Federal Free Printable Form 4810 (Rev. 2-2009) for 2017 Federal Request for Prompt Assessment Under Internal Revenue Code Section 6501(d)

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Request for Prompt Assessment Under Internal Revenue Code Section 6501(d)
Form 4810 (Rev. 2-2009)

Form 4810 Request for Prompt Assessment Under Internal Revenue Code Section 6501(d) (Rev. February 2009) Department of the Treasury Internal Revenue Service © OMB No. 1545-0430 For IRS Use Only See instructions on back. Requester’s name Kind of tax Income Gift Employment Excise Title Number, street, and room or suite no. (If a P.O. box, see instructions.) Daytime phone number City, town, or post office, state, and ZIP code Tax Returns for Which Prompt Assessment of Any Additional Tax is Requested Form Number Tax Period Ended SSN/EIN on Return Name and Address Shown on Return Service Center Where Filed Date Filed Spouse’s social security number If applicable, provide the name of decedent’s spouse (surviving or deceased) If corporate income tax returns are included, check the applicable box below: Dissolution has been completed. Dissolution has begun and will be completed either before or after the 18-month period of limitation. Dissolution has not begun but will begin before the 18-month period of limitation expires and will be completed either before or after that period expires. Attached are copies of: The returns listed above. Letters of administration or letters testamentary. Other (describe): I request a prompt assessment of any additional tax for the kind of tax and periods shown above, as provided by Internal Revenue Code section 6501(d). Under penalties of perjury, I declare that I have examined this request, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Sign Here I certify that I have never been assessed any penalties for civil fraud for any federal or state tax matter nor have I been charged with, indicted for, or convicted of fraud. If you cannot certify this statement, attach a detailed statement explaining the circumstances under which you were assessed a penalty, charged with, indicted for, or convicted of fraud. © Signature of requester For Privacy Act and Paperwork Reduction Act Notice, see back of form. Date Cat. No. 42022S © Identifying number Form 4810 (Rev. 2-2009) Form 4810 (Rev. 2-2009) General Instructions Section references are to the Internal Revenue Code. Purpose of Form Use Form 4810 to request prompt assessment of tax. Attach to your request the documentation requested on Form 4810. If you prefer to use your own format, your request must list the same information as requested on this form and include the applicable attachments. Specifically, you must verify your authority to act for the taxpayers (for example, letters testamentary or letters of administration) and provide copies of the authorizing document. Also, your request must clearly show: ● It is a request for prompt assessment under section 6501(d); ● The kind of tax and the tax periods involved; ● The name and social security number (SSN) or employer identification number (EIN) shown on the return (copies of the returns may be attached to help identify the return; write at the top of the return copy: “COPY - DO NOT PROCESS AS ORIGINAL”); and ● The date and location of the IRS office where the returns were filed. When To File Do not file Form 4810 requesting prompt assessment until after you file the tax returns listed on the front of this form. You must submit a separate request for prompt assessment for any tax returns filed after this Form 4810. Where To File Send your request to the Internal Revenue Service Center where you filed the returns for which you are requesting prompt assessment. Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. We collect this information under the authority under Internal Revenue Code section 6501(d). We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax. You are Page 2 not required to request prompt assessment; however, if you do so you are required to provide the information requested on this form. Failure to provide the information may delay or prevent processing your request. Section 6109 requires you to provide the requested taxpayer identification numbers. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential as required by section 6103. However, section 6103 allows or requires the Internal Revenue Service to disclose or give such information shown on your Form 4810 to the Department of Justice to enforce the tax laws, both civil and criminal, and to cities, states, the District of Columbia, and U.S. commonwealths or possessions. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. The time needed to complete and file this form and related schedules will vary depending on individual circumstances. The estimated average times are: Recordkeeping 5 hrs., 30 min. Learning about the law or the form 0 hrs., 18 min. Preparing the form 0 hrs., 24 min. Copying, assembling, and sending the form to the IRS 0 hrs., 0 min. If you have comments concerning the accuracy of these time estimates or suggestions for making this request simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send this tax form to the above address. Instead, see Where To File on this page.
Extracted from PDF file 2016-federal-form-4810.pdf, last modified January 2009

More about the Federal Form 4810 Other TY 2016

We last updated the Request for Prompt Assessment Under Internal Revenue Code Section 6501(d) in May 2017, so this is the latest version of Form 4810, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 4810 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 4810 from the Internal Revenue Service in May 2017.

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Historical Past-Year Versions of Federal Form 4810

We have a total of four past-year versions of Form 4810 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 4810

Form 4810 (Rev. 2-2009)

Request for Prompt Assessment Under Internal Revenue Code Section 6501(d) 2015 Form 4810

Form 4810 (Rev. 2-2009)

Request for Prompt Assessment Under Internal Revenue Code Section 6501(d) 2012 Form 4810

Form 4810 (Rev. 2-2009)

Request for Prompt Assessment Under Internal Revenue Code Section 6501(d) 2011 Form 4810

Form 4810 (Rev. 2-2009)


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