Craig I. Smith and Mary Lou Smith - Page 4




                                        - 4 -                                         
               Petitioners submitted a completed Form 12256 on April 6,               
          2004.4  By signing the form, each petitioner acknowledged:                  
               I’ve received a resolution with the Internal Revenue Service           
               regarding the tax and tax period that my hearing request               
               concerned and I’m satisfied that I no longer need a hearing            
               with Appeals.  Therefore, I withdraw my request for a                  
               Collection due Process (CDP) Hearing under * * * IRC Section           
               6330, notice and opportunity for a hearing before a levy               
               * * *                                                                  
               I understand that by withdrawing my request:                           
               •    I give up my right to a Collection Due Process Hearing            
                    with the Office of Appeals.  I understand that the                
                    Office of Appeals will not issue a Notice of                      
                    Determination with respect to the tax and tax period              
                    the hearing request concerned.                                    
               •    I give up my right to seek judicial review, in the Tax            
                    Court or a U.S. District Court, of the Notice of                  
                    Determination that the Office of Appeals would have               
                    issued as a result of the Collection Due Process                  
                    Hearing, as the Office of Appeals will not issue a                
                    Notice of Determination.                                          
               •    I give up my right to have the Office of Appeals retain           
                    jurisdiction with respect to any determination that it            
                    would have made as a result of the Collection Due                 
                    Process Hearing.                                                  
               •    The suspension of levy action and the suspension of the           
                    statute of limitations on the period of collection, as            
                    required under the provisions of IRC Sections 6320 and            
                    6330, are no longer in effect upon the receipt by                 
                    Internal Revenue Service (IRS) of this withdrawal.                
               •    I have the right to request a hearing with the Office             
                    of Appeals that is equivalent to a Collection Due                 
                    Process Hearing without judicial appeal to the Tax                
                    Court or a U.S. District court under IRC Section 6320             
                    or 6330.                                                          
               •    I do not give up any other appeal rights that I am                
                    entitled to, such as an appeal under the Collection               
                    Appeals Program (CAP).                                            



               4The Apr. 6, 2004, Form 12256 pertained to 2002.                       
          Petitioners stipulated that they also executed a Form 12256 for             
          2001.                                                                       





Page:  Previous  1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  Next 

Last modified: November 10, 2007