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Director, Jacksonville District              Certified Mail No.: ___________
Internal Revenue Service
FOIA Request, Attn: Disclosure Officer
P.O. Box 35045, Stop 40340
Jacksonville, Fla. 32202                     August ____, 1998.
"Other Requester":          _________
"Identifying Number":       _________
     Re: FREEDOM OF INFORMATION ACT and PRIVACY ACT REQUEST
NOTICE TO DISCLOSURE OFFICER:

This request is made pursuant to both the Freedom and Information Act and the Privacy Act, must be processed under both Acts, and does meet all procedural requirements of 31 CFR Subtitle A, Part 1, Appendix B, Subpart C, Appendix B; 26 CFR 601.702, and those listed on the Federal Register. I am requesting that you submit all of the items listed on the back of this request that are maintained under this Requester's assigned name and Identifying number, as stated above, pertaining to each of the years, 1990 through 1997 inclusive:

(Please see the back of this request form for a list of the records requested.)

If there are any fees for searching for, or copying any of these items, please inform me of them before you complete this request. I am requesting this information so that I may better understand the operating policies and procedures of your agency. As you know, the Freedom of Information Act permits you to reduce or waive fees when the release of the information is considered as "primarily benefiting the public." I believe that this request satisfies that criteria and ask that you waive any fees.

I understand the penalties for requesting information under false pretenses. I believe that the documents requested herein are publicly available, within the custody of your Commission's Office, and not exempt or excluded under any statute, e.g. "the documents are not exempt under exemption (b)(5) as they represent a purely factual record of the agency's post decisional file in this matter." I also believe that reasonable grounds do not exist for withholding, in accordance with § (a)(4)(F) of the Act's penalties section. If all or any part of this request is denied, please provide me with indexing, itemization and return to me a detailed statement citing the specific exemption(s) which you believe would justify your refusal to release the information, and inform me of the appeal procedure available to me as prescribed by law.

Please remember that it is the policy of the Department of Justice (FOIA Update spring/summer 1993) to refuse to represent your agency when it has failed to comply with regulations pertaining to this request, and because the Congress has not authorized the Secretary to appear on behalf of your agency, I would be awarded my claim plus all costs if the need to file a civil complaint in the U.S. District Court arose. However, I am very optimistic that I can obtain the information requested without such action.

I would appreciate your processing this request as quickly as possible, and I look forward to your written acknowledgment within twenty (20) days, as provided by law.

Best regards,                         return   ______________________
                                      address: ______________________

__________________________________             ______________________
signature of Requester

1) Information Returns Master File (IRMF) Transcript

2) Form 5604, Section 6020(b) Action Sheet

3) all summary records of assessment, each of which must identify the taxpayer, the type of tax owed, the taxable period, the amount of the assessment and the signature of a duly designated official for the district or regional tax center, (see Robinson v. United States, 920 F.2d 1157; 26 USC § 6203 and 26 CFR § 301.6203-1),

4) all returns prepared by the Secretary for the above named Requester for the years stated. These are the returns which must be executed and subscribed to by the Secretary under 26 CFR 301.6020-

1. Please review the following regulation for a full description:

Code of Federal Regulations
Title 26, Volume 17, Parts 300 to 499
Revised as of April 1, 1997
From the U.S. Government Printing Office via GPO Access
CITE: 26 CFR 301.6020-1
TITLE 26--INTERNAL REVENUE
CHAPTER I--INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY--(Continued)

Information and Returns--Table of Contents

Sec. 301.6020-1 Returns prepared or executed by district directors or other internal revenue officers.

(a) Preparation of returns--(1) In general. If any person required by the Code or by the regulations prescribed thereunder to make a return fails to make such return, it may be prepared by the district director or other authorized internal revenue officer or employee provided such person consents to disclose all information necessary for the preparation of such return. The return upon being signed by the person required to make it shall be received by the district director as the return of such person.

(2) Responsibility of person for whom return is prepared. A person for whom a return is prepared in accordance with subparagraph (1) of this paragraph shall for all legal purposes remain responsible for the correctness of the return to the same extent as if the return had been prepared by him.

(b) Execution of returns--(1) In general. If any person required by any internal revenue law or by the regulations prescribed thereunder to make a return (other than a declaration of estimated tax required under section 6015 or 6016) fails to make such return at the time prescribed therefor, or makes, willfully or otherwise, a false or fraudulent return, the district director or other authorized internal revenue officer or employee shall make such return from his own knowledge and from such information as he can obtain through testimony or otherwise.

(2) Status of returns. Any return made in accordance with subparagraph (1) of this paragraph and subscribed by the district director or other authorized internal revenue officer or employee shall be prima facie good and sufficient for all legal purposes.


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