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Request for Prompt Assessment Under OMB No. 1545-0430
Form 4810 Internal Revenue Code Section 6501(d)
(Rev. August 2022)
Department of the Treasury See instructions on back. For IRS Use Only
Internal Revenue Service Go to www.irs.gov/Form4810 for the latest information.
Requester’s name Kind of tax
Income
Gift
Title
Employment
Excise
Number, street, and room or suite no. (If a P.O. box, see instructions.)

City, town, or post office, state, and ZIP code Daytime phone number

Tax Returns for Which Prompt Assessment of Any Additional Tax Is Requested

Form Tax Period SSN/EIN on Name and Address Shown on Return Service Center Where Filed Date Filed
Number Ended Return

If applicable, provide the name of decedent’s spouse (surviving or deceased). Spouse’s social security number

If corporate income tax returns are included, check the applicable box below:
Dissolution has been completed.
Dissolution has begun and will be completed either before or after the 18-month period of limitation.
Dissolution has not begun but will begin before the 18-month period of limitation expires and will be completed either before or after that
period expires.

Attached are copies of:
The returns listed above.
Letters of administration or letters testamentary.
Other (describe):

I request a prompt assessment of any additional tax for the kind of tax and periods shown above, as provided by Internal Revenue Code section 6501(d).
Under penalties of perjury, I declare that I have examined this request, including accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct, and complete.
I certify that I have never been assessed any penalties for civil fraud for any federal or state tax matter nor have I been charged with, indicted for,
Sign or convicted of fraud. If you cannot certify this statement, attach a detailed statement explaining the circumstances under which you were
assessed a penalty, charged with, indicted for, or convicted of fraud.
Here

Signature of requester Date Identifying number
For Privacy Act and Paperwork Reduction Act Notice, see back of form. Cat. No. 42022S Form 4810 (Rev. 8-2022)

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Form 4810 (Rev. 8-2022) Page 2

General Instructions Privacy Act and Paperwork Reduction Act Notice. We
ask for the information on this form to carry out the
Section references are to the Internal Revenue Code Internal Revenue laws of the United States. We collect
unless otherwise noted. this information under the authority under Internal
Revenue Code section 6501(d). We need it to ensure that
Future Developments you are complying with these laws and to allow us to
For the latest information about developments related to figure and collect the right amount of tax. You are not
Form 4810 and its instructions, such as legislation required to request prompt assessment; however, if you
enacted after they were published, go to www.irs.gov/ do so, you are required to provide the information
Form4810. requested on this form. Failure to provide the information
may delay or prevent processing your request. Section
Purpose of Form 6109 requires you to provide the requested taxpayer
Use Form 4810 to request prompt assessment of tax. identification numbers.
Attach to your request the documentation requested on You are not required to provide the information
Form 4810. If you prefer to use your own format, your requested on a form that is subject to the Paperwork
request must list the same information as requested on Reduction Act unless the form displays a valid OMB
this form and include the applicable attachments. control number. Books or records relating to a form or its
Specifically, you must verify your authority to act for the instructions must be retained as long as their contents
taxpayers (for example, letters testamentary or letters of may become material in the administration of any Internal
administration) and provide copies of the authorizing Revenue law. Generally, tax returns and return
document. Also, your request must clearly show: information are confidential as required by section 6103.
• It is a request for prompt assessment under section However, section 6103 allows or requires the IRS to
6501(d); disclose or give such information shown on your Form
4810 to the Department of Justice to enforce the tax
• The kind of tax and the tax periods involved; laws, both civil and criminal, and to cities, states, the
• The name and social security number (SSN) or District of Columbia, and U.S. commonwealths or
employer identification number (EIN) shown on the return possessions. We may also disclose this information to
(copies of the returns may be attached to help identify the other countries under a tax treaty, to federal and state
return; write at the top of the return copy: “COPY - DO agencies to enforce federal nontax criminal laws, or to
NOT PROCESS AS ORIGINAL”); and federal law enforcement and intelligence agencies to
combat terrorism.
• The date and location of the IRS office where the
returns were filed. The time needed to complete and file this form and
related schedules will vary depending on individual
When To File circumstances. The estimated average times are:
Do not file Form 4810 requesting prompt assessment Recordkeeping . . . . . . . . . . 5 hr., 30 min.
until after you file the tax returns listed on the front of this Learning about the law or the form . . . . 18 min.
form. You must submit a separate request for prompt
assessment for any tax returns filed after this Form 4810. Preparing the form . . . . . . . . . . 24 min.
Where To File Copying, assembling, and
sending the form to the IRS . . . . . . . . 0 min.
Send your request to the Internal Revenue Service Center
where you filed the returns for which you are requesting If you have comments concerning the accuracy of
prompt assessment. However, if this is related to gift tax these time estimates or suggestions for making this
reported on a Form 709, send to: request simpler, we would be happy to hear from you.
You can send us comments through www.irs.gov/
Internal Revenue Service FormComments. Or you can write to:
Stop 824G
7940 Kentucky Drive Internal Revenue Service
Florence, KY 41042-2915 Tax Forms and Publications
1111 Constitution Ave. NW, IR-6526
Private delivery services. You can use certain private Washington, DC 20224
delivery services (PDSs) designated by the IRS, in
addition to the United States mail, to file Form 4810. Go Do not send Form 4810 to this address. Instead, see
to www.irs.gov/PDS for the current list of designated Where To File, earlier.
services. The PDS can tell you how to get written proof of
the mailing date.
PDSs can’t deliver items to P.O. boxes. You
must use the U.S. Postal Service to mail any
¶! item to an IRS P.O. box address.
CAUTION

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