Petition (Simplified Form) {Form 2}

Information About Filing a Case in the United States Tax CourtAttached are the forms to use in filing your case in the United States Tax Court. It is very important thatyou take time to carefully read the information on this page and that you properly complete and submit theseforms to the United States Tax Court, 400 Second Street, N.W., Washington, D.C. 20217, or file the formselectronically pursuant to the Court222s eFiling provisions. Small Tax Case or Regular Tax CaseIf you seek review of an action (other than a whistleblower or a certification action) listed in paragraph 1of the petition form (Form 2), you may file your petition as a 223small tax case224 if your dispute meets certaindollar limits (described below). 223Small tax cases224 are handled under simpler, less formal procedures than regular cases. However, the Tax Court222s decision in a small tax case cannot be appealed to a Court of Appealsby the IRS or by the taxpayer(s). You can choose to have your case conducted as either a small tax case or aregular case by checking the appropriate box in paragraph 4 of the petition form (Form 2). If you check neitherbox, the Court will file your case as a regular case. Dollar Limits: Dollar limits for a small tax case vary slightly depending on the type of IRS action youseek to have the Tax Court review:(1) If you seek review of a Notice of Deficiency, the amount of the deficiency (including any additions totax or penalties) that you dispute cannot exceed $50,000 for any year. (2) If you seek review of a Notice of Determination Concerning Collection Action, the total amount ofunpaid tax cannot exceed $50,000 for all years combined.(3) If you seek review of a Notice of Determination Concerning Relief From Joint and Several LiabilityUnder Section 6015 (or if the IRS failed to send you any Notice of Determination with respect to a request forspousal relief that you submitted to the IRS at least 6 months ago), the amount of spousal relief sought cannotexceed $50,000 for all years combined.(4) If you seek review of a Notice of Determination of Worker Classification, the amount in disputecannot exceed $50,000 for any calendar quarter.(5) If you seek review of a Notice of Final Determination for [Full/Partial] Disallowance of InterestAbatement Claim (or if the IRS failed to send you a Notice of Final Determination with respect to a claim forinterest abatement that you filed with the IRS at least 180 days before), the amount of the abatement cannotexceed $50,000. EnclosuresTo help ensure that your case is properly processed, please enclose the following items when you mailyour petition to the Tax Court: 1. A copy of any Notice of Deficiency, Notice of Determination, or Final Determination the IRS sent you; 2. Your Statement of Taxpayer Identification Number (Form 4); 3.The Request for Place of Trial (Form 5); and 4.The $60 filing fee, payable by check, money order, or other draft, to the "Clerk, United States TaxCourt"; or, if applicable, the fee waiver form. For further important information, see the Court222s Web site at www.ustaxcourt.gov or the 223Informationfor Persons Representing Themselves Before the U.S. Tax Court224 booklet available from the Tax Court. American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES TAX COURT www.ustaxcourt.gov(FIRST) (MIDDLE) (LAST) (PLEASE TYPE OR PRINT)Petitioner(s) v.COMMISSIONER OF INTERNAL REVENUE, RespondentDocket No.PETITION1. Please check the appropriate box(es) to show which IRS ACTION(S) you dispute:GNotice of DeficiencyGNotice of Determination Concerning Collection ActionGNotice of Final Determination for [Full/Partial]Disallowance of Interest Abatement Claim (or Failureof IRS to Make Final Determination Within 180 DaysAfter Claim for Abatement) *GNotice of Determination of Worker Classification *GNotice of Determination Concerning Relief From Jointand Several Liability Under Section 6015 (or Failure ofIRS to Make Determination Within 6 Months AfterElection or Request for Relief) *GNotice of Certification of Your Seriously DelinquentFederal Tax Debt to the Department of StateGNotice of Determination Under Section 7623Concerning Whistleblower Action **For additional information, please see 223Taxpayer Information: Starting a Case224 at www.ustaxcourt.gov (accessible by hyperlink from asterisks above, or in the Court222s information booklet).2. If applicable, provide the date(s) the IRS issued the NOTICE(S) checked above and the city and State of the IRS office(s) issuing the NOTICE(S): 3. Provide the year(s) or period(s) for which the NOTICE(S) was/were issued: 4. SELECT ONE OF THE FOLLOWING (unless your case is a whistleblower or a certification action): If you want your case conducted under small tax case procedures, check here:G(CHECK If you want your case conducted under regular tax case procedures, check here:GONE BOX)NOTE: A decision in a 223small tax case224 cannot be appealed to a Court of Appeals by the taxpayer or the IRS. If youdo not check either box, the Court will file your case as a regular tax case. 5. Explain why you disagree with the IRS determination in this case (please list each point separately): T.C. FORM 2 (REV. 11/18) American LegalNet, Inc. www.FormsWorkFlow.com 6. State the facts upon which you rely (please list each point separately): You may use additional pages to explain why you disagree with the IRS determination or to state additional facts. Please do not submit tax forms, receipts, or other types of evidence with this petition. ENCLOSURES:Please check the appropriate boxes to show that you have enclosed the following items with this petition: G A copy of any NOTICE(S) the IRS issued to you G Statement of Taxpayer Identification Number (Form 4) (See PRIVACY NOTICE below)G The Request for Place of Trial (Form 5) G The filing fee PRIVACY NOTICE: Form 4 (Statement of Taxpayer Identification Number) will not be part of the Court222s public files. All other documents filed with the Court, including this Petition and any IRS Notice that you enclose with this Petition, will become part of the Court222s public files. To protect your privacy, you are strongly encouraged to omit or remove from thisPetition, from any enclosed IRS Notice, and from any other document (other than Form 4) your taxpayer identificationnumber (e.g., your Social Security number) and certain other confidential information as specified in the Tax Court222s 223NoticeRegarding Privacy and Public Access to Case Files224, available at www.ustaxcourt.gov. SIGNATURE OF PETITIONER DATE (AREA CODE) TELEPHONE NO. MAILING ADDRESS CITY, STATE, ZIP CODE State of legal residence (if different from the mailing address): E-mail address (if any): SIGNATURE OF ADDITIONAL PETITIONER (e.g., SPOUSE) DATE (AREA CODE) TELEPHONE NO. MAILING ADDRESS CITY, STATE, ZIP CODE State of legal residence (if different from the mailing address): E-mail address (if any): SIGNATURE OF COUNSEL, IF RETAINED BY PETITIONER(S) NAME OF COUNSEL DATE TAX COURT BAR NO. MAILING ADDRESS, CITY, STATE, ZIP CODE E-MAIL ADDRESS (AREA CODE) TELEPHONE NO. 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