Fillable Request for a Collection Due Process or Equivalent Hearing Form 12153 Dec 2013

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Request for a Collection Due Process or Equivalent Hearing Form 12153 Dec 2013

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The Internal Revenue Service (IRS) is a government agency responsible for collecting taxes and administering the federal statutory tax laws of the United States. The IRS provide tax assistance to taxpayers and pursue and resolve fraudulent tax filings.

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Form 12153
(Rev. 12-2013)
Request for a Collection Due Process or Equivalent Hearing
Form 12153 (Rev. 12-2013)
Catalog Number 26685D www.irs.gov Department of the Treasury - Internal Revenue Service
Use this form to request a Collection Due Process (CDP) or equivalent hearing with the IRS Office of
Appeals if you have been issued one of the following lien or levy notices:
• Notice of Federal Tax Lien Filing and Your Right to a Hearing under IRC 6320,
• Notice of Intent to Levy and Notice of Your Right to a Hearing,
• Notice of Jeopardy Levy and Right of Appeal,
• Notice of Levy on Your State Tax Refund,
• Notice of Levy and Notice of Your Right to a Hearing.
Complete this form and send it to the address shown on your lien or levy notice. Include a copy
of your lien or levy notice to ensure proper handling of your request.
Call the phone number on the notice or 1-800-829-1040 if you are not sure about the correct address
or if you want to fax your request.
You can find a section explaining the deadline for requesting a Collection Due Process
hearing in this form's instructions. If you've missed the deadline for requesting a CDP
hearing, you must check line 7 (Equivalent Hearing) to request an equivalent hearing.
1. Taxpayer Name: (Taxpayer 1)
Taxpayer Identification Number
Current Address
City State Zip Code
2. Telephone Number and Best Time
to Call During Normal Business
Hours
Home ( )
-
am. pm.
Work ( )
-
am. pm.
Cell ( )
-
am. pm.
3. Taxpayer Name: (Taxpayer 2)
Taxpayer Identification Number
Current Address
(If Different from
Address Above)
City State Zip Code
4. Telephone Number and Best Time
to Call During Normal Business
Hours
Home ( )
-
am. pm.
Work ( )
-
am. pm.
Cell ( )
-
am. pm.
5. Tax Information as Shown on the Lien or Levy Notice (If possible, attach a copy of the notice)
Type of Tax (Income,
Employment, Excise,
etc. or Civil Penalty)
Tax Form Number
(1040, 941, 720, etc)
Tax Period or Periods
Form 12153
(Rev. 12-2013)
Request for a Collection Due Process or Equivalent Hearing
Form 12153 (Rev. 12-2013)
Catalog Number 26685D www.irs.gov Department of the Treasury - Internal Revenue Service
6. Basis for Hearing Request (Both boxes can be checked if you have received both a lien
and levy notice)
Filed Notice of Federal Tax Lien Proposed Levy or Actual Levy
7. Equivalent Hearing (See the instructions for more information on Equivalent Hearings)
I would like an Equivalent Hearing - I would like a hearing equivalent to a CDP Hearing if my
request for a CDP hearing does not meet the requirements for a timely CDP Hearing.
8. Check the most appropriate box for the reason you disagree with the filing of the lien or the levy.
See page 4 of this form for examples. You can add more pages if you don't have enough space.
If, during your CDP Hearing, you think you would like to discuss a Collection Alternative to the
action proposed by the Collection function it is recommended you submit a completed Form
433A (Individual) and/or Form 433B (Business), as appropriate, with this form. See www.irs.gov
for copies of the forms. Generally, the Office of Appeals will ask the Collection Function to
review, verify and provide their opinion on any new information you submit. We will share their
comments with you and give you the opportunity to respond.
Collection Alternative
Installment Agreement Offer in Compromise I Cannot Pay Balance
Lien
Subordination WithdrawalDischarge
Please explain:
My Spouse Is Responsible
Innocent Spouse Relief (Please attach Form 8857,
Request for Innocent Spouse Relief, to your request.)
Other (For examples, see page 4)
Reason (You must provide a reason for the dispute or your request for a CDP hearing will not be honored. Use as
much space as you need to explain the reason for your request. Attach extra pages if necessary.):
9. Signatures
I understand the CDP hearing and any subsequent judicial review will suspend the statutory
period of limitations for collection action. I also understand my representative or I must sign and
date this request before the IRS Office of Appeals can accept it. If you are signing as an officer of
a company add your title (president, secretary, etc.) behind your signature.
SIGN HERE
Taxpayer 1's Signature Date
Taxpayer 2's Signature (if a joint request, both must sign) Date
I request my CDP hearing be held with my authorized representative (attach a copy of Form
2848)
Authorized Representative's Signature Authorized Representative's Name Telephone Number
IRS Use Only
IRS Employee (Print) Employee Telephone Number IRS Received Date
click to sign
signature
click to edit
click to sign
signature
click to edit
dd mmm yyyy
dd mmm yyyy
Information You Need To Know When Requesting A Collection Due Process Hearing
Form 12153 (Rev. 12-2013)
Catalog Number 26685D www.irs.gov Department of the Treasury - Internal Revenue Service
What Is the Deadline for Requesting a Timely Collection Due Process (CDP) Hearing?
• Your request for a CDP hearing about a Federal Tax Lien filing must be postmarked by the date indicated in
the Notice of Federal Tax Lien Filing and Your Right to a Hearing under IRC 6320 (lien notice).
• Your request for a CDP hearing about a levy must be postmarked within 30 days after the date of the Notice of
Intent to Levy and Notice of Your Right to a Hearing (levy notice) or Notice of Your Right to a Hearing After an
Actual Levy.
Your timely request for a CDP hearing will prohibit levy action in most cases. A timely request for CDP hearing will also
suspend the 10-year period we have, by law, to collect your taxes. Both the prohibition on levy and the suspension of the
10-year period will last until the determination the IRS Office of Appeals makes about your disagreement is final. The
amount of time the suspension is in effect will be added to the time remaining in the 10-year period. For example, if the
10-year period is suspended for six months, the time left in the period we have to collect taxes will be extended by six
months.
You can go to court to appeal the CDP determination the IRS Office of Appeals makes about your disagreement.
What Is an Equivalent Hearing?
If you still want a hearing with the IRS Office of Appeals after the deadline for requesting a timely CDP hearing has
passed, you can use this form to request an equivalent hearing. You must check the Equivalent Hearing box on line 7 of
the form to request an equivalent hearing. An equivalent hearing request does not prohibit levy or suspend the 10-
year period for collecting your taxes; also, you cannot go to court to appeal the IRS Office of Appeals' decision
about your disagreement. You must request an equivalent hearing within the following timeframe:
• Lien Notice—one year plus five business days from the filing date of the Notice of Federal Tax Lien.
• Levy Notice—one year from the date of the levy notice.
• Your request for a CDP levy hearing, whether timely or Equivalent, does not prohibit the Service from filing a
Notice of Federal Tax Lien.
Where Should You File Your CDP or Equivalent Hearing Request?
File your request by mail at the address on your lien notice or levy notice. You may also fax your request. Call the
telephone number on the lien or levy notice to ask for the fax number. Do not send your CDP or equivalent hearing
request directly to the IRS Office of Appeals, it must be sent to the address on the lien or levy notice. If you send
your request directly to Appeals it may result in your request not being considered a timely request. Depending
upon your issue the originating function may contact you in an attempt to resolve the issue(s) raised in your
request prior to forwarding your request to Appeals.
Where Can You Get Help?
You can call the telephone number on the lien or levy notice with your questions about requesting a hearing. The contact
person listed on the notice or other representative can access your tax information and answer your questions.
In addition, you may qualify for representation by a low-income taxpayer clinic for free or nominal charge. Our Publication
4134, Low Income Taxpayer Clinic List, provides information on clinics in your area.
If you are experiencing economic harm, the Taxpayer Advocate Service (TAS) may be able to help you resolve your
problems with the IRS. TAS cannot extend the time you have to request a CDP or equivalent hearing. See Publication
594, The IRS Collection Process, or visit www.irs.gov/advocate/index-html. You also can call 1-877-777-4778 for TAS
assistance.
Note–The IRS Office of Appeals will not consider frivolous requests. You can find examples of frivolous reasons for
requesting a hearing or disagreeing with a tax assessment in Publication 2105, Why do I have to Pay Taxes?, or at
www.irs.gov by typing “frivolous” into the search engine.
You can get copies of tax forms, schedules, instructions, publications, and notices at www.irs.gov, at
your local IRS office, or by calling toll-free 1-800-TAX-FORM (829-3676).
Information You Need To Know When Requesting A Collection Due Process Hearing
Form 12153 (Rev. 12-2013)
Catalog Number 26685D www.irs.gov Department of the Treasury - Internal Revenue Service
What Are Examples of Reasons for Requesting a Hearing?
You will have to explain your reason for requesting a hearing when you make your request. Below are examples of
reasons for requesting a hearing.
You want a collection alternative— “I would like to propose a different way to pay the money I owe.” Common
collection alternatives include:
• Full payment—you pay your taxes by personal check, cashier's check, money order, or credit card.
• Installment Agreement—you pay your taxes fully or partially by making monthly payments.
• Offer in Compromise—you offer to make a payment or payments to settle your tax liability for less than the full amount
you owe.
“I cannot pay my taxes.” Some possible reasons why you cannot pay your taxes are: (1) you have a terminal illness or
excessive medical bills; (2) your only source of income is Social Security payments, welfare payments, or unemployment
benefit payments; (3) you are unemployed with little or no income; (4) you have reasonable expenses exceeding your
income; or (5) you have some other hardship condition. The IRS Office of Appeals may consider freezing collection action
until your circumstances improve. Penalty and interest will continue to accrue on the unpaid balance.
You want action taken about the filing of the tax lien against your property—You can get a Federal Tax Lien
released if you pay your taxes in full. You also may request a lien subordination, discharge, or withdrawal. See
www.irs.gov for more information.
When you request lien subordination, you are asking the IRS to make a Federal Tax Lien secondary to a non-IRS lien.
For example, you may ask for a subordination of the Federal Tax Lien to get a refinancing mortgage on your house or
other real property you own. You would ask to make the Federal Tax Lien secondary to the mortgage, even though the
mortgage came after the tax lien filing. The IRS Office of Appeals would consider lien subordination, in this example, if
you used the mortgage proceeds to pay your taxes.
When you request a lien discharge, you are asking the IRS to remove a Federal Tax Lien from a specific property. For
example, you may ask for a discharge of the Federal Tax Lien in order to sell your house if you use all of the sale
proceeds to pay your taxes even though the sale proceeds will not fully pay all of the tax you owe.
When you request a lien withdrawal, you are asking the IRS to remove the Notice of Federal Tax Lien (NFTL)
information from public records because you believe the NFTL should not have been filed. For example, you may ask for
a withdrawal of the filing of the NFTL if you believe the IRS filed the NFTL prematurely or did not follow procedures, or you
have entered into an installment agreement and the installment agreement does not provide for the filing of the NFTL. A
withdrawal does not remove the lien from your IRS records.
Your spouse is responsible—“My spouse (or former spouse) is responsible for all or part of the tax liability.” You
may believe that your spouse or former spouse is the only one responsible for all or a part of the tax liability. If this is the
case, you are requesting a hearing so you can receive relief as an innocent spouse. You should complete and attach
Form 8857, Request for Innocent Spouse Relief, to your hearing request.
Other Reasons—“I am not liable for (I don't owe) all or part of the taxes.” You can raise a disagreement about the
amount you owe only if you did not receive a deficiency notice for the liability (a notice explaining why you owe taxes—it
gives you the right to challenge in court, within a specific timeframe, the additional tax the IRS says you owe), or if you
have not had another prior opportunity to disagree with the amount you owe.
“I do not believe I should be responsible for penalties.” The IRS Office of Appeals may remove all or part of the
penalties if you have a reasonable cause for not paying or not filing on time. See Notice 746, Information About Your
Notice, Penalty and Interest for what is reasonable cause for removing penalties.
“I have already paid all or part of my taxes.” You disagree with the amount the IRS says you haven't paid if you think
you have not received credit for payments you have already made.
See Publication 594, The IRS Collection Process, for more information on the following topics:
Installment Agreements and Offers in Compromise; Lien Subordination, Discharge, and Withdrawal;
Innocent Spouse Relief; Temporarily Delay Collection; and belief that tax bill is wrong.
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Completed 23 May 2019

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