Form 211, Application for Award for Original Information.
The IRS Form 211, Application for Award for Original Information, is the form that whistleblowers must complete and submit to the IRS in order to perfect a claim for an award under Internal Revenue Code section 7623(a) or section 7623(b). The Form 211 must be filed with the IRS Whistleblower Office in Ogden, Utah, with the whistleblower’s original signature signed under penalty of perjury. If the Form 211 is not signed, the IRS will not accept the claim and will give you a limited amount of time to sign and return.
Space is limited on the Form 211 so the IRS encourages the use of separate attachments that can be referenced within the space provided on the Form 211. Do not try to jam all of your information on this form. Rather, a carefully crafted and organized submission with a Form 211 and attached memorandum of facts and law with supporting exhibits is crucial to the success of your tax whistleblower claim. For example, Question 11 on the Form 211 asks the whistleblower to describe the alleged violation and to state all pertinent facts to the alleged violation. Rather than squeezing all that information in the small space provided on the Form, whistleblowers can direct the IRS to an attachment by writing, for example, “see the attached explanation.” Even if a whistleblower directs the IRS to attachments throughout the Form, the Form 211 must contain an original signature under penalty of perjury to be valid. A [tax lawyer] [link to Informant US Form] who is familiar with the IRS Whistleblower Office procedures and with tax controversies should be consulted to put the tax whistleblower submission together.
The instructions for the Form 211 break completion of the Form into nine parts:
- Questions 1 – 4. Information about the taxpayer being reported.
- Questions 5 – 6. Information, if any, about the IRS employee that the information was reported to.
- Questions 7 – 8. Information, if any, about the Federal or State Agency that the information was reported to.
- Question 9. Question regarding whether the information is a new whistleblower submission or information that supplements a submission previously submitted. If the whistleblower is providing additional information regarding the same or similar non-compliance by the same taxpayer that was identified in a previously submitted Form 211, you are providing a “supplemental submission.”
- Questions 10 – 11. Specific information about the tax violation being reported and supporting documentation that substantiates the claim.
- Questions 12 – 19. Information about how the whistleblower learned of the tax violation being reported and the whistleblower’s relationship to the taxpayer.
- Questions 20 – 21. Information about the amount of tax owed and the applicable tax years.
- Questions 22 – 26. Information about the whistleblower.
- Question 27. Original signed under penalty of perjury.
Once the Form 211 is complete, the original signed Form 211 must be mailed to the address listed below.
Internal Revenue Service
Whistleblower Office – ICE
1973 N. Rulon White Blvd.
M/S 4110
Ogden, UT 84404
At this time there is no option for tax whistleblowers to submit claims online or over the phone. Upon receiving and processing the Form 211, the IRS will provide the whistleblower with a claim number. That claim number will be used to refer to that particular tax whistleblower submission in all correspondence with the IRS.
Form 3949-A, Information Referral
The IRS Form 3949-A, Information Referral, is the form used to report alleged tax violations by an individual, business, or both. A major difference between the Form 3949 and the Form 211 is that the Form 3949 does not claim an award for the information provided to the IRS where the Form 211 does claim an award for the information provided to the IRS. Unlike the Form 211, Form 3949 can be completed anonymously although the IRS says that information about the filer is helpful in case they have questions or would like additional information.
The Form 3949 is broken into three sections:
- Section A. Information about the taxpayer being reported.
- Section B. Information about the tax violation being reported including the specific tax issue involved, the amounts of tax owed and the applicable tax years at issue, and how the filer learned of the information being reported.
- Section C. Information about the filer of the form including name, address, and telephone number. Although this section is not required to be completed to process the Form 3949, the IRS requests it and they state on the form that “We never share this information with the person or business you are reporting.”
Unlike the Form 211, the Form 3949 does not require an original signature signed under penalty of perjury. Once the Form 3949 is complete, it must be mailed to the following address:
Internal Revenue Service
Stop 31313
Fresno, CA 93888
At this time, there is not an option to submit this information online or over the phone.