Fill - Free fillable Form L-01 REQUEST FOR APPEAL 2019 PDF form

StateofCalifornia

OfficeofTaxAppeals

OTAFormL-01

(April 2019)

REQUESTFORAPPEAL

Completetheinformationinthespacesbelow,includingyoursignatureandthedate.

1. Taxpayer’sName(s): 2. RepresentativeName,ifapplicable:

(Attach completed PowerofAttorneyform (OTA Form L-03)

3. TaxpayerIdentificationNumber: 4. Taxpayer’sTelephoneNumber: 5. Representative’sTelephone

Number,ifapplicable:

6. Taxpayer’sMailingAddress:

7. Taxpayer's Email Address:

8. AppealingFrom: 9. DollarAmountofAppeal: 11. IamAttaching:(mustselectand

attachoneforvalidappeal)

ActionoftheCalifornia

DepartmentofTaxandFee

Administration(CDTFA)

ActionoftheFranchiseTaxBoard

(FTB)

CDTFAAppealsBureau’sDecision

FTB’sNoticeofAction

FTB’sClaimforRefundDenial

AcopyofmyFTBrefundclaim

thatIhavedeemeddenied

10. TaxableYear(s)/LiabilityPeriod

atIssue:

12. Telluswhyyoudisagreewiththetaxingagency’sdecision.Youmustidentifywhatyoubelieveisinerrororhas

beenomittedfromthetaxingagency’sdecisionandexplainwhytheidentifiederrorsoromissionsjustifya

differentresult.Pleasebeasspecificasyoucan.Youcanattachmorepagesifthisisnotenoughspace.

NameofTaxpayer Signature Date

Checkifyouarearepresentativethathassignedthisformonbehalfoftaxpayer(s).AttachacompletedPowerofAttorneyform.

MailorfaxthiscompletedformANDacopyofthedocumentidentifiedinBox11,above,to:

OfficeofTaxAppeals

P.O.Box989880

WestSacramento,CA95798‐9880

Fax:(916)492‐2089

STRUCTIONSFORREQUESTFORAPPEALFORM

OTA Form L-01 (April 2019)



Purposeofthisform

YoucanusethisformtoinitiateanOfficeofTaxAppeals(OTA)reviewofaproposedtaxliabilityordenialofaclaimfor

refundbytheCaliforniaDepartmentofTaxandFeeAdministration(CDTFA)ortheFranchiseTaxBoard(FTB).OTAis

anindependentbody,separateanddistinctfromCDT

FAandFTB.WhenyoufileanappealwithOTA,

youwillhavethe

opportunitytopresentyourcasetoathree‐memberpanelofAdministrativeLawJudgesandgetawrittendecision.OTA

doesnothaveanyofthedocumentsthatyousubmittedtothetaxagency.Ifyouwishtorelyonadocume

ntforyour

appealyoumustsu

bmitthatdocumenttoOTAevenifyoualreadysubmittedittothetaxagency.

SpecificFieldInstructions

Box1–Name

Enterthename(s)oftheperson(s)orentitysubmittingthe

appeal.IfyouareappealinganactionbyFTBonajoint

return, you should enter both spouses’ or registered

domesticpartners’namesinthisbox.

Box2–RepresentativeName

Enterthenameofthepersontha

twillberepresentingyou

in your appeal. You are not required to have a

representative.OTA’sprocessesareintendedtomakeit

easyforanyonetopresentacasewithouttheneedforany

specializedlegalknowledge.Youmayrepresentyourself

inyourappealoryoucanchoosetohaveanyoneoverthe

ageof18representyou.Yourrepresentativedoesnot

needtobeanattorneyoraccountant.Ifyoudochooseto

have someone represent you, you must include a

completed Power of Attorney form, such as OTA Form

L-03.

Box3–TaxpayerIdentificationNumber

Entertheidentificationnumberthatyouusedwhenfiling

your tax return (i.e. social security number, federal

employee identification number, California corporation

number,orBOE/CDTFAaccountnumber).

Box4–Taxpayer’sTelephoneNumber

Enteryourtelephonenumber.

Box5–Representative’sTelephoneNumber

If you designated a representative in Box 2, enter your

representative’stelephonenumber.

Box6–Taxpayer’sMailingAddress

Enterthestreetaddress,city,state,andzipcodewhere

youreceiveyourmail.

Box7–Taxpayer's EmailAddress

Enter the email address at which you receive your

electronic mail.

Box8–Appealingfrom

IfyouareappealingaNoticeofAction,ClaimforRefund

Denial, or Deemed Claim for Refund Denial by FTB,

checkthe“ActionoftheFranchiseTaxBoard(FTB)”box.

IfyouareappealingaDecisionbytheAppealsBureauof

CDTFA, check the “Action of the California Department

of Tax and Fee Administration (CDTFA)” box. 

Box9–DollarAmountofAppeal

If you know the dollar amount of the proposed tax

assessmentorclaimedrefunddenial/deemeddenialthat

youdisagreewith,enterthatamountinthisbox.

Box10‐TaxableYear(s)/LiabilityPeriodatIssue

Enterthetaxyearsorliabilityperiodsforwhichyouare

appealing.

Box11‐IamAttaching

If you are appealing from a decision by CDTFA’s Appeals

Bureau, check the “CDTFA Appeals Bureau’s Decision”

box and attach both your Decision Cover Letter and

Decision. Attaching the Decision will satisfy the

requirement to provide CDTFA’s account number, the

case identification number, and the date of the Decision. If

you are appealing from FTB’s Notice of Action proposing

additional tax, check the box for and attach “FTB’s Notice

of Action." If you are appealing from FTB’s denial of a

claim for refund, check the box for and attach “FTB’s

Claim for Refund Denial." If you did not receive a notice,

but it has been six or more months since you filed your

claim for refund with FTB, check the box for and attach “A

copy of my FTB refund claim that I have deemed denied.”

You must attach one of these items for your appeal to be

valid.

Box 12‐Tell us why you disagree with the taxing agency’s

decision

Enterthefactsinvolvedandthespecificreasonsthatyou

disagreewiththetaxagency.Youmayuseordinaryand

informal language and although it is not necessary to

include legal authorities, like statutes and/or courtor

administrativeagencydecisionsinyourappeal,you

shouldincludethemifyouthinktheysupportyour

position. Attach additional sheets if you need more space.

Signatures

Signanddatetheform.Ifyouareappealinganactionona

jointreturnbyFTB,bothspousesorregistereddomestic

partnersshouldsignanddatetheform.

Ifyouhavequestionsorneedhelpfilingyourappeal

Contact OTA’s Ombudsperson for assistance.You can

reachtheOmbudspersonbyemailatinfo@ota.ca.govor

by phone at 916‐206‐4355.You can also find more

informationonourwebsiteatwww.ota.ca.gov.

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