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Injured Spouse Claim Form - Michigan

Injured Spouse Claim Form Form. This is a Michigan form and can be used in Friend Of The Court Circuit Court Wayne Local County .
 Fillable pdf Last Modified 2/11/2005
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The Circuit CourtThe Circuit Court for the Third Judicial Circuit of Michiganfor the Third Judicial Circuit of Michigan OFFICE OF THE FRIEND OF THE COURT PENOBSCOT BUILDING 645 GRISWOLD DETROIT, MICHIGAN 48226 FRIEND OF THE COURT CASE NUMBER: PAYOR NAME: PAYOR SOC IAL SECURITY NUMBER: Dear Friend of the Court Payor: This is in response to your inquiry about your joint income tax refund. It will take approximately 90 days from the date you receive your letter notifying you that your tax refund was intercepted for your Federal tax refund to reach Wayne County Friend of the Court. If an Injured Spouse Claim has been filed, the IRS requires that the Court hold the funds six months. This allows the IRS to adjust the amount of money the Court may credit the account. The IRS will determine your current spouses portion of the income tax refund and return it directly to them. ***I__________________________________________________ have not and will not file an Injured Spouse Claim form. Please apply the tax refund to any arrears the account may have and return the remainder to us*** I understand, that as a condition of signing this form, I also authorize the Wayne County Friend of the Court to recoup any negative adjustments that may occur on this account as a result of my filing an Injured Spouse Claim form after signing this letter. I _______________________________________________________ have filed an Injured Spouse Claim form for my share of the income tax refund. ***X _________________________________________ (NAME) ***This statement must be notarized. Please return this form to: TIP FOC P.O. BOX 3059 DETROIT, MI 48231 PAYMENT INFORMATION REGARDING YOUR ACCOUNT IS AVAILABLE 24 HOURS PER DAY AT (313) 224-5300
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