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Form 13369: Agreement to Mediate
IRS Form 13369 is an Agreement to Mediate that taxpayers and their representatives use when agreeing to mediation with the IRS Independent Office of Appeals. The form confirms consent to disclosures authorized by the taxpayer.
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IRS Form 13369 - Agreement to Mediate
IRS Form 13369 is an Agreement to Mediate that taxpayers and their representatives use when agreeing to mediation with the IRS Independent Office of Appeals. The form confirms consent to disclosures authorized by the taxpayer.
Risk Radar
Scan points- 1Ensure the Power of Attorney clearly grants authority to consent to disclosure and attach a copy if applicable.
- 2Filing without listing the Taxpayer's Identification Number (TIN) on Form 13369.
- 3Omitting the required Home street address for the Taxpayer (p.o. boxes are not allowed).
- 4Not attaching a copy of the Power of Attorney when filing through a representative.
- 5Failing to include the specific Type of tax or collection issue on Form 13369.
Plain English
This form lets a taxpayer officially agree to participate in a mediation process with the Internal Revenue Service (IRS). By signing, the filer consents to certain rules and allows the IRS to share their tax information with anyone involved in the mediation. The primary purpose is to acknowledge adherence to these agreed-upon mediation terms.
Submission Date
- Filing date: 2023-08-16 22:10:23
- 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 agree to participate in mediation with the IRS Independent Office of Appeals and wish to formally acknowledge adherence to the rules and disclosures.
- Do not use Form 13369 when you are disputing an issue but have not yet agreed to mediate, or if you do not consent to the authorized disclosures.
- Check Form 13369 instead when agreeing to mediation because your case involves a specific tax type (e.g., 1040) or collection issue (e.g., CDP).
Form selector
Use this form or another form?
Tax return is for an individual filer
This form allows you to consent to disclosures regarding your personal tax returns during mediation.
✓ Check before you continue
Dispute involves a Collection Due Process (CDP) issue
You must use this form to agree to mediate the specific collection matter identified by the IRS.
✓ Check before you continue
You are filing on behalf of a corporation
This form allows you to consent to disclosures related to your business's tax returns during mediation.
✓ Check before you continue
Deadline or filing window
The form does not specify a trigger event deadline, but it must be completed when agreeing to adhere to mediation rules. The estimated average time needed for completion is 3 minutes, and no specific extension period is noted in the official source.
Checklist
What you need before filling it out
Taxpayer's Identification Number (TIN)
The taxpayer’s TIN must be provided. · Page 1
Type of tax or collection issue
Specify the form (e.g., 1040) or collection type (e.g., CDP). · Page 1
Taxpayer's Home address
Must be a physical street address; P.O. boxes are not allowed. · Page 1
Confidentiality Provisions
All parties acknowledge adherence to I.R.C. sections 6103, 7213, 7213A, and 7431. · Page 1
Voluntary Submission Status
The information provided is voluntary, but required if you wish to participate in mediation. · Page 2
Power of Attorney Consent
If using a representative, confirm the POA explicitly grants consent for disclosure. · Page 1
Before you submit
- 1Ensure all fields on page 1 are completed to the best of knowledge.
- 2Confirm that the Taxpayer's home street address does not use a P.O. box.
- 3Verify that if an agent is signing, their Power of Attorney clearly grants authority for disclosure.
- 4Check that the date signed fields correspond with the actual dates of execution.
- 5Review and complete all necessary sections for any listed 'Other Participants' on page 1.
- 6Confirm you have acknowledged acceptance of the mediation rules (Page 2 primary purpose).
- 7If applicable, verify that a copy of the Power of Attorney is attached to this agreement.
How to file this form
- 1Complete all required fields on IRS Form 13369, including Taxpayer identification and contact information.
- 2Sign the form where indicated by the Taxpayer and their Representative (if applicable), ensuring dates are filled in.
- 3If other participants are involved, fill out their details and sign/date those sections as well.
- 4Attach a copy of any Power of Attorney if it was executed by someone acting on behalf of the Taxpayer.
- 5Mail or submit the completed Form 13369 to the IRS Independent Office of Appeals Team Manager.
Known limitations
- 1The form does not specify which specific IRS Independent Office of Appeals Team Manager must receive it.
- 2If a taxpayer uses a power of attorney, that document must clearly state authority to consent to disclosures, and a copy must be attached to Form 13369.
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.
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Fillable formOpen in Editor->The current edition of IRS Form 13369 is March 2022 (Form 13369 (3-2022)). The source does not point to a specific 'latest information' page, but it confirms the revision date.
What changed or needs a fresh check
- Edition date — confirm the revision date reads March 2022 (3-2022).
- Catalog Number — confirm the number is 35327G.
- Filer Name — ensure the Taxpayer's name and address are accurately entered on page 1.
- Signature — verify that all required signatures (Taxpayer, Representative, Compliance Officer) have dates next to them.
Quick Facts
Downloads
After you file
- 1Retain books or records relating to Form 13369 as long as their contents may become material in the administration of any Internal Revenue law.
- 2The estimated average time needed to complete this form is 3 minutes.
- 3If submitting comments about the completion time estimate, write them to the Tax Forms Committee at Western Area Distribution Center, Rancho Cordova, CA 95743-0001 (do not send the completed Form 13369 there).
- 4The form acknowledges that all involved IRS and Treasury employees are bound by I.R.C. section 7214(a)(8) to report information concerning violations of any revenue law to the Secretary.
Sources
- SRCForm 13369 is an Agreement to Mediate (Catalog Number 35327G) — [Form p.1]
- SRCThe form provides fields for Compliance Officer, Taxpayer, and Representative contact information — [Form p.1]
- SRCParticipants are subject to confidentiality provisions under I.R.C. sections 6103, 7213, 7213A, and 7431 (See also 5 U.S.C. section 574) — [Form p.1]
- SRCThe Taxpayer consents to the disclosure of returns/return information incident to mediation to any participant or observer — [Form p.1]
- SRCInformation on Form 13369 is requested under 26 U.S.C. 7801 and RRA Section 3468 (Section 7123 of the Internal Revenue Code) — [Form p.2]
- SRCProviding information on Form 13369 is voluntary, but required if the taxpayer wishes to participate in mediation — [Form p.2]
Common confusion points
Who must sign this form?
The Taxpayer, Taxpayer's Representative (if applicable), Compliance Officer, and Other Participants (if applicable) all have signature lines.
→ Ensure every required party signs and dates their respective line.
What is the difference between 'Taxpayer's name' and 'Representative's name'?
The former is the individual filing; the latter is the person acting on behalf of the taxpayer.
→ Verify which entity is listed in the Taxpayer's Identification Number (TIN) field.
Does a P.O. Box count as a valid address?
No, the Home street address section specifies that P.O. boxes are not allowed for the Taxpayer's home address.
→ Double-check the mailing address provided for the taxpayer to ensure it is a physical street address.
If I am an IRS employee participating in mediation, what must I do?
You are subject to confidentiality and disclosure provisions of the Internal Revenue Code (including I.R.C. sections 6103, 7213, 7213A, and 7431).
→ Confirm your name is listed among those participating in the mediation process.
What happens if I don't provide all the information on Form 13369?
Not providing all or part of the information may preclude or impede participation in the mediation process.
→ Ensure every field, especially contact and TIN details, has corresponding data entered.
Where should I send my completed Form 13369?
The form is submitted to the IRS Independent Office of Appeals Team Manager (as directed by the case), not directly to the Tax Forms Committee at Western Area Distribution Center.
→ Check the specific instructions related to your mediation case to confirm the exact recipient address/method.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- The form itself acknowledges participation under I.R.C. section 6103, which governs confidentiality of returns and return information.
Questions about IRS Form 13369
What is IRS Form 13369 used for?
This form lets a taxpayer officially agree to participate in a mediation process with the Internal Revenue Service (IRS). By signing, the filer consents to certain rules and allows the IRS to share their tax information with anyone involved in the mediation. The primary purpose is to acknowledge adherence to these agreed-upon mediation terms.
Who must file IRS Form 13369?
Taxpayers or their representatives must file Form 13369 (Agreement to Mediate) when agreeing to participate in the mediation process with the IRS Independent Office of Appeals.
What information does IRS Form 13369 require?
The form collects identifying information such as the Taxpayer's name, TIN, and address; details about the issue (Type of tax or collection issue); and signatures from the Taxpayer, Representative, and Compliance Officer.
Where do I file IRS Form 13369?
The completed Form 13369 should generally be sent to the IRS Independent Office of Appeals Team Manager; however, comments regarding accuracy can be written to the Tax Forms Committee at Rancho Cordova, CA 95743-0001.
How do I complete IRS Form 13369?
First, complete all required contact and identification fields on Form 13369. Next, the Taxpayer must sign and date the agreement. Finally, if a representative is involved, they must also sign and date their section before submission to the IRS Independent Office of Appeals Team Manager.
What happens if IRS Form 13369 is filed incorrectly?
Not providing all or part of the information on Form 13369 may preclude or impede participation in the mediation process. Additionally, participants are subject to confidentiality provisions under I.R.C. sections 6103, 7213, 7213A, and 7431.
Who must sign this form?
The Taxpayer, Taxpayer's Representative (if applicable), Compliance Officer, and Other Participants (if applicable) all have signature lines. Ensure every required party signs and dates their respective line.
What is the difference between 'Taxpayer's name' and 'Representative's name'?
The former is the individual filing; the latter is the person acting on behalf of the taxpayer. Verify which entity is listed in the Taxpayer's Identification Number (TIN) field.
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