SOI-614 AUR Non-Response Interviews 2024 - Attachment 3

Campus Examination Interview Consent Form

You are being asked to participate in an interview conducted by Fors Marsh regarding your experiences receiving a CP2000 Notice and Statutory Notice of Deficiency from the Internal Revenue Service (IRS). A CP2000 Notice is sent to IRS taxpayers whose tax returns have been adjusted, while a Statutory Notice of Deficiency indicates that a taxpayer owes additional income tax. This information sheet describes the purpose, procedures, benefits, risks, and precautions of the interview. It also describes your right to withdraw from the interview at any time. A member of the Fors Marsh team is available to read through this information sheet with you and discuss all the information if you wish.

Why is this interview being done?

This interview is being done to learn more about taxpayers’ experiences with the CP2000 Notice and Statutory Notice of Deficiency, including taxpayers’ interpretations of the notices, actions taken because of the notices, and any contact taxpayers had with the IRS as a result of the notices. The feedback from the interview may help the IRS improve communication and outreach to taxpayers.

What do I need to know about this interview?

This opportunity is being offered to people who received a CP2000 Notice and Statutory Notice of Deficiency and are willing to share information about their experiences with the notices.

The interview will last 60 minutes. You will speak with a moderator virtually via [Microsoft Teams | Zoom]. Participants will need access to a laptop, desktop, or tablet to view screenshared materials. Other staff and IRS employees may listen to the interview during sessions, so we request that participants use only their first names and do not use video during the interview. Participants are expected to discuss their interpretation of the notices they received and the actions they took in response to the notices.

What are the potential risks of participating in this interview?

There are no known risks associated with this interview. Participants will complete the interview via [Microsoft Teams | Zoom], sharing their experiences and thoughts regarding the notices they received and communications with the IRS. You do not have to answer any questions that you do not wish to answer. We will only be using first names in the interview and will not be using video. Your name will not be used in any reports and no quotes will be associated with your identity. Your standing with the IRS will not be affected by your participation in this interview.

Does participating in this interview provide any benefit?

Participants will receive an electronic gift card in the amount of $100 as compensation for participation in the interview. The feedback from the interview may help improve the IRS’s communication with people whose income taxes require adjustment.

Will it cost me anything to participate in this interview?

There are no costs for you to participate in the interview.

Do I have to participate in this interview?

Your participation is voluntary. There are no penalties associated with refusal to participate, and you can withdraw at any time. However, your participation is encouraged to get a wider range of feedback from people who received these notices.

Who will have access to the recordings from the interview and/or my contact information?

Only Fors Marsh and IRS staff working on this project will have access to the audio recordings from the interview. Only Fors Marsh will have access to your contact information.

Who do I contact if I have questions about the Campus Examination Interviews?

If you have questions or concerns about the interview, you can contact Hunter Peebles at [email protected].

Your signature below indicates that you understand the conditions stated above and agree to participate and be audio recorded in this interview. You may request a copy of this consent form to keep for your records.

Signature: _____________________________________ Date: ________________

The Paperwork Reduction Act requires that IRS provide an OMB Control Number on all approved public information requests. That number is OMB# 1545-1349. You may send comments and questions regarding this process or suggestions for making it simpler to the following name and address: Internal Revenue Service, Special Services Section, SE:W:CAR:MP:T:M:S, Room 6129, 1111 Constitution Avenue, NW, Washington, DC 20224.