Federal Questionnaire for Non-Requesting Spouse

Questionnaire for Non-Requesting Spouse
Form 12508 (Rev. 6-2021)
Form

Department of the Treasury - Internal Revenue Service

12508

Questionnaire for Non-Requesting Spouse

(June 2021)

We recognize that some of these questions involve sensitive subjects. However, we need this information to evaluate the
circumstances of the request for relief and properly determine whether relief should be given. If this form is not completed and returned,
the request for relief will be considered based on the information available to us.
If the requesting spouse petitions the Tax Court to review their request for relief, the Tax Court may only be allowed to consider
information you and the requesting spouse provided before we made our final determination, additional information we included in our
administrative file about the requesting spouse’s request for relief, and any information that is newly discovered or previously
unavailable. Therefore, it is important that you provide us with information you want us or the Tax Court to consider.

Part I - Tell Us About Yourself
1. Your current name

Your social security number

Your current home address (number & street)

Apartment number

City, town or post office box, state and ZIP code

County

Daytime phone number (between 6 a.m. and 5
p.m. eastern time)

2. What is the current status between you and your spouse for the years that relief was requested? (On this form we refer to your spouse
for the years that relief was requested as that individual)

Married and living together
Married living apart since

(MM/DD/YYYY)

Legally separated since

(MM/DD/YYYY)

Divorced since

(MM/DD/YYYY)

Widowed since

(MM/DD/YYYY)

Note: A divorce decree stating you must pay all taxes does not necessarily mean that individual will qualify for relief.

Part II - Tell Us About Filing the Returns and Your Financial Situation for the Years Listed on the Letter
If the information is not the same for all tax years, explain. If you need more room to write your answer for any question,
attach more pages. Be sure to write your name and social security number on the top of all pages you attach.
3. How were both of you involved with preparing the returns during those tax years? Check all that apply and explain, if necessary. If
the answers are not the same for all the years, explain
You

That Individual
Prepared or helped prepare the returns
Gathered receipts and canceled checks
Gave tax documents (such as W-2s, 1099s, etc.) to the person who prepared the returns
Asked the person who prepared the returns to explain any items or amounts
Reviewed the returns before filing them
Did not review the returns before filing them
Was not involved with preparing the return
Other

Explain, if necessary

Catalog Number 28730P

www.irs.gov

Form 12508 (Rev. 6-2021)

Page 2
4. When you filed the returns, were any amounts owed to the IRS for those years
Yes. Explain how the amounts owed were to be paid

No
5. When that individual signed/filed any of the returns, was he/she aware of any financial problems you were having (for example,
bankruptcy or bills you could not pay)

Yes. Explain

No
Do not know
6. For those years, what kinds of accounts did you have? Check all that apply. Explain if the answers are not the same for all the years
Joint

Separate
Checking or money market
Savings or certificate of deposit

How did that individual use those accounts? Check all that apply
Joint

Separate
Made deposits
Reviewed bank statements or balanced the checkbook
Paid bills
Knew how much money was in the account
Made withdrawals from the account
Did not know about the account
Did not use the account
Was not involved in handling money for the household

Explain, if necessary

7. Did you ever transfer assets to that individual? (Did you put something of value, such as real estate or stocks, in that individual's name rather
than in your own name)

Yes. List the assets and the dates they were transferred. Explain why the assets were transferred

No
8. During those tax years, were you self employed
Yes. Explain how that individual was involved in your business

No
Catalog Number 28730P

www.irs.gov

Form 12508 (Rev. 6-2021)

Page 3
9. If the tax year(s) in question were audited, what items, if any, changed? Were the changed items yours or that individual’s? (For
example, unreported income, disallowed deductions, unclaimed credits)

10. If the audit results changed your business income or deductions on your tax return, did that individual help you in the business? If
so how? If not, did that individual know about your business affairs? Explain

11. If the items changed by the audit were yours, did that individual benefit from them? (Example, unreported income paid for a family
vacation, car, jewelry, etc.) Explain

12. Do you have any other information you want us to consider

Sign Here
Under penalties of perjury, I declare that I have examined this statement and to the best of my knowledge it is true, correct, and
complete.
Signature

Date

Keep a copy for your records. Return the original signed form and any attachments or you may fax the signed form and attachments.
Catalog Number 28730P

www.irs.gov

Form 12508 (Rev. 6-2021)