Form 6118 Claim for Refund of Income Tax Return

Preparer Penalties OMB No. 1545-0240 (Rev. January 2001)

Department of the Treasury

Internal Revenue Service  See instructions on page 2.

Name of preparer Taxpayer identification number

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)

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 I Negotiation of check—section 6695(f)

D Failure to sign return or claim for refund—section 6695(b)

Identification of Penalties. Enter the information from your statement.

(f)

Form

number

(g)

Tax 

year

(c)

Type of

penalty

(b)

Date of

statement

(a)

Statement document

locator number (DLN)

1

2

3

4

5

6

7

8

9

10

11

12

(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 12 

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.

Date

Sign

Here

For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 24415J Form 6118 (Rev. 1-2001)

(e)

Taxpayer’s identification

number

1

2

3

4

5

6

7

8

9

10

11

12

 For Penalties Assessed Under IRC Sections 6694 and 6695.

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) 

See instructions.

 Signature 
Form 6118 (Rev. 1-2001) Page 2

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.

The time needed to complete and file this form will vary

depending on individual circumstances. The estimated

average time is: Recordkeeping, 13 min.; Learning about

the law or the form, 16 min.; Preparing the form, 10 min.;

and Copying, assembling, and sending the form to the

IRS, 20 min.

Where and When To File

File Form 6118 with the IRS service center or IRS office that

sent you the statement(s). Generally, your claim must be filed

within 3 years from the date you paid the penalty.

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

Tax Forms Committee, Western Area Distribution Center,

Rancho Cordova, CA 95743-0001. Do not send this form to

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

Taxpayer Identification Number (TIN)

General Instructions

Section references are to the Internal Revenue Code unless

otherwise noted.

Purpose of Form

Additional Information

For additional information about refunds of preparer

penalties, see Regulations section 1.6696–1.

Claims for More Than One Penalty

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.

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. 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.

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.

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.

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.

Type of Penalty

For K, 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.

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