12009

Request for an Informal Conference and Appeals Review

Agency
IRS
Revision
Rev. 12-2006
Fillable fields
28
Pages
1
Official source
IRS form page
Checked
October 21, 2026
Fill 12009 online
Page 1 of form 12009

Form 12009: Request for an Informal Conference and Appeals Review

Form 12009, Request for an Informal Conference and Appeals Review, is a one-page IRS form about a proposed IRS penalty. The form says to use it to request an informal conference with an IRS Supervisor. After the request is received and reviewed, the supervisor contacts the taxpayer. If the matter is not resolved at the supervisor level, the form says that, at the taxpayer's request, the IRS will send the case to the appropriate Appeals Office for an administrative appeal.

The form asks for the taxpayer's name, taxpayer identification number and address, the IRS penalty and penalty date, and an explanation of why the taxpayer does not agree with the proposed penalty. It prints no mailing address of its own: the block that says where to send it has blank spaces for an IRS manager's name, I.D. number and address. Form 12009 has no separate instructions and prints no deadline.

You can fill out Form 12009 free in your browser on this page and download it without an account.

What's on Form 12009

Taxpayer information

Taxpayer name(s), taxpayer identification number and address.

IRS penalty and penalty date

Two fields that name the penalty in question and its date.

Explanation

A space to explain why the taxpayer does not agree with the proposed IRS penalty. The form says additional sheets may be used and to attach any supporting documentation.

Signature block

Signature, print name, date, title and telephone number(s).

Where to send it

Internal Revenue Service, with blank spaces for the manager name and I.D. number and an address.

Official Use Only

The date of the taxpayer request for Appeals review, and a supervisor date and initial box.

How to fill out Form 12009

  1. 1

    Taxpayer details

    Enter the taxpayer name(s), taxpayer identification number and address.

  2. 2

    Name the penalty

    Enter the IRS penalty in question and the penalty date.

  3. 3

    Explain the disagreement

    Write why the taxpayer does not agree with the proposed penalty. The form says to attach an additional sheet if more space is needed, along with any supporting documentation.

  4. 4

    Sign and date

    Sign, print the name, add the date and a title if one applies, and give one or more telephone numbers.

  5. 5

    Send it

    The form says to send the completed form and any additional information to the Internal Revenue Service at the manager name and address in its send to block. The Official Use Only section is for the IRS.

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Where it goes and what happens next

Where to send it

The form says to send the completed form and any additional information to the Internal Revenue Service. The manager name, I.D. number and address are blank spaces; the form prints no address of its own.

Supervisor contact

The form says that after the request is received and reviewed, the supervisor will contact the taxpayer.

Appeals review

If the matter is not resolved at the supervisor level, the form says the IRS will send the case to the appropriate Appeals Office for an administrative appeal, at the taxpayer's request.

No separate instructions

Form 12009 has no separate instructions and prints no deadline or fee.

Related forms

Who fills out Form 12009?

  • Taxpayers disputing a proposed penalty

    The form asks the taxpayer to explain why they do not agree with the proposed IRS penalty and to attach any supporting documentation.

  • Signers with a title

    The name line reads Taxpayer Name(s), and the signature block has Print Name and Title lines next to the signature and date.

  • IRS supervisor

    The form says the supervisor will contact the taxpayer after the request is received and reviewed. A supervisor date and initial box sits in the Official Use Only section.

  • IRS Appeals Office

    If the matter is not resolved at the supervisor level, the form says the case is sent to the appropriate Appeals Office at the taxpayer's request.

The taxpayer who does not agree with a proposed IRS penalty completes, signs and sends the form. An IRS supervisor reviews it, and the bottom section is marked Official Use Only.

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Questions about Form 12009

What is Form 12009 used for?

The form says it is used to request an informal conference with an IRS Supervisor about a proposed IRS penalty, with an administrative appeal if the matter is not resolved at that level.

Who reviews the request?

An IRS supervisor. The form says the supervisor will contact the taxpayer after the request is received and reviewed.

Does the case go to Appeals automatically?

The form says that if the matter is not resolved at the supervisor level, the IRS will send the case to the appropriate Appeals Office at the taxpayer's request.

Where is Form 12009 sent?

To the Internal Revenue Service. The form leaves spaces for an IRS manager's name, I.D. number and address and prints no address itself.

Can extra pages be attached?

Yes. The form says additional sheets may be used if needed and to attach any supporting documentation.