Taxpayer header
Taxpayer name, tax period and Social Security Number.
12661
Disputed Issue Verification
- Agency
- IRS
- Revision
- Rev. 10-2015
- Fillable fields
- 15
- Pages
- 1
- Official source
- IRS form page
- Checked
- October 21, 2026
Form 12661: Disputed Issue Verification
Form 12661, Disputed Issue Verification, is a one-page IRS form for listing each issue or adjustment from an audit that the taxpayer disagrees with. For each one, it asks for a description of the disputed issue or adjustment, the reason the taxpayer disagrees with the audit results, the amount claimed on the original return and the amounts allowed on the audit report.
The top of the form asks for the taxpayer name, the tax period and a Social Security Number. The form says to complete a separate block for each issue, attach photocopies of supporting information numbered to match the issue, and send photocopies only, not original documents. The form does not print a mailing address or a deadline.
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What's on Form 12661
Instructions for completing disputed issues
A short printed note: one block per issue or adjustment, numbered photocopies of supporting information, and extra photocopied sheets if needed.
Disputed issue or adjustment
Three numbered blocks, each starting with a space to describe one disputed issue or adjustment.
Reason why you disagree
In each block, a space for the reason the taxpayer disagrees with the audit results.
Amounts
In each block, the amount claimed on the original return and the amounts allowed on the audit report.
Footer notes
Do not send original documents, send photocopies only. For the Privacy Act Notice, the form points to the instructions for your return.
How to fill out Form 12661
- 1
Fill in the header
Enter the taxpayer name, the tax period and the Social Security Number.
- 2
Describe each disputed issue
Use a separate block for each issue or adjustment you disagree with, and describe it in the first space of the block.
- 3
Give the reason
In the same block, write why you disagree with the audit results for that issue.
- 4
Enter both amounts
Enter the amount claimed on the original return and the amount allowed on the audit report for that issue.
- 5
Attach numbered photocopies
Number each piece of supporting information with the same number as its disputed issue. The form says to send photocopies only.
- 6
Add sheets if needed
For more than three issues, the form says to photocopy additional sheets and number them accordingly.
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Sending it, attachments and privacy
Where it goes
The form does not print a mailing address, fax number or deadline. It refers to an audit report and the amounts allowed on it.
Photocopies only
The form says: Do not send original documents. Send photocopies only.
Numbering attachments
Supporting information for each issue is numbered with the same number as its disputed issue.
Privacy Act Notice
The form says to see the instructions for your return for the Privacy Act Notice.
Related forms
Who fills out Form 12661?
The form is written for a taxpayer who disagrees with one or more audit results. It does not name the office that receives it.
Official sources and the blank
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Questions about Form 12661
Can I list more than three disputed issues?
Yes. The form has three blocks and says to photocopy additional sheets and number them accordingly if you need more.
Do I send original receipts or records with Form 12661?
No. The form says: Do not send original documents. Send photocopies only.
How do I link a document to an issue?
The form says to number the supporting information with the same number as its disputed issue.
What amounts does Form 12661 ask for?
For each issue, the amount claimed on the original return and the amounts allowed on the audit report.
Where do I send Form 12661?
The form itself does not print an address, office or fax number.