Fillable Form 843

843 form is used by the taxpayers to ask the IRS to claim a refund or to ask for an abatement of certain kinds of taxes, penalties, fees, and interest.

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What is Form 843?

The Internal Revenue Service (IRS) Form 843 or Claim for Refund and Request for Abatement is used by U.S. taxpayers to claim a refund or request an abatement of certain taxes, interest, penalties, fees, and additions to tax. 

 According to the IRS, you may use Form 843 to claim or request the following:

  • A refund of tax, other than a tax for which a different form must be used. 

  • An abatement of tax, other than income, estate, or gift tax. Note that employers cannot use Form 843 to request an abatement of Federal Insurance Contributions Act (FICA) tax, Railroad Retirement Tax Act)(RRTA) tax, or income tax withholding.

  • A refund to an employee of excess social security, Medicare, or RRTA tax withheld by any one employer, but only if your employer will not adjust the overcollection.

  • A refund to an employee of social security or Medicare taxes that were withheld in error, but only if your employer will not adjust the overcollection. 

  • A refund of excess tier 2 RRTA tax when you had more than one railroad employer for the year and your total tier 2 RRTA tax withheld or paid for the year was more than the tier 2 limit.

  • A refund or abatement of interest, penalties, or additions to tax, caused by certain IRS errors or delays, or certain erroneous written advice from the IRS.

  • A refund or abatement of a penalty or addition to tax due to reasonable cause or other reason (other than erroneous written advice provided by the IRS) allowed under the law.

  • A refund of the penalty imposed under section 6715 for misuse of dyed fuel.

  • A refund or abatement of tier 1 RRTA tax for an employee representative.

  • A refund of a branded prescription drug fee.

    • Taxpayers may file Form 843 within two years from the date when taxes were paid or three years when the return was filed, whichever is later.

     It is important to note that a separate Form 843 should be filed for each type of tax or fee for each tax year.

     If you are the taxpayer, you can file Form 843 without submitting other legal documents. On the contrary, if an authorized representative will file the form for you, the original copy of Form 2848, or Power of Attorney ad Declaration of Representative, must be attached to your Form 843 and your signature must be on Form 2848 for it to be valid.

    How to Fill Out Form 843?

    The single-page Form 843 is simple and only requires information relevant to your claim.

    Name(s)

    Provide your full legal name. If a joint return, provide the full legal name of your spouse.

    Your social security number

    Provide the SSN assigned to you.

    Address

    Provide your current address.

    Spouse’s social security number

    If a joint return, provide the SSN of your spouse.

    Employer identification number (EIN)

    Provide the unique EIN of your employer.

    Name and address shown on return if different from above

    If your name and address on your return are different from the ones you have provided above, provide them here.

    Daytime telephone number

    Provide the telephone number that the IRS can use to contact you.

    Number 1 — Period

    Provide the tax period for which you are making the claim for refund or request for abatement. Prepare a separate Form 843 for each tax period or fee year.

    Number 2 — Amount

    Provide the amount to be refunded or abated.

    Number 3 — Type of tax or fee

    Mark the appropriate checkbox to determine the type of tax or fee to be refunded or abated. The claim can also be related to interest, penalty, or addition to tax. You may select Employment, Estate, Gift, Excise, Income, or Fee.

    Number 4 — Type of penalty

    Provide the applicable Internal Revenue Code section if you are requesting a refund or abatement of an assessed penalty. You can find the Code section on the Notice of Assessment you received from the IRS.

    Number 5a and 5b — Interest, penalties, and additions to tax

    In 5a, mark the appropriate checkbox that indicates the reason for the request for refund or abatement. You may indicate that interest was assessed as a result of IRS errors or delays, a penalty or addition to tax was the result of erroneous written advice from the IRS, or a reasonable cause or other reason allowed under the law (other than erroneous written advice) can be shown for not assessing a penalty or addition to tax.

    In 5b, provide the dates of payments.

    Number 6 — Original return

    If applicable, select the appropriate checkbox to show the type of fee or return to which your claim or request is relevant. The options are 706, 709, 940, 941, 943, 945, 990-PF, 1040, 1120, and 4720. Or you may just specify the fee or return in the provided space.

    Number 7 — Explanation

    Explain in detail your reasons for filing and show accurate computations that you made.

    Signature

    Sign the document and provide the date of signing. If applicable, provide your title. Claims by corporations must be signed by an officer.

    If a joint return, your spouse should also provide his or her signature and the date of signing.

     

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    Fillable Form 843