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Date:____________


Internal Revenue Service

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Taxpayer: ________
SSN: ________
IRS Form: ________
Tax Period: ________

To Whom It May Concern:

I have received the enclosed letter, dated ________, from the IRS concerning a proposed adjustment to my ________ for ________. Your notice indicated that I did not report the following income on my ________ for ________:

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I disagree with your findings and proposed adjustment because this income was correctly reported on my return. This item was included on ________ and was reported in the following manner:

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A copy of ________ is included with this letter for your reference.

The reported ________ may have been prepared incorrectly or prepared using the wrong year. Please adjust your records accordingly.

Please contact me if you have any questions or need additional information. Thank you for your assistance.

Best,



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Enclosure