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Certified U.S.

Mail Serial Number #P-xxx-xxx-xxx Return Receipt Requested Restricted Delivery Requested Chief, Automated Collection Branch Department of the Treasury [sic] Internal Revenue Service [sic] c/o [POST-OFFICE-BOX] [CITY] (zip code exempt) [UNION-STATE] STATE Re:

c/o [mailing location] [CITY] (zip code exempt) [UNION-STATE] STATE [mm/dd/yy2]

CP-515 Notice dated [mm/dd/yy1] requesting Tax Form 1040 (copy attached) SSN: #000-00-0000

Dear Chief: I elected not to file for special refunds prescribed in the regulation at 26 C.F.R., Part 601.401(d) for calendar year 1995 but, as prescribed by 26 C.F.R. 601.401(c), I will seek a refund from My employer, if I have, or if I had, such an employer who was required to withhold, file returns, and pay withholding to your Treasury Department [sic]. If such "employer" refuses to comply with the provisions of 26 C.F.R., Part 601.401(c), I may file for a refund directly from your Treasury Department, but I have no such plans at the present time. Your notice is very confusing to Me, because the regulation at 26 C.F.R., Part 31.6001-1(d) stipulates the following: (d) Records of employees. While not mandatory (except in the case of claims), it is advisable for each employee to keep permanent, accurate records showing the name and address of each employer for whom he performs services as an employee, the dates of beginning and termination of such services, the information with respect to himself which is required by the regulations in this subpart to be kept by employers, and the statements furnished in accordance with the provisions of Section 31.6051-1. After reviewing My records, I do not find that I am directly liable to your Treasury Department for any given tax prescribed in the Internal Revenue Code ("IRC"). See IRC Sections 7701(a)(12)(A) and 7805(a). I am not involved with any offshore activity which is subject to United States (federal government) customs laws within the jurisdiction of the Internal Revenue Service ("IRS"). See Executive Order #10289 (1951), and T.D.O. 150-42 (1956). Therefore, I am unaware of any other return which I might be required to file. If you know of any taxing statute(s) in the IRC which identify a service, transaction, or object of tax which makes Me a "person liable", then please forward actual notice from the Secretary, pursuant to 26 C.F.R., Part 31.6001-6, or direct Me to a legislative regulation with general applicability which has been properly published in the Federal Register in compliance with 44 U.S.C. 1505, per the requirements of IRC Section 6001.

At 31 C.F.R., Part 0.735-60, in relative part, the following is found, to wit: (b) (2) Employees of the Department of the Treasury shall: Collect from individuals only that information which is necessary to Department functions or responsibilities; ... Inform individuals from whom information is collected of the authority for collection, the purposes thereof, the use that will be made of the information, and the effects, both legal and practical, of not furnishing information. [emphasis added]


Once you have supplied the information required above, in compliance with the provisions at 31 C.F.R., Part 0.735-60, I will be able to identify what financial records are applicable, and I will report accordingly. Sincerely yours, /s/ John Q. Doe John Q. Doe, Sui Juris Citizen of [UNION-STATE] state All Rights Reserved without Prejudice # # #

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