Form 843 claim for refund or abatement: cover letter (template)

Who it is for

An owner claiming back a penalty, interest or fee that was paid, or asking the IRS to cancel one not yet paid, where Form 843 is the right form.

When to use it

Use it with Form 843 when the explanation or the list of documents is longer than the form’s line 8. Check first that Form 843 applies: it is not for income tax, not for amending a return, and not for employer FICA or withholding refunds.

The deadline and form it relates to

• Form 843 claims a refund or requests abatement of certain taxes, penalties, additions to tax, interest and fees (IRS — Instructions for Form 843 (12/2024)).
• It is not used to request abatement of income, estate or gift tax, or to amend an income or employment tax return (IRS — Instructions for Form 843 (12/2024)).
• A refund claim is generally due within 3 years from the date the original return was filed or 2 years from the date the tax was paid, whichever is later (IRS — Instructions for Form 843 (12/2024)).
• A separate Form 843 is generally needed for each tax period and each type of tax or fee (IRS — Instructions for Form 843 (12/2024)).

The template

Replace every [BRACKETED] field and delete any line that does not apply. Keep a copy of everything you send.

[DATE]

[IRS ADDRESS — copy it exactly from your notice]

Re: Form 843 — claim for [refund / abatement] of [PENALTY, INTEREST OR TAX TYPE]
Taxpayer name: [BUSINESS OR INDIVIDUAL NAME, exactly as on the return]
Taxpayer identification number: [EIN or last four digits of SSN, as the notice shows it]
Tax form: [e.g. Form 1120-S, Form 1065, Form 941, Form 1040]
Tax period(s): [e.g. tax year 2024, or quarter ending 03/31/2025]
Notice or letter number: [e.g. CP14, CP2000, LT11 — top or bottom right corner] dated [NOTICE DATE]

To whom it may concern:

Enclosed is a signed Form 843, Claim for Refund and Request for Abatement, for [TAX PERIOD] in the amount of $[AMOUNT].

What is being claimed: [e.g. "the failure-to-pay penalty of $[AMOUNT] assessed on [DATE] under Internal Revenue Code section [SECTION, from the notice]" / "interest of $[AMOUNT] charged from [DATE] to [DATE]"]

Why: [Summarize the reason in two or three sentences; the full explanation is on line 8 or the attached sheet. Example: "The late payment was caused by [EVENT] on [DATE], as shown in the enclosed records."]

Computation: [Show how the amount was reached. Example: "Penalty assessed $[AMOUNT] + interest on the penalty $[AMOUNT] = $[TOTAL] claimed."]

[IF PAID: The amount was paid on [DATE]. Please refund it to the address above.]
[IF NOT PAID: Please abate the amount and adjust the balance.]

Sincerely,

[SIGNATURE]
[PRINTED NAME], [TITLE — e.g. Owner, Managing Member, President]
[BUSINESS NAME]
[DAYTIME PHONE]

Enclosures: Form 843; copy of the notice; [LIST EACH SUPPORTING DOCUMENT]

What to attach

• Form 843, one per tax period and tax type, signed.
• A copy of the notice that shows the assessment.
• Supporting evidence for the reason given on line 8, and any extra sheets with your name and taxpayer identification number on each.
• Form 2848, only if a representative files the claim for you.

Where to send it

• When the claim answers an IRS notice, the instructions say to mail it to the return address from which the notice was sent (IRS — Instructions for Form 843 (12/2024)).
• For penalties and most other claims, it goes to the service center where you would file a current-year return for that tax (IRS — Instructions for Form 843 (12/2024)).
• Line 8 asks you to explain the reasons in detail and show the computation (IRS — Instructions for Form 843 (12/2024)).

Official forms and pages

• Form 843 (PDF, IRS)
• About Form 843 (IRS)