Form 12508 

(July 2008) Questionnaire for Non-Requesting Spouse

We recognize that some of these questions involve sensitive subjects. However, we need this information to evaluate 

the circumstances of the claim and properly determine whether relief should be given. If this form is not completed 

and returned, the claim will be considered based on the information available to us. 

Questions? 

Call the IRS at 1-866-897-4270. 

Part I Tell us about yourself 

1. Your Current Name Your Social Security Number 

Your Current Home Address (number & street) Apt. No. County 

City, town or post office box, state and ZIP code Best daytime phone number 

( ) 

2. What is the current status between you and your spouse for the years that relief was requested? (On this 

form we refer to your spouse for the years that relief was requested as that individual.) 

Married and living together 

Married living apart since 

MM 

/ 

DD 

/ 

YYYY 

Legally separated since 

MM 

/ 

DD 

/ 

YYYY 

Divorced since 

MM 

/ 

DD 

/

YYYY 

Widowed since 

MM 

/ 

DD 

/

YYYY 

Note: A divorce decree stating you must pay all taxes does not necessarily mean that individual will qualify for relief. 

Part II Tell us about filing the returns and your financial situation for the years listed on the letter. If the 

information is not the same for all tax years, please explain. If you need more room to write your 

answer for any question, attach more pages. Be sure to write your name and social security number 

on the top of all pages you attach. 

3. How were both of you involved with preparing the returns during those tax years? Check all that apply and explain, 

if necessary. If the answers are not the same for all the years, explain. 

You That Individual 

Prepared or helped prepare the returns. 

Gathered receipts and canceled checks. 

Gave tax documents (such as W-2s, 1099s, etc.) to the person who prepared the returns. 

Asked the person who prepared the returns to explain any items or amounts. 

Reviewed the returns before signing them. 

Did not review the returns before signing them. 

Other 

Explain, if necessary 

Form 12508 (Rev. 7-2008) Catalog Number 28730P www.irs.gov Page 1 of 3 Department of the Treasury – Internal Revenue Service 
4. When you signed the returns, were any amounts owed to the IRS for those years? 

Yes. Explain how the amounts owed were to be paid. 

No 

5. When that individual signed any of the returns, was he/she aware of any financial problems you were having (for 

example, bankruptcy or bills you could not pay)? 

Yes. Explain 

No 

Do not know 

6. For those years, what kinds of accounts did you have? Check all that apply. Explain if the answers are not the 

same for all the years. 

Joint Separate 

Checking or money market 

Savings or certificate of deposit 

How did that individual use those accounts? Check all that apply. 

Joint Separate 

Made deposits 

Reviewed bank statements or balanced the checkbook 

Paid bills 

Knew how much money was in the account 

Made withdrawals from the account 

Did not know about the account 

Did not use the account 

Was not involved in handling money for the household 

Explain, if necessary 

7. Did you ever transfer assets to that individual? (Did you put something of value, such as real estate or stocks, in that 

individual's name rather than in your own name?) 

Yes. List the assets and the dates they were transferred. Explain why the assets were transferred. 

No 

8. During those tax years, were you self employed? 

Yes. Explain how that individual was involved in your business. 

No 

Form 12508 (Rev. 7-2008) Catalog Number 28730P Page 2 of 3 Department of the Treasury – Internal Revenue Service 
9. If no tax year(s) in question were audited, what items, if any, changed? Were the changed items yours or that 

individual’s? (For example, unreported income, disallowed deductions, unclaimed credits) 

10. If the audit results changed your business income or deductions on your tax return, did that individual help you in 

the business? If so how? If not , did that individual know about your business affairs? Explain. 

11. If the items changed by the audit were yours, did that individual benefit from them? (Example, unreported income 

paid for a family vacation, car, jewelry, etc.) Explain. 

12. Do you have any other information you want us to consider? 

SIGN 

HERE 

Under penalties of perjury, I declare that I have examined this statement and to the best of my knowledge it 

is true, correct, and complete. 

Signature Date 

Keep a copy for your records and return 

the original in the enclosed envelope. 

Form 12508 (Rev. 7-2008) Catalog Number 28730P Page 3 of 3 Department of the Treasury – Internal Revenue Service