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Fillable Form IRS 843

Taxpayers can use IRS Form 843 to ask the IRS to claim a refund or to ask for an abatement of certain kinds of taxes, penalties, fees, and interest.

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What is Form 843?

Form 843 or Claim for Refund and Request for Abatement form is an Internal Revenue Service (IRS) document that U.S. taxpayers use to claim a refund of certain assessed taxes or to request an abatement of interest, penalties, and fees, applied by the IRS.

In general, Form 843 is used by taxpayers to request an abatement of tax other than income, estate, or gift tax and to ask an abatement due to an IRS error or delay or written advice from the IRS. For refunds, use the form to request a refund of penalties you have paid, of taxes withheld by your employer in error — only if your employer refuses to do the necessary adjustments, and of penalties for misuse of dyed fuel.

You may file Form 843 within two years from the date when taxes were paid or three years when the return was filed, whichever is later. For each type of tax or fee for each tax year, you need to file a separate Form 843.

You cannot use Form 843 to request a refund of income tax or Additional Medicare Tax. In addition, you cannot use it to amend a previously filed income or employment tax return; to claim a refund of agreement fees, offer-in-compromise fees, or lien fees; and to request a refund of Federal Insurance Contributions Act (FICA) tax, Railroad Retirement Tax Act (RRTA), or income tax withholding.

While you can file Form 843 without difficulties, take note that the U.S. federal tax agency can give you a penalty if it believes that you are claiming an excessive refund amount. In general, a penalty is 20% of the amount determined to be excessive. You or your authorized representative can file Form 843. If an authorized representative will file the form for you, the original or copy of Form 2848 or Power of Attorney and Declaration of Representative should be attached.

How to Fill Out Form 843?

Form 843 is a single-page legal form. Just like other tax forms, it is straightforward and only asks information relevant to the transaction.

Follow the instructions below to complete Form 843 accurately.

Name(s)
Provide your full legal name. If a joint return, provide the full legal name of your spouse.

Your social security number
Provide the SSN assigned to you.

Address
Provide your current address.

Spouse’s social security number
If a joint return, provide the SSN of your spouse.

Employer identification number (EIN)
Provide the unique EIN of your employer.

Name and address shown on return if different from above
If your name and address on your return are different from the ones you have provided above, provide them here.

Daytime telephone number
Provide the telephone number that the IRS can use to contact you.

Number 1 — Period
Provide the tax period for which you are making the claim for refund or request for abatement. Prepare a separate Form 843 for each tax period or fee year.

Number 2 — Amount
Provide the amount to be refunded or abated.

Number 3 — Type of tax or fee
Mark the appropriate checkbox to determine the type of tax or fee to be refunded or abated. The claim can also be related to interest, penalty, or addition to tax. You may select Employment, Estate, Gift, Excise, Income, or Fee.

Number 4 — Type of penalty
Provide the applicable Internal Revenue Code section if you are requesting a refund or abatement of an assessed penalty. You can find the Code section on the Notice of Assessment you received from the IRS.

Number 5a and 5b — Interest, penalties, and additions to tax
In 5a, mark the appropriate checkbox that indicates the reason for the request for refund or abatement. You may indicate that 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, or a 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.

In 5b, provide the dates of payments.

Number 6 — Original return
If applicable, select the appropriate checkbox to show the type of fee or return to which your claim or request is relevant. The options are 706, 709, 940, 941, 943, 945, 990-PF, 1040, 1120, and 4720. Or you may just specify the fee or return in the provided space.

Number 7 — Explanation
Explain in detail your reasons for filing and show accurate computations that you made.

Signature
Sign the document and provide the date of signing. If applicable, provide your title. Claims by corporations must be signed by an officer.

If a joint return, your spouse should also provide his or her signature and the date of signing.

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