Form 6118 Claim of Income Tax Return Preparers

OMB No. 1545-0240 (Rev. August 1995)

Department of the Treasury

Internal Revenue Service © See instructions on page 2.

Name of preparer 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)

Please Print or Type

E

Type of Penalty (Enter letter in column (c) below.)

Failure to furnish identifying number—section 6695(c) A Understatements due to unrealistic positions—section 6694(a)

F Failure to retain copy or list—section 6695(d)

G Failure to file a record of return preparers—section 6695(e)(1)

Willful or reckless conduct (intentional disregard of rules and

regulations)—section 6694(b)

B

H Failure to include an item in the required record of return

preparers—section 6695(e)(2)

Failure to furnish copy of return or claim for refund to taxpayer—

section 6695(a)

C

D Failure to sign return or claim for refund—section 6695(b) I Negotiation of check—section 6695(f)

Identification of Penalties (See Specific Instructions.)

(f)

Form

number

(g)

Tax 

year

(c)

Type of

penalty

(b)

Date of

statement

(a)

Statement document

locator number

1

2

3

4

5

6

7

8

9

10

11

12

13

14

(i)

Amount 

paid

(j)

Date paid

(mo., day, yr.)

(h)

Amount

assessed

(d)

Name(s) of taxpayer(s)

Amount of Claim (Enter the total of column (i), lines 1 through 14.) ©

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.

Signature © Date ©

For Paperwork Reduction Act Notice, see back of form. Cat. No. 24415J Form 6118 (Rev. 8-95)

(e)

Taxpayer’s identification

number

1

2

3

4

5

6

7

8

9

10

11

12

13

14

© For Penalties Assessed Under IRC Sections 6694 and 6695.
Form 6118 (Rev. 8-95) Page 2

Paperwork Reduction Act Notice

We ask for the information on this form to carry out the

Internal Revenue laws of the United States. You are required

to give us the information. We need it to ensure that you are

complying with these laws and to allow us to figure and

collect the right amount of tax.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated

average time is:

Where and When To File

Recordkeeping 13 min.

File Form 6118 with the IRS service center or IRS district

office that sent you the statement(s). Generally, your claim

must be filed within 3 years from the date you paid the

penalty. Learning about the law or the form 11 min.

Preparing the form 8 min.

Copying, assembling, and sending

the form to the IRS 20 min.

Specific Instructions

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, Attention: Tax Forms Committee,

PC:FP, Washington, DC 20224. DO NOT send this form to

this address. Instead, see Where and When To File below.

Identifying Number

General Instructions

Section references are to the Internal Revenue Code unless

otherwise noted.

Purpose of Form Additional Information

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

next to it. You may use the space below to do this. If you

need additional space, attach a separate sheet. Be sure to

write your name and identifying number on each sheet.

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 under Type of Penalty, you may combine

certain of the penalties on one Form 6118 for:

1. Penalties G and H, only if you were billed for them on

the same statement.

2. Penalties C, D, E, and F, only if the penalties were

imposed by the same IRS office. It does not matter if these

penalties were billed separately. However, you must file a

separate Form 6118 for each IRS district office and each IRS

service center. If you file one claim for penalties that were

You must file a separate Form 6118 for each penalty A, B,

and I. A separate form must be filed even if you were

charged for two or more of the same type.

Identification of Penalties

Be sure to enter in columns (a) and (b) the document locator

number (DLN) and the date from each penalty statement.

Enter in column (c) the identifying letter (A through I) listed

under Type of Penalty. Using the information shown on the

statements, complete columns (d)–(h) for each penalty. Then

complete columns (i) and (j) for the amount paid and date.

Printed on recycled paper

File 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.

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.

You may want to attach a copy of the penalty statements to

your claim.

billed separately, be sure to group the penalties from each

statement together.