Form 843 (Claim for Refund and Request for Abatement) is the single form used to request abatement of penalties or refund of overpaid taxes, interest, or fees. The current revision is Rev. 12-2021. The form is one page, but the spaces are tight and the IRS examiner reads each line carefully.
Top section: identification
Name & Address
Use the name and address that match the most recent return for the tax period at issue. If the taxpayer's name has changed (marriage, entity reorganization), file under the name in effect at the time of the assessment with a note.
Spouse SSN (if joint)
Required for joint returns. The penalty applies jointly; the abatement must be requested in both names.
Employer Identification Number
For business entities. Match the EIN on the assessed return.
Daytime Phone
The IRS may contact the taxpayer or representative for clarification. Provide the representative's phone if a Form 2848 is on file.
Line 1: tax period
Specify the tax period the penalty was assessed for. For an annual return, the form year (e.g., 2020). For Form 941, the quarter (e.g., 2020Q3). One Form 843 can cover multiple periods — list them all on Line 1, with detail in the attachment.
Line 2: amount
The amount of the refund or abatement requested. Use the total penalty plus the interest assessed on that penalty. Round to whole dollars.
Line 3: tax type
Check the box that matches the underlying tax — Employment, Excise, Income, etc. For income tax abatement, "Income."
Line 4: employment tax filer
For employment-tax claims only — Form 941, 940, 943, etc. — check the relevant box.
Line 5: type of relief requested
This is the most important line. Check the boxes that apply:
- Box 5a — Interest assessed on penalties or tax
- Box 5b — Penalty assessed on the underlying tax
- Box 5c — Addition to Tax for certain procedural penalties
For most penalty abatement cases, check both 5a (the interest charged on the penalty) and 5b (the penalty itself).
Line 6: IRC section
Enter the IRC section under which the penalty was assessed:
- IRC §6651(a)(1) — Failure-to-File
- IRC §6651(a)(2) — Failure-to-Pay
- IRC §6654 / §6655 — Underpayment of estimated tax
- IRC §6656 — Failure-to-deposit
- IRC §6721 — Information return failures (filer side)
- IRC §6722 — Information return failures (payee side)
Line 7: explanation
This is where the reasonable-cause statement attaches. Write "See attached statement" on Line 7 and attach the letter as a separate page. The space provided on the form itself is insufficient for a meaningful reasonable-cause argument.
The attached statement should be on plain paper (no letterhead required), single-sided, with the taxpayer's name, EIN/SSN, tax period, and "Attachment to Form 843" at the top of each page. Exhibits should be tabbed and labeled A, B, C, with each referenced inline in the narrative.
Signature block
Form 843 requires a wet signature. Electronic signatures are not accepted. The taxpayer signs for individual returns; for entities, an authorized officer (CFO, CEO, controller) signs. If a paid preparer or representative signs, the preparer signs the "Paid Preparer Use Only" section and a Form 2848 (POA) must be attached or on file.
Where to mail
Form 843 is mailed to the IRS service center associated with the taxpayer's state — typically Ogden, UT or Kansas City, MO for most filers, with specific destinations for certain entity types and locations. See the mailing addresses page for the current list.