowance of Reimbursement District Sum Recovered Amount of Reimbursement $ In consideration of the original information that was furnished by the claimant named above, which concerns a violation of the internal revenue laws and which led to the collection of taxes, penalties, and additions to tax collected in the sum shown above, I approve payment of a reimbursement in the amount stated. Signature of Service Center Director Form 211A (3-89) Catalog Number 16572D Date See Reverse for Instruction Department of the Treasury-Internal Revenue Service State or Local Law Enforcement Application for Reimbursement for Original Information General Information 1) This application is voluntary and the information requested enables us to determine and pay reimbursements. 2) Not providing the information requested may result in the suspension of the processing of this application. 3) Our authority for asking for the information on this form is derived from 26 U.S.C. 7624. 4) No reimbursement shall be paid to you in any case where the taxes recovered total less than $50,000. 5) The term ''taxes recovered'' means additional taxes, penalties, and additions to tax collected with respect to illegal drug-related activities (or money laundering in connection with such activities), but not additional interest or criminal fines that may be collected. 6) The amount of the reimbursement payable is at the discretion of the IRS District Director or Service Center Director and shall be equal to the cost incurred in your investigation of the taxpayer (including but not limited to reasonable expenses, per diem, salary, and overtime) but not to exceed 10 percent of the sum recovered. 7) No reimbursement will be made for expenses incurred in the investigation of a taxpayer which have been reimbursed under any other program or arrangement including, but not limited to, Federal or state equitable sharing arrangements. 8) The reimbursement will be paid after collection from the taxpayer and after the expiration of the applicable period of limitations for filing a claim for refund by the taxpayer, unless adequate indemnification is provided. Instructions 1) Submit this application to the Chief, Criminal Investigation Division of the Internal Revenue Service District in which the taxpayer is located as soon as practicable after submitting the information but not later than 30 days after the Service notifies you of the amount of taxes recovered as a result of the information submitted. 2) Include all of the information which you provided to the IRS. For an agency to be eligible for a reimbursement, the information provided must have substantially contributed to the recovery of the tax. Form 211A Page 2
Extracted from PDF file 2021-federal-form-211-a.pdf, last modified December 2002

More about the Federal Form 211-A Corporate Income Tax

We last updated the State or Local Law Enforcement in April 2022, and the latest form we have available is for tax year 2021. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Federal Internal Revenue Service. You can print other Federal tax forms here.

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Other Federal Corporate Income Tax Forms:

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

Form Code Form Name
Publication 15 Employer's Tax Guide
Form 1041-ES Estimated Income Tax for Estates and Trusts
Form 211 Application for Reward for Original Information
Form 941 Employer's Quarterly Federal Tax Return
Form 13909 Tax-Exempt Organization Complaint (Referral)

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 211-A from the Internal Revenue Service in April 2022.

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About the Corporate Income Tax

The IRS and most states require corporations to file an income tax return, with the exact filing requirements depending on the type of company.

Sole proprietorships or disregarded entities like LLCs are filed on Schedule C (or the state equivalent) of the owner's personal income tax return, flow-through entities like S Corporations or Partnerships are generally required to file an informational return equivilent to the IRS Form 1120S or Form 1065, and full corporations must file the equivalent of federal Form 1120 (and, unlike flow-through corporations, are often subject to a corporate tax liability).

Additional forms are available for a wide variety of specific entities and transactions including fiduciaries, nonprofits, and companies involved in other specific types of business.

Historical Past-Year Versions of Federal Form 211-A

We have a total of nine past-year versions of Form 211-A in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2021 Form 211-A

Form 211A (3-1989)

2020 Form 211-A

Form 211A (3-1989)

2019 Form 211-A

Form 211A (3-1989)

2018 Form 211-A

Form 211A (3-1989)

2017 Form 211-A

Form 211A (3-1989)

2016 Form 211-A

Form 211A (3-1989)

State or Local Law Enforcement Application for Reimbursement for Original Information 2015 Form 211-A

Form 211A (3-1989)

State or Local Law Enforcement Application for Reimbursement for Original Information 2012 Form 211-A

Form 211A (3-1989)

State or Local Law Enforcement Application for Reimbursement for Original Information 2011 Form 211-A

Form 211A (3-1989)

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