Transcription of Form 9423 Collection Appeal Request
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Form 9423 Collection Appeal Request
form 9423 (Rev. 8-2014) Catalog Number 14169 IDepartment of the Treasury - internal revenue Taxpayer s name2. Representative (Attach a copy of form 2848, Power of Attorney)3. SSN/EIN4. Taxpayer s business phone5. Taxpayer s home phone6. Representative s phone7. Taxpayer s street address8. City9. State10. ZIP code11. Type of tax (Tax form )12. Tax periods being appealed13. Tax dueCollection Action(s) Appealed14. Check the Collection action(s) you are appealingFederal Tax LienLevy or Proposed LevySeizureRejection of Installment AgreementTermination of Installment AgreementModification of Installment AgreementExplanation15. Explain why you disagree with the Collection action(s) you checked above and explain how you would resolve your tax problem. Attach additional pages if needed. Attach copies of any documents that you think will support your position.
Form. 9423 (Rev. 8-2014) Department of the Treasury - Internal Revenue Service. Catalog Number 14169I. www.irs.gov. Instructions for Form 9423, Collection Appeal Request
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