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Official form guide
Form 12009: Request for an Informal Conference and Appeals Review
Internal Revenue Service Form 12009 is a request to hold an informal conference with an IRS Supervisor about a proposed penalty. Taxpayers who disagree with an IRS penalty file it, providing their details and explanation.
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IRS Form 12009 - Request for an Informal Conference and Appeals Review
Internal Revenue Service Form 12009 is a request to hold an informal conference with an IRS Supervisor about a proposed penalty. Taxpayers who disagree with an IRS penalty file it, providing their details and explanation.
Risk Radar
Scan points- 1Submitting the form without a signature will prevent processing.
- 2Omitting the Taxpayer Identification Number
- 3Failing to explain why you disagree with the proposed IRS penalty
- 4Leaving the IRS Penalty amount blank
- 5Not providing the Penalty Date
Plain English
This form lets you ask the IRS for an informal meeting with a supervisor if you think a penalty is wrong. You explain why you disagree and attach any proof. If the supervisor cannot resolve it, the case can be sent to the Appeals Office for a formal review.
Submission Date
- Filing date: 2012-07-17 00:00:00
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when you want to request an informal conference with an IRS Supervisor regarding a proposed IRS penalty.
Form selector
Use this form or another form?
Disagree with a proposed IRS penalty and want an informal conference
The form initiates a supervisor‑level conference
✓ Verify the penalty details before you continue
Penalty not resolved at supervisor level and you want an administrative appeal
The form can be used to request an Appeals Review after supervisor decision
✓ Confirm you have requested the supervisor review first
Need to attach additional documentation to support your penalty dispute
The form allows extra sheets and attachments
✓ Ensure all supporting documents are included
Deadline or filing window
Not stated in the official source.
Checklist
What you need before filling it out
Taxpayer Name(s)
Taxpayer’s legal name as on tax return · Form field “Taxpayer Name(s)”
Taxpayer Identification Number
Social Security Number or EIN · Form field “Taxpayer Identification Number”
IRS Penalty
Amount of proposed penalty · Form field “IRS Penalty”
Penalty Date
Date the penalty was issued · Form field “Penalty Date”
Explanation of disagreement
Written statement of why you disagree · Space provided under “please explain why you do not agree”
Before you submit
- 1Verify Taxpayer Name(s) is entered.
- 2Verify Taxpayer Identification Number is entered.
- 3State the IRS Penalty amount in the designated field.
- 4Enter the Penalty Date correctly.
- 5Write a clear explanation in the space provided.
- 6Attach any supporting documentation or additional sheets.
- 7Provide your telephone number(s) in the appropriate field.
- 8Sign the form and print your name.
- 9Date the form in the Date field.
How to file this form
- 1Fill in Taxpayer Name(s), Identification Number, address, and telephone number on Form 12009.
- 2Enter the IRS Penalty amount and Penalty Date.
- 3Write the explanation of why you disagree with the proposed penalty.
- 4Attach supporting documentation and any additional sheets.
- 5Sign, print your name, and date the form.
- 6Mail the completed form to the IRS address indicated on the form.
- 7Keep a copy of the mailed package for your records.
Known limitations
- 1Confirm the form shows Rev. 12‑2006; if the edition is older, verify the current version on the IRS website before filing.
- 2The official source does not list a filing fee; you should check the IRS instructions or contact the agency to confirm any required payment.
- 3No mailing address appears in the source; locate the correct IRS address on the form itself or the agency’s website before sending.
- 4A signature is required in the Signature field; ensure you sign, print your name, date, and title to avoid processing delays.
Field map
Compact field-by-field guide
General Info
2 items
Full legal name and taxpayer identification number (SSN or EIN).
Current mailing address.
Details
2 items
Complete all applicable sections of this form according to the official IRS instructions.
Enter the relevant dollar amount if this form involves tax calculation.
Certification
1 items
Read and acknowledge any certifications required by this form.
Signatures
1 items
Sign and date. Unsigned forms cannot be processed.
Almost done reviewing the fields?
Fillable formOpen in Editor->Form 12009 is the December 2006 revision (Rev. 12-2006); the source does not reference a latest‑information webpage or indicate any changes since that date.
What changed or needs a fresh check
- Edition date — confirm the form shows Rev. 12-2006 (December 2006).
- Fee — Not stated in the official source.
- Mailing address — Not stated in the official source.
- Signature — confirm a signature is provided in the Signature field.
Quick Facts
Downloads
After you file
- 1Expect the IRS supervisor to contact you after the request is received and reviewed
- 2If the matter is not resolved at the supervisor level, you may request the case be sent to the appropriate Appeals Office for an administrative appeal
- 3Send the completed form and any additional information to the address shown on the form
- 4Attach any supporting documentation to the form
Sources
- SRCForm p.1 — request an informal conference with an IRS Supervisor
- SRCForm p.1 — supervisor will contact you after your request is received and reviewed
- SRCForm p.1 — if not resolved at the supervisor level, you may request the case be sent to the appropriate Appeals Office for an administrative appeal
- SRCForm p.1 — fields include Taxpayer Name(s), Taxpayer Identification Number, Address, explanation of disagreement, IRS Penalty, Penalty Date, Signature, Print Name, Date, Title, Your Telephone Number(s)
- SRCForm p.1 — attach any supporting documentation
- SRCForm p.1 — send the completed form and any additional information to the address indicated on the form
- SRCForm p.1 — official use only fields: Date of Taxpayer Request for Appeals Review, Supervisor Date and Initial, Catalog No. 25631V, www.irs.gov
- SRCNot stated in the official source — verify on the agency site
Common confusion points
Do I need to include my telephone number?
The form lists a field labeled 'Your Telephone Number(s):' which may be overlooked
→ Verify the telephone number field is filled before signing
Do I have to attach supporting documents?
The form states 'Attach any supporting documentation' but some filers assume it is optional
→ Ensure all relevant documents are attached to the submission
Do I need to provide a title?
A field labeled 'Title:' appears on the form and is sometimes missed
→ Fill the Title field with your appropriate title (e.g., Mr., Ms., etc.)
Do I have to sign the form?
The form includes a 'Signature:' line that must be completed
→ Sign the form in the Signature field and date it
Do I need to print my name separately?
The form contains a 'Print Name:' field distinct from the signature line
→ Print your name legibly in the Print Name field
What penalty information must I provide?
The form has separate fields for 'IRS Penalty:' and 'Penalty Date:' which some filers confuse with other dates
→ Enter the exact penalty amount and the date it was assessed in the respective fields
Questions about IRS Form 12009
What is IRS Form 12009 used for?
This form lets you ask the IRS for an informal meeting with a supervisor if you think a penalty is wrong. You explain why you disagree and attach any proof. If the supervisor cannot resolve it, the case can be sent to the Appeals Office for a formal review.
Who must file IRS Form 12009?
Taxpayers who disagree with a proposed IRS penalty must file IRS Form 12009.
What information does IRS Form 12009 require?
The form collects the taxpayer’s name, identification number, address, telephone number, the IRS penalty amount and date, a written explanation of the disagreement, and requires a signature, printed name, date, and title, plus any supporting documentation.
How do I complete IRS Form 12009?
Enter your name, Taxpayer Identification Number, address, and telephone number. Describe why you do not agree with the proposed IRS penalty, list the penalty amount and date, and attach supporting documents. Sign the form, print your name, date, and title. Mail the completed form to the IRS address indicated on the form.
What happens if IRS Form 12009 is filed incorrectly?
If the request is not received and reviewed, the supervisor will not contact you, potentially delaying resolution of the penalty dispute.
Do I need to include my telephone number?
The form lists a field labeled 'Your Telephone Number(s):' which may be overlooked Verify the telephone number field is filled before signing
Do I have to attach supporting documents?
The form states 'Attach any supporting documentation' but some filers assume it is optional Ensure all relevant documents are attached to the submission
Do I need to provide a title?
A field labeled 'Title:' appears on the form and is sometimes missed Fill the Title field with your appropriate title (e.g., Mr., Ms., etc.)
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