IRS 211 Template

IRS 211 Template

The IRS Form 211 is a document used to report information about potential tax fraud or misconduct. This form allows individuals to provide the IRS with details that may lead to the recovery of unpaid taxes. If you have information to share, consider filling out the form by clicking the button below.

Table of Contents

The IRS 211 form plays a significant role in the tax process, particularly for individuals seeking to resolve their tax debts. This form is primarily used to apply for a settlement offer, allowing taxpayers to negotiate a reduced payment amount with the Internal Revenue Service. By submitting the IRS 211, individuals can present their financial situation, including income, expenses, and assets, to support their request for a compromise. The form is designed to help those who may be struggling with tax liabilities find a manageable solution. Understanding the requirements and implications of this form is essential for anyone looking to navigate the complexities of tax resolution. Additionally, the IRS 211 form not only helps taxpayers communicate their needs but also provides the IRS with the necessary information to evaluate each case fairly. Overall, this form serves as a vital tool for achieving financial relief and moving forward with a fresh start.

IRS 211 Sample

 

Form 211

 

Department of the Treasury - Internal Revenue Service

 

OMB Number 1545-0409

 

 

Application for Award for

 

Date Claim received

 

 

 

 

 

 

 

(July 2018)

 

Original Information

 

Claim number (completed by IRS)

 

 

 

 

 

 

 

 

 

 

Section A – Information About the Person or Business You Are Reporting

 

 

1.

Is this

New submission or

Supplemental submission

2. Last 4 digits of Taxpayer Identification

 

If a supplemental submission, list previously assigned claim number(s)

Number(s) (e.g., SSN, ITIN, or EIN)

 

 

 

 

 

3.

Name of taxpayer (include aliases) and any related taxpayers who committed the violation

 

 

4. Taxpayer's address, including ZIP code

5. Taxpayer's date of birth or approximate age

6.Name and title and contact information of IRS employee to whom violation was first reported, if known

7.Alleged Violation of Tax Law (check all that apply)

Income Tax

Employment Tax

Estate & Gift Tax

Tax Exempt Bonds

Employee Plans

Governmental Entities

Exempt Organizations

Excise

Other (identify)

 

 

 

 

 

 

 

8.Describe the Alleged Violation. State all pertinent facts to the alleged violation. (Attach a detailed explanation and include all supporting information in your possession and describe the availability and location of any additional supporting information not in your possession.) Explain why you believe the act described constitutes a violation of the tax laws

9.Describe how you learned about and/or obtained the information that supports this claim. (Attach sheet if needed)

10.What is your relationship (current and former) to the alleged noncompliant taxpayer(s)? Check all that apply. (Attach sheet if needed)

 

Current Employee

Former Employee

 

Attorney

 

CPA

 

Relative/Family Member

Other (describe)

 

 

 

 

 

 

 

 

 

 

11.

Do you still maintain a relationship with the taxpayer

Yes

No

 

 

 

 

 

 

 

12.

If yes to number 11, describe your relationship with the taxpayer

 

 

 

 

 

 

 

13.

Are you involved with any governmental or legal proceeding involving the taxpayer

Yes

No

14.If yes to number 13, Explain in detail. (Attach sheet if needed)

15.Describe the amount of tax owed by the taxpayer(s). Provide a summary of the information you have that supports your claim as to the amount owed

(i.e. books, ledgers, records, receipts, tax returns, etc). (Attach sheet if needed)

16.Fill in Tax Year (TY) and Dollar Amount ($), if known

TY $TY $TY $TY $TY $

Section B – Information About Yourself

17.

Name of individual claimant

 

 

18.

Claimant's date of birth (MMDDYYYY)

19.

Last 4 digits of Claimant's SSN or ITIN

 

 

 

 

 

 

 

 

 

20.

Are you currently an IRS employee

Yes

No

21.

Are you the spouse or a dependent of an IRS employee

Yes

No

 

 

 

 

 

 

 

 

22.

Are you currently an IRS contractor

Yes

No

23.

Are you a Federal, State or Local Government employee

Yes

No

 

 

 

 

 

 

 

 

24.

Address of claimant, including ZIP code

 

 

 

 

25.

Telephone number (including area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26.

Email address

 

 

 

 

 

 

 

 

 

 

 

 

27.Declaration under Penalty of Perjury I declare that I have examined this application, all accompanying statement and supporting documentation, and, to the best of my knowledge and belief, they are true, correct, and complete

Signature of Claimant

Date

Catalog Number 16571S

www.irs.gov

Form 211 (Rev. 7-2018)

Page 2

Instructions for Form 211, Application for Award for Original Information

General Information: The Whistleblower Office has responsibility for the administration of the whistleblower award program under section 7623 of the Internal Revenue Code. Section 7623 authorizes the payment of awards from the proceeds of amounts the Government collects as a result of the information provided by the whistleblower. A claimant must file a formal claim for award by completing and sending Form 211, Application for Award for Original Information, to be considered for the Whistleblower Program.

Send completed form along with any supporting information to: Internal Revenue Service Whistleblower Office - ICE 1973 N. Rulon White Blvd. M/S 4110

Ogden, UT 84404

Instructions for Completion of Form 211:

Question 1 If you have not previously submitted a Form 211 regarding the same or similar non-compliant activities, or the taxpayer(s) identified in this information have no known relationship to the taxpayer(s) identified in a previously submitted Form 211, check the box for “new submission.”

If you are providing additional information regarding the same or similar non-compliant activities, and are identifying additional non- complaint activities by the same taxpayer(s), check the box for “supplemental submission.” If you are identifying additional taxpayers involved in the same or similar tax non-compliance identified on a previously submitted Form 211, and those additional taxpayers are related to the taxpayer(s) identified on a previously submitted Form 211, check the box for “supplemental submission.” If this is supplemental information, list previously assigned claim number(s).

Questions 2 – 5 Information about the Taxpayer – Provide the taxpayer’s name, address, taxpayer identification number – last 4 digits (if known), and the taxpayer’s date of birth or approximate age.

Question 6 If you reported the violation to an IRS employee; please provide the employee’s name, title and the date the violation was reported. If known, provide contact information.

Questions 7 - 8 Indicate the type of tax that has not been paid or the tax liability that has not been reported and describe the alleged violation. Explain why you believe the act described constitutes a violation of the tax laws. Attach all supporting documentation (for example, books and records) to substantiate the claim. If documents or supporting evidence are not in your possession, describe these documents and their location.

Questions 9 - 14 These questions ask how and when you learned of the alleged violation and what relationship, if any, you have to the taxpayer.

Questions 15 – 16 These questions are asking for an estimate of the tax owed and the years/periods that the tax applies.

Questions 17 – 26 Information about the claimant – Provide the claimant’s name, address, date of birth, SSN or ITIN (last 4 digits), email address, and telephone number.

Question 27 Information provided in connection with a claim under this provision of law must be made under an original signed Declaration under Penalty of Perjury. For joint or multiple claimants. Form 211 must be signed by each claimant.

Privacy Act and Paperwork Reduction Act Notice

We ask for the information on this form to carry out the internal revenue laws of the United States. Our authority to ask for this information is 26 USC 6109 and 7623. We collect this information for use in determining the correct amount of any award payable to you under 26 USC 7623. We may disclose this information as authorized by 26 USC 6103, including to the subject taxpayer(s) as needed in a tax compliance investigation and to the Department of Justice for civil and criminal litigation. You are not required to apply for an award. However, if you apply for an award you must provide as much of the requested information as possible. Failure to provide information may delay or prevent processing your request for an award; providing false information may subject you to penalties.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any internal revenue law. Generally, tax returns and return information are confidential, as required by 26 U.S.C. 6103.

The time needed to complete this form will vary depending on individual circumstances. The estimated average time is 45 minutes. If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can email us at *taxforms@irs.gov (please type "Forms Comment" on the subject line) or write to the Internal Revenue Service, Tax Forms Coordinating Committee, SE: W: CAR: MP: T: T: SP, 1111 Constitution Ave. NW, IR-6406, Washington, DC 20224.

Send the completed Form 211 to the above Ogden address of the Whistleblower Office. Do NOT send the Form 211 to the Tax Forms Coordinating Committee.

Catalog Number 16571S

www.irs.gov

Form 211 (Rev. 7-2018)

Document Attributes

Fact Name Description
Purpose The IRS Form 211 is used to submit a claim for an award for information provided to the IRS regarding tax violations.
Eligibility Individuals who provide specific and credible information about tax fraud or tax evasion may be eligible to file this form.
Submission Process Form 211 must be submitted to the IRS Whistleblower Office, and it is essential to include all necessary documentation to support the claim.
Governing Laws This form is governed by the Internal Revenue Code, specifically Section 7623, which outlines the provisions for whistleblower awards.

IRS 211: Usage Instruction

The IRS Form 211 is used to submit a claim for an award for information about violations of federal laws. After filling out the form, it is important to review the information provided and ensure that all necessary documentation is attached before submitting it to the IRS. Follow these steps to complete the form accurately.

  1. Obtain a copy of IRS Form 211 from the IRS website or your local IRS office.
  2. Begin by entering your personal information in the designated fields, including your name, address, and contact details.
  3. Provide information about the violation you are reporting. Be as detailed as possible, including dates, locations, and individuals involved.
  4. Clearly state how you obtained the information and any evidence you have to support your claim.
  5. If applicable, indicate whether you wish to remain anonymous. This can affect the processing of your claim.
  6. Sign and date the form to certify that the information provided is true and complete to the best of your knowledge.
  7. Gather any supporting documents that may strengthen your claim and attach them to the completed form.
  8. Make a copy of the completed form and any attachments for your records.
  9. Submit the form and attachments to the address specified in the form instructions.

Frequently Asked Questions

  1. What is the IRS Form 211?

    The IRS Form 211, also known as the "Application for Reward for Original Information," is used to report information about tax law violations. Individuals who provide substantial information that leads to the collection of taxes, penalties, or forfeitures may be eligible for a reward.

  2. Who can submit Form 211?

    Any individual with knowledge of tax fraud or other violations can submit Form 211. This includes employees, former employees, or anyone who has relevant information. However, the information must be original and not previously disclosed to the IRS.

  3. What type of information is considered for a reward?

    Information that leads to the detection of tax fraud, tax evasion, or other significant violations of tax law is considered for a reward. This can include evidence of underreported income, unreported income, or fraudulent deductions.

  4. How is the reward determined?

    The IRS determines the reward amount based on the value of the information provided. Generally, rewards can range from 15% to 30% of the amount collected as a result of the information. The specific percentage depends on various factors, including the significance of the information and the amount of tax collected.

  5. Is there a deadline for submitting Form 211?

    There is no specific deadline for submitting Form 211. However, it is advisable to submit the form as soon as possible after obtaining the information. Delays may affect the eligibility for a reward, especially if the IRS has already initiated an investigation.

  6. Will my identity be kept confidential?

    The IRS takes confidentiality seriously. While the information provided will be kept confidential, there are instances where the identity of the informant may be disclosed in legal proceedings. Individuals concerned about anonymity should consider this before submitting a claim.

  7. How do I submit Form 211?

    Form 211 can be submitted by mailing it to the IRS Whistleblower Office. It is essential to follow the instructions carefully and provide all necessary information to ensure the submission is complete.

  8. Can I submit Form 211 anonymously?

    While it is possible to submit Form 211 without revealing your identity, providing personal information can help the IRS assess the claim more effectively. Anonymity may limit communication regarding the status of the claim.

  9. What happens after I submit Form 211?

    After submission, the IRS reviews the information provided. If the information is deemed valuable, the IRS may open an investigation. The informant will receive updates on the status of the claim, but specific details about the investigation may not be disclosed.

  10. Are there any risks associated with submitting Form 211?

    Submitting Form 211 can carry risks, especially if the information involves a former employer or associates. There may be concerns about retaliation or legal repercussions. It is crucial to weigh these risks against the potential rewards before proceeding.

Common mistakes

Filling out the IRS Form 211, which is used to claim a reward for information about tax fraud, can be a straightforward process. However, many individuals make common mistakes that can lead to delays or even rejection of their claims. Understanding these pitfalls can help ensure that your submission is successful.

One frequent mistake is incomplete information. Many people fail to provide all the required details about the fraud they are reporting. This includes not only the specifics of the fraudulent activity but also the identity of the individuals involved. Omitting critical information can hinder the IRS's ability to investigate the claim effectively.

Another common error is failing to sign the form. A signature is necessary to validate the submission. Without it, the IRS may consider the form invalid, which can lead to a denial of the claim. It’s crucial to remember that both the whistleblower and any witnesses must sign the form if applicable.

Some individuals also make the mistake of not providing sufficient evidence to support their claims. The IRS requires concrete evidence to take action on any report of tax fraud. Providing only vague allegations without supporting documentation can result in the claim being dismissed.

Additionally, people often ignore the deadlines for submitting Form 211. There are specific timeframes within which claims must be filed. Missing these deadlines can mean losing the opportunity to receive a reward for reporting fraud.

Another mistake is inaccurate personal information. Providing incorrect contact details can prevent the IRS from reaching you for follow-up questions or updates regarding your claim. Ensure that all personal information is accurate and up-to-date.

Many individuals also underestimate the importance of clarity in their descriptions of the fraud. Using technical jargon or overly complex language can confuse the IRS reviewers. Clear and concise descriptions are more likely to be understood and acted upon.

Some claimants fail to keep copies of their submissions. This is a critical oversight. Keeping a copy of the submitted form and any accompanying documents can be invaluable if there are questions or if follow-up is needed.

Another common issue is not following the instructions provided by the IRS. Each section of the form has specific requirements. Ignoring these instructions can lead to incomplete or incorrect submissions.

Finally, some individuals do not seek assistance when needed. Navigating the complexities of tax fraud reporting can be daunting. Consulting with a tax professional or legal expert can provide clarity and increase the chances of a successful claim.

Documents used along the form

The IRS Form 211, also known as the "Application for Award for Original Information," is used by individuals to report information about tax violations. When submitting this form, several other documents and forms may be necessary to support the application or provide additional context. Below is a list of other commonly used forms and documents that may accompany the IRS Form 211.

  • Form 1040: This is the U.S. Individual Income Tax Return form. It is used by individuals to report their annual income, calculate taxes owed, and claim refunds or credits.
  • Form 1099: A series of forms used to report various types of income other than wages, salaries, and tips. Different versions exist for different income types, such as interest or freelance work.
  • Form W-2: This form reports an employee's annual wages and the amount of taxes withheld from their paycheck. Employers must provide this to their employees for tax reporting purposes.
  • Form 3949-A: This is used to report suspected tax fraud or tax law violations. Individuals can provide information about tax evasion or other illegal activities using this form.
  • Form 8852: This form is for taxpayers who want to request a change in their accounting period. It is relevant when the reporting period affects the information reported on Form 211.
  • Form 8862: This form is used to claim the Earned Income Credit after it has been denied in a previous year. If relevant, it can support claims made in Form 211.
  • Form 4506: This form allows individuals to request a copy of their tax return from the IRS. It can be useful for providing evidence or context when reporting information on Form 211.
  • Form 8821: This form designates a third party to receive confidential tax information. It may be necessary if someone else is assisting in the reporting process.
  • Form 843: Used to claim a refund or request an abatement of certain taxes, penalties, or interest. This can provide context for the information reported in Form 211.

Each of these forms serves a specific purpose and can provide valuable information when submitting the IRS Form 211. Understanding these documents will help ensure that the application is complete and thorough, increasing the likelihood of a favorable outcome.

Similar forms

The IRS Form 211 is used for reporting information related to whistleblower claims. It allows individuals to report tax fraud or other violations of tax laws. Here are ten other documents that share similarities with Form 211:

  • IRS Form 3949-A: This form is also used to report suspected tax fraud or tax law violations, making it a direct alternative for whistleblowers.
  • IRS Form 14039: This form is utilized for reporting identity theft related to tax matters, helping individuals protect themselves and report fraudulent activity.
  • IRS Form 8821: This document allows individuals to authorize someone else to receive and inspect their tax information, similar to how whistleblowers may need representation.
  • IRS Form 4506: This form requests a copy of tax returns, which can be necessary for individuals gathering evidence to support a whistleblower claim.
  • IRS Form 1040: As the standard individual income tax return, it is essential for anyone involved in tax matters, including those reporting fraud.
  • IRS Form 1065: This is the partnership return, and it may be relevant for whistleblowers reporting on partnerships involved in tax violations.
  • IRS Form 990: Nonprofits use this form to report financial information. Whistleblowers may report discrepancies or fraud within these organizations.
  • IRS Form 941: Employers use this form to report payroll taxes. Whistleblowers may report employers who misreport payroll tax obligations.
  • IRS Form 1120: This is the corporate income tax return, and it can be relevant for whistleblowers reporting corporate tax fraud.
  • IRS Form 1099: Used for reporting various types of income, this form can be involved in cases of misreported income or fraud.

Dos and Don'ts

When filling out the IRS 211 form, it is important to follow certain guidelines to ensure accuracy and compliance. Here are some things you should and shouldn't do:

  • Do read the instructions carefully before starting the form.
  • Do provide accurate and complete information to avoid delays.
  • Do keep a copy of the submitted form for your records.
  • Do check for any required signatures before submitting.
  • Don't leave any fields blank unless instructed to do so.
  • Don't use incorrect or outdated forms; always use the latest version.
  • Don't submit the form without verifying all information is correct.
  • Don't forget to follow up if you do not receive a response in a reasonable time frame.

Misconceptions

Understanding the IRS Form 211 can be challenging, and several misconceptions often arise. Here are eight common misunderstandings regarding this form:

  • Form 211 is only for large businesses. Many believe that only corporations or large businesses can file Form 211. In reality, individuals and small businesses can also use it to report information.
  • You must have a lawyer to file Form 211. While having legal representation can be beneficial, it is not a requirement. Individuals can file the form on their own if they feel comfortable doing so.
  • Form 211 guarantees a reward. Some people think that submitting this form automatically entitles them to a reward. However, the IRS evaluates each submission on its merits, and a reward is not guaranteed.
  • All tips reported will be kept confidential. While the IRS strives to protect the identity of informants, there are circumstances where information may be disclosed, especially if legal action is taken.
  • Filing Form 211 will lead to immediate action by the IRS. Submitting the form does not mean the IRS will act right away. Investigations can take time, and the agency will assess the information before proceeding.
  • You can only report tax fraud. Many think that Form 211 is limited to tax fraud cases. However, it can also be used to report other types of misconduct related to tax laws.
  • Form 211 is only for reporting individuals. Some believe that the form is exclusively for reporting individuals. In fact, it can also be used to report businesses that are violating tax laws.
  • You must provide extensive evidence to file Form 211. While supporting evidence is helpful, you do not need to have all the proof in hand to submit the form. A credible tip can still be valuable to the IRS.

By clarifying these misconceptions, individuals can better understand the purpose and process of IRS Form 211, ensuring they make informed decisions when considering filing.

Key takeaways

The IRS Form 211 is an important document for individuals who wish to report information regarding tax fraud. Here are some key takeaways to keep in mind when filling out and using this form:

  • Purpose: The form is used to report suspected tax fraud or tax evasion to the IRS.
  • Anonymity: You can choose to remain anonymous when submitting the form, but providing your contact information can help the IRS follow up if needed.
  • Eligibility for Reward: If your information leads to the collection of taxes, you may be eligible for a reward.
  • Detailed Information: Provide as much detail as possible about the suspected fraud to assist the IRS in their investigation.
  • Submission: The completed form can be mailed to the IRS or submitted electronically, depending on your preference.
  • Confidentiality: The information you provide is kept confidential and will not be disclosed to the public.
  • Follow-Up: After submission, you may not receive updates on the status of your report due to privacy laws.
  • Legal Protection: Reporting suspected fraud protects the integrity of the tax system and helps ensure fairness for all taxpayers.
  • Seek Guidance: If you have questions about the form or the process, consider consulting a tax professional for assistance.

Taking these points into account can help ensure that your submission is thorough and effective. Your efforts contribute to maintaining the integrity of the tax system.