Form 6524 Office of Chief Counsel - Application

Office of Chief Counsel - Application
1. Name and permanent address of applicant (Including ZIP code)

6. Temporary address of applicant (including ZIP code)

O.M.B. No. 1545-0796

2. Date of birth

3. Social Security Number

4. Telephone number

5. E-Mail Address

6a. Until (Date)
6b. Telephone number

7. Have you passed a Bar exam?
Have you been admitted to a Bar?

Yes
Yes

8. State

No
No

9. Date

11. Bar plans

12. Citizen of what country

14. Law school

15. Graduation date

10. Lowest pay or grade acceptable
13. LSAT score

16. Class standing (% rank) 17. Date available

18. Activities and honors (Law Review, Coif, Legal Aid, employment while in school, etc. Continue on a separate sheet if necessary.)

19. College(s)

Dates attended

Major

Degree

20. Activities and honors (Honorary societies, awards, etc.)

21. Graduate school (LL.M. or other degree) Graduation date

Class standing (% rank)

Degree

22. Tax, accounting or other legal experience (Include writing, jobs, special studies, course work, or research. Continue on a separate sheet
if necessary.)

23. If currently employed, list name, address and telephone number of employer
(Including ZIP and area code)

24. Dates of employment
25. Salary/Earnings
26. Name and title of immediate supervisor

27. Reason for wanting to leave

28. Description of work (Continue on a separate sheet if necessary.)

29. May we ask your current employer about your character, qualifications, and employment record?

Yes

No

30. Desired employment location(s)

Form 6524 (Rev. 11-2000)

Cat. No. 61948P

www.irs.ustreas.gov

Department of the Treasury-Internal Revenue Service

31. Military service

32. Type of work
Please check off all areas which interest you. Rank them in order (1, 2, 3, etc.) ONLY if you have specific preferences.
Field Component: (Throughout U.S.)
General legal Services

National Office: (Washington D.C. Area)
Corporate
Income Tax & Accounting

Criminal Tax
Tax Exempt/Government Entities

Financial Institutions & Products

Small Business/Self Employed

Passthroughs & Special Industries
Procedures & Administration
General Legal Services

Large & Mid-Size Business

Tax Exempt/Government Entities
Small Business/Self Employed

International Tax
Advanced Pricing Agreement Program

Large & Mid-Size Business
Wage & Investment(Atlanta only)

Criminal Tax

Wage & Investment
33. References (include complete mailing address and daytime phone number)
1.
2.
3.
See notice required by Privacy Act of 1974.
Signature

Date

Privacy Act and Paperwork Reduction Act Notice
General
This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974), December 31, 1974, for individuals completing the Chief Counsel
Application Form. This notice is applicable to all requests made to you to submit information under the Chief Counsel application process.
Authority
The authority to collect the information requested under the Chief Counsel application process is derived from 5 U.S.C. 301, and 26 U.S.C. 7801.
However, disclosure is voluntary.
Purposes and Uses
The information you supply will be used principally to evaluate your qualifications for employment. This information may be furnished:
1. to the Office of Personnel Management for appropriate personnel actions;
2. to members of Congress for the purpose of answering congressional inquiries in cases in which confidentiality has been waived by the individual;
3. to the Department of Justice for the purpose of litigating an action or seeking legal advice;
4. an apparent violation of the law may be referred to the appropriate law enforcement authorities for investigation of possible criminal prosecution,
civil court action, or regulatory order;
5. to a Federal State, or local agency maintaining civil, criminal or other relevant enforcement information or other pertinent information, such as
current licenses, if necessary to obtain information relevant to an agency decision concerning the hiring or retention of an employee, the issuance of a
security clearance, the letting of a contract, or the issuance of a license, grant or other benefit;
6. to a Federal agency, in response to its request, in connection with the hiring or retention of an employee, the issuance of a security clearance, the
reporting of an investigation of an employee, the letting of a contract, or the issuance of a license, grant, or other benefit by the requesting agency, to the
extent that the information is relevant and necessary to the requesting agency's decision on the matter.
Effect of Nondisclosure
You are not required to supply the information requested in the application process. However, the effect of not providing all of the information
requested could be rejection of your application for employment. A false answer to any question on the application form is punishable by law under 18
U.S.C. 1001.
Applicants are encouraged to retain this Notice for future reference as to their rights under the Privacy Act.
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 Code section 6103.
The time needed to complete this form will vary depending on individual circumstances. The estimated average time is 18 minutes.
If you have comments concerning the accuracy of this time estimate or suggestions for making this form simpler, we would be happy to hear from
you. You can write to the Tax Forms Committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. DO NOT send this form to this
office. Instead, send this form to the Office of Chief Counsel, Attorney Recruitment Unit, Room 4032, CC:F&M:PPO:W, 1111 Constitution Ave.,
NW, Washington, DC 20224.
Additional Remarks

Form 6524 (Rev. 11-2000)

Cat. No. 61948P

www.irs.ustreas.gov

Department of the Treasury-Internal Revenue Service