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Federal Free Printable Form 843 (Rev. August 2011) for 2022 Federal Claim for Refund and Request for Abatement

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Claim for Refund and Request for Abatement
Form 843 (Rev. August 2011)

Form 843 Claim for Refund and Request for Abatement OMB No. 1545-0024 (Rev. August 2011) Department of the Treasury Internal Revenue Service ▶ See separate instructions. Use Form 843 if your claim or request involves: (a) a refund of one of the taxes (other than income taxes or an employer’s claim for FICA tax, RRTA tax, or income tax withholding) or a fee, shown on line 3, (b) an abatement of FUTA tax or certain excise taxes, or (c) a refund or abatement of interest, penalties, or additions to tax for one of the reasons shown on line 5a. Do not use Form 843 if your claim or request involves: (a) an overpayment of income taxes or an employer’s claim for FICA tax, RRTA tax, or income tax withholding (use the appropriate amended tax return), (b) (c) a refund of excise taxes based on the nontaxable use or sale of fuels, or an overpayment of excise taxes reported on Form(s) 11-C, 720, 730, or 2290. Name(s) Your social security number Address (number, street, and room or suite no.) Spouse’s social security number City or town, state, and ZIP code Employer identification number (EIN) Name and address shown on return if different from above Daytime telephone number 1 3 4 5a Period. Prepare a separate Form 843 for each tax period or fee year. 2 Amount to be refunded or abated: From to $ Type of tax or fee. Indicate the type of tax or fee to be refunded or abated or to which the interest, penalty, or addition to tax is related. Employment Estate Gift Excise Income Fee Type of penalty. If the claim or request involves a penalty, enter the Internal Revenue Code section on which the penalty is based (see instructions). IRC section: Interest, penalties, and additions to tax. Check the box that indicates your reason for the request for refund or abatement. (If none apply, go to line 6.) Interest was assessed as a result of IRS errors or delays. A penalty or addition to tax was the result of erroneous written advice from the IRS. Reasonable cause or other reason allowed under the law (other than erroneous written advice) can be shown for not assessing a penalty or addition to tax. b Date(s) of payment(s) ▶ 6 7 Original return. Indicate the type of fee or return, if any, filed to which the tax, interest, penalty, or addition to tax relates. 706 709 940 941 943 945 990-PF 1040 1120 4720 Other (specify) ▶ Explanation. Explain why you believe this claim or request should be allowed and show the computation of the amount shown on line 2. If you need more space, attach additional sheets. Signature. If you are filing Form 843 to request a refund or abatement relating to a joint return, both you and your spouse must sign the claim. Claims filed by corporations must be signed by a corporate officer authorized to sign, and the officer’s title must be shown. Under penalties of perjury, I declare that I have examined this claim, including accompanying schedules and statements, and, to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Signature (Title, if applicable. Claims by corporations must be signed by an officer.) Date Signature (spouse, if joint return) Paid Preparer Use Only Date Print/Type preparer’s name Firm’s name Preparer's signature ▶ Firm's address ▶ For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Date Check if self-employed PTIN Firm's EIN ▶ Phone no. Cat. No. 10180R Form 843 (Rev. 8-2011)
Extracted from PDF file 2021-federal-form-843.pdf, last modified March 2009

More about the Federal Form 843 Individual Income Tax TY 2021

We last updated the Claim for Refund and Request for Abatement in January 2022, so this is the latest version of Form 843, fully updated for tax year 2021. You can download or print current or past-year PDFs of Form 843 directly from TaxFormFinder. You can print other Federal tax forms here.

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Related Federal Individual Income Tax Forms:

TaxFormFinder has an additional 774 Federal income tax forms that you may need, plus all federal income tax forms. These related forms may also be needed with the Federal Form 843.

Form Code Form Name
Form 8843 Statement for Exempt Individuals and Individuals With a Medical Condition

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 843 from the Internal Revenue Service in January 2022.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Federal Form 843

We have a total of nine past-year versions of Form 843 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2021 Form 843

Form 843 (Rev. August 2011)

2020 Form 843

Form 843 (Rev. August 2011)

2019 Form 843

Form 843 (Rev. August 2011)

2018 Form 843

Form 843 (Rev. August 2011)

2017 Form 843

Form 843 (Rev. August 2011)

2016 Form 843

Form 843 (Rev. August 2011)

Claim for Refund and Request for Abatement 2015 Form 843

Form 843 (Rev. August 2011)

Claim for Refund and Request for Abatement 2012 Form 843

Form 843 (Rev. August 2011)

Claim for Refund and Request for Abatement 2011 Form 843

Form 843 (Rev. August 2011)

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