IRS Form 911

Taxpayer's Name

Enter the Taxpayer's name:

TIN

Do you wish to enter an SSN or EIN?

Do you wish to enter an SSN or EIN? SSNEIN

If the taxpayer is an individual, the Taxpayer Identifying Number (TIN) is typically a Social Security Number. If the taxpayer is a corporation, the TIN is generally an Employer Identification Number (EIN).

Enter the Taxpayer's SSN:

Enter the Taxpayer's EIN:

Taxpayer's Address

Enter the Taxpayer's street address:

What city does the Taxpayer live in?

Which state does the Taxpayer live in?

Enter the Taxpayer's ZIP code:

Enter the Taxpayer's country:

Spouse's Information

Is the Taxpayer married and filing jointly?

Is the Taxpayer married and filing jointly? YesNo

Enter Spouse's name:

Enter Spouse's SSN:

Email Address

Enter the Taxpayer's email address:

Contact

The Taxpayer Advocate Service (TAS) is an independent organization within the IRS that helps taxpayers resolve federal tax issues and protects taxpayers' rights.

Who should the TAS contact about this request?

Daytime Phone

Enter a daytime number the TAS can call:

Do you want to enter a fax number?

Do you want to enter a fax number? YesNo

Enter a fax number where the Taxpayer can be reached:

Consent

May the IRS leave a message on your voicemail or answering machine?

May the IRS contact you via email?

Language

Specify any special communication needs:

Specify any special communication needs: TTYInterpreterOtherNot Applicable

Select a language:

Enter language:

Describe other communciation needs:

Tax Form

Which Tax Form does this request for assistance pertain to?

Description of Issue

Describe the issue you are experiencing:

Description of Request

Describe the relief/assistance you are requesting:

Tax Year

Enter the Tax Year or Period to which the request applies:

Authorized Representative

Is there an Authorized Representative the TAS can call?

Is there an Authorized Representative the TAS can call? YesNo

Enter the Authorized Representative's name:

Enter the Authorized Representative's Centralized Authorization File (CAF) number:

Enter the Authorized Representative's street address:

Enter the Authorized Representative's city:

Enter the Authorized Representative's state:

Enter the Authorized Representative's zip code:

Enter the Authorized Representative's country:

Enter the Authorized Representative's phone number:

Do you want to enter a fax number for the Authorized Representative?

Do you want to enter a fax number for the Authorized Representative? YesNo

Enter the Authorized Representative's fax:

TAS

How did the Taxpayer hear about the TAS?

How did the Taxpayer hear about the TAS? IRS FormsMediaEmployeeOther

Specify:

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