Form 911AL, Request for Taxpayer Assistance Instructions

Enter the full legal business name or the name shown on the tax return for this taxpayer.

Enter the business's Employer Identification Number (EIN) issued by the IRS. Fill only if 'Business Name' is filled.

Enter the taxpayer's primary contact telephone number, including area code and any extension if applicable.

Enter the taxpayer's primary email address for contact and correspondence.

Provide a brief one-line summary of the specific relief or remedy you are requesting from the court.

Give a full, detailed explanation of the relief requested, including facts, reasons, and any supporting details or legal basis; attach additional sheets if necessary.

Check this box when the tax problem involves issues with estimated tax returns or payments.

Check this box when the tax problem is not listed among the other options and you will specify the issue in the space provided below.

Enter a detailed description of the tax problem, including what happened, relevant tax type(s), tax period(s), key dates, amounts involved, and any other facts or events that explain the issue. Fill only if 'Other (Specify Below)' is 'Yes'.

Check this box if the tax problem you are reporting is related to your domicile or residency status.

Check this box if you are requesting a waiver or abatement of penalties related to the tax issue.

Check this box if the tax problem was caused by identity theft affecting your tax account or filings.

Check this box if you are seeking innocent spouse relief for liability arising from a joint return.

Enter the taxpayer's current mailing street address, including apartment, suite, or unit number if applicable.

Enter the city for the taxpayer's current mailing address.

Enter the U.S. state or territory for the mailing address (use the standard two-letter postal abbreviation if space is limited).

Enter the ZIP Code for the mailing address (5-digit ZIP or ZIP+4, e.g., 12345 or 12345-6789).

Enter the spouse's full legal name exactly as shown on the tax return (first, middle initial if used, and last name).

Enter the spouse's nine-digit Social Security Number as shown on official documents (include or omit dashes according to the form's instructions). Fill only if 'Spouse's Name (if applicable)' is filled.

Enter the type of tax or tax account involved (for example: Sales Tax, Income Tax, Withholding, Use Tax, or the specific tax account code).

Enter the tax period(s) for the issue you are reporting (for example: month/year, quarter/year, or a range of periods such as 01/2024–03/2024).

Enter the taxpayer's full name exactly as it appears on the tax return.

Enter the taxpayer's nine-digit Social Security Number (SSN).

Check this box if a Power of Attorney is currently in effect for this taxpayer and you are attaching a copy of Form 2848A.