Form 6118 Claim for Refund of Income Tax Return Preparer Penalties

5
TLS, have you
transmitted all R
text files for this
cycle update?

Date

I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 6118, PAGE 1 of 2
MARGINS: TOP 13mm (1⁄2 ") CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (81⁄2 ")
279mm (11")
PERFORATE: (NONE)
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

6118

Form

(Rev. June 2005)
Department of the Treasury
Internal Revenue Service

Action

Revised proofs
requested

Claim for Refund of Income Tax Return
Preparer Penalties
䊳

Signature

O.K. to print

OMB No. 1545-0240

For Penalties Assessed Under IRC Sections 6694 and 6695.
䊳 See instructions on page 2.

Name of preparer

Print or Type

Date

Identifying number
See instructions.

Address to which statement(s) of notice and demand were mailed

City, town or post office, state, and ZIP code

IRS office that sent statement(s)

Address of preparer shown on return(s) for which penalties were assessed (if different from above)

Type of Penalty. Enter letter in column (c) below.
A Understatements due to unrealistic positions—section 6694(a)
B Willful or reckless conduct (intentional disregard of rules and
regulations)—section 6694(b)
C Failure to furnish copy of return or claim for refund to taxpayer—
section 6695(a)
D Failure to sign return or claim for refund—section 6695(b)
E Failure to furnish identifying number—section 6695(c)
F Failure to retain copy or list—section 6695(d)

G Failure to file a record of return preparers—section 6695(e)(1)
H Failure to include an item in the required record of return
preparers—section 6695(e)(2)
I Negotiation of check—section 6695(f)
J Failure to exercise due diligence in determining eligibility for,
and/or amount of, the earned income credit—section
6695(g)
K Other (specify) (see instructions)

䊳

Identification of Penalties. Enter the information from your statement.
(a)
Statement document
locator number (DLN)

(b)
Date of
statement

(c)
Type of
penalty

(e)
Taxpayer’s identification
number

(f)
Form
number

(g)
Tax
year

(d)
Name(s) of taxpayer(s)

1
2
3
4
5
6
7
8
9
10
11
12
(i)
Amount
paid

(h)
Amount
assessed

(j)
Date paid
(mo., day, yr.)

1
2
3
4
5
6
7
8
9
10
11
12

Amount of Claim. Enter the total of column (i), lines 1 through 12
Sign
Here

䊳

Under penalties of perjury, I declare that I have examined this claim, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct, and complete.

䊳

Signature

For Privacy Act and Paperwork Reduction Act Notice, see back of form.

䊳

Date
Cat. No. 24415J

Form

6118

(Rev. 6-2005)

5
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 6118, PAGE 2 of 2
MARGINS: TOP 13mm (1⁄2 ") CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (81⁄2 ")
279mm (11")
PERFORATE: (NONE)
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 6118 (Rev. 6-2005)

Page

2

General Instructions

Additional Information

Section references are to the Internal Revenue Code unless
otherwise noted.

You may want to attach a copy of the penalty statements to
your claim. In addition to completing the form, you must give
your reasons for claiming a refund for each penalty listed.
Identify each penalty by its line number and write your
explanation in the space below.

Purpose of Form
Use Form 6118 if you are a tax return preparer and want to
claim a refund of preparer penalties you paid but that you
believe were incorrectly charged.

For additional information about refunds of preparer
penalties, see Regulations section 1.6696-1.

Claims for More Than One Penalty
If you are claiming a refund for more than one of the
penalties listed, you may be able to combine some of the
penalties on one Form 6118. Follow the chart below for
combining the penalties. See Type of Penalty on the form for
the list of penalties.
IF you were billed...

THEN combine penalties...

On the same statement

G and H only

On separate statements
but by the same IRS office
or service center

C, D, E, and F only
Note. Be sure to group the
penalties from each
statement together.

You cannot combine:
● Penalties from different IRS offices or service centers. See
When and Where To File below.
● Penalties A, B, I, J, and K. You must file a separate Form
6118 for each of these even if you were charged for two or
more of the same type.

Where and When To File
File Form 6118 with the IRS service center or IRS office that
sent you the statement(s). Your claim under sections 6694 and
6695 must be filed within 3 years from the date you paid the
penalty. Your claim under sections 6700 and 6701 must be
filed within 6 years from the date you paid the penalty.

Specific Instructions
Identifying Number
If you are self-employed or employed by another preparer,
enter your social security number. If you are the employer of
other preparers, enter your employer identification number.

Type of Penalty
For item K (other penalties), enter the name of the penalty
and the corresponding Internal Revenue Code section. These
other penalties include promoting abusive tax shelters under
section 6700 and aiding and abetting an understatement of
tax liability under section 6701.

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. Subtitle F, Procedure and
Administration, allows for additions to tax, additional
amounts, and assessable penalties. This form is used by
return preparers to make a claim for refund of any overpaid
penalty amount. Section 6696 requires the return preparer to
provide the requested information including his taxpayer
identification number (SSN or EIN) within the prescribed time
for filing a claim for refund. Routine uses of this information
include giving it to the Department of Justice for civil and
criminal litigation, and to cities, states, and the District of
Columbia for use in administering their tax laws.
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 section 6103. However, section
6103 allows or requires the Internal Revenue Service to
disclose or give the information shown on your return to
others as described in the Code. For example, we may
disclose your tax information to the Department of Justice for
civil and criminal litigation, and to cities, states, and the
District of Columbia for use in administering their tax laws. We
may also disclose this information to other countries under a
tax treaty, to federal and state agencies to enforce federal
nontax criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is: Recordkeeping, 6 min.; Learning about the
law or the form, 17 min.; Preparing the form, 11 min.; and
Copying, assembling, and sending the form to the IRS,
20 min.
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 write to the
Internal Revenue Service, Tax Products Coordinating
Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
NW, IR-6406, Washington, DC 20224. Do not send this form
to this address. Instead, see Where and When To File above.

Reasons for claiming refund. Attach additional sheets if more space is needed. Write your name and Identifying number on each sheet.