Department of the Treasury - Internal Revenue Service
Form 8546 
(November 2024)
                            Claim for Reimbursement of Bank Charges
Instructions: Carefully read the instructions on the back of this form and provide the information requested. Use additional sheet(s) if 
necessary. Submit this form to the address of the IRS office which served the levy, the address of the office that misplaced the payment 
or the address that you used to file your tax return for Direct Debit Installment Agreement Request. 
1. Name and address of claimants                                  2. Telephone number (including area code) 

a. Address (number, street)                                       3. Best time to call                  4. Amount of claim

b. City                                                           5. Social security or employer identification number (Disclosure is 
                                                                              voluntary. Omission may delay your claim or prevent locating your 
                                                                              records) 
c. State                                    d. ZIP code

Electronic Funds Transfer (EFT) Information (see instructions on the back of this form)
6. Name(s) on bank account                                        7. American Bankers Association (ABA) number 

8. Bank name and address                                          9. Bank account number 

a. Address (number, street)                                       10. Type of account 
                                                                              Checking                  Savings 
b. City                                                           11. I am filing a claim for reimbursement of bank charges for
                                                                              An erroneous levy
                                                                              Stopping payment on a check that the IRS lost or misplaced
c. State                                    d. ZIP code
                                                                              Direct Debit Installment Agreement (DDIA) processing error 
                                                                              on the part of the Service
12. Description of claim (State the circumstances which resulted in the loss for which you are claiming reimbursement.) 

Certification
I certify that the amount of my claim covers only bank charges which resulted from either an erroneous IRS levy, processing error by 
the Service for a Direct Debit Installment Agreement or having to stop payment on a check which was lost or misplaced by the IRS. I  
agree to accept this amount in full satisfaction and final settlement of this incident. 
13. Signature of claimants (this signature should be used in all future correspondence)                 14. Date of claim

15. Signature of secondary claimant (if it is a joint bank account or return)                           16. Date of claim

               Civil Penalty for Presenting                                             Civil Penalty for Presenting  
                         Fraudulent Claim                                     Fraudulent Claim or Making False Statements   
The claimant shall be liable to the United States for the sum of  Fine of not more than $10,000 or imprisonment for not more 
$2,000 plus double the amount of damages sustained by the         than 5 years or both. (See 62 Stat. 698, 749; 18 USC 287, 1001.) 
United States. (See R S § 3490, 5438, 31 USC 3729.) 

Catalog Number 63488O                                      www.irs.gov                                                  Form 8546 (Rev. 11-2024)

           Instructions for Form 8546, Claim for Reimbursement of Bank Charges

Complete all blocks. Write "NONE" if the block does not apply. 
Use this form only for reimbursement of bank charges for:            2. records showing the bank charges caused by the erroneous  
                                                                            levy, the request for replacement of a lost or misplaced 
1. an erroneous levy, or                                                    check, or DDIA processing error on the part of the Service,  
2. stopping payment on a check that the IRS lost or misplaced.              and 
3. Direct Debit Installment Agreement (DDIA) processing error        3. records showing that the bank charges have been paid. 
on the part of the Service. 
                                                                     Records to support your claim must include bank statements and 
The claimants must sign this form. If the bank account involved      correspondence. 
is a joint account, each owner on the account must sign the 
Form 8546 as a claimant for erroneous levy. DDIA processing          If you have any questions about this claim, contact the IRS office 
error claims on joint returns also require signature of both         that issued the levy or requested replacement of your check. The 
spouses. However, an authorized agent or legal representative        address is on your copy of the levy or the request for a new 
can file and sign the claim if the claimant can't because of         check. If your questions relate to a Direct Debit Installment 
disability, death, or other acceptable reason. Include proof of      Agreement, contact the IRS at 1-800-829-1040 or mail your 
authorization if the claim is being filed on behalf of someone.      questions to the address that you used to file your tax return. 
Claims must be made within one year of the date the claim            If IRS approves your claim, the money can be sent to your bank 
accrues and are limited to $1,000. (See 31 USC 3723)                 by electronic funds transfer (EFT), or we can send you a check.  
                                                                     Payment by EFT will be faster, safer, and more convenient for 
Attach verification of the amount you are claiming. Include any      you. If you want us to pay your claim by EFT, we need the bank  
documentation you may have explaining or acknowledging the           information in items 6 through 10. The American Bankers  
IRS error. Also, include:                                            Association (ABA) number (item 7) is the first nine digits in the  
                                                                     number at the bottom of your checks. If you have no checking  
1. a copy of the levy (if the charges were caused by an              account, ask your bank what its ABA number is. If you do not  
erroneous levy),                                                     complete items 6 through 10, a check will be sent to you. 

Internal Revenue Policy P-5-39 
Reimbursement of Bank Charges Due to Erroneous Levy and Service Loss or Misplacement of Taxpayer 
                          Checks, or Direct Debit Installment Agreement Processing Errors. 
The Service recognizes that there are circumstances when an          (3) Prior to the levy, the taxpayer did not refuse (either orally or 
erroneous use of its unique enforcement powers may cause tax-        in writing) to timely respond to Service inquiries or provide 
payers to incur certain bank charges. Taxpayers who incur bank       information relevant to the liability for which the levy was made. 
charges due to an erroneous levy or a Direct Debit Installment  
Agreement (DDIA) processing error on the part of the Service         The following criteria must be present in all lost check cases: 
may file a claim for reimbursement of those expenses. Bank           (1) The Service acknowledges it lost or misplaced the check  
charges include a financial institution's customary charge for       during processing; 
complying with the levy instructions as well as charges for  
overdrafts that are a direct consequence of an erroneous levy or     (2) the Service asks the taxpayer for a replacement of the 
DDIA processing error on the part of the Service. In addition,       payment; and 
there are times when a taxpayer's check may be lost or               (3) the Service is satisfied that the replacement payment has  
misplaced in processing. When the Service asks for a                 been received. 
replacement check, the taxpayer maybe reimbursed for bank  
charges incurred in stopping payment on the original check. The      The following criteria must be present in all DDIA processing  
charges must have been paid by the taxpayer and must not have        error cases. 
been waived or reimbursed by the financial institution. Claims       (1) The Service failed to act timely, took an incorrect or  
must be filed with the District Director or Service Center Director  improper action, or a systemic failure caused the bank fees; 
within one year after accrual of the expense. 
                                                                     (2) The taxpayer must not have contributed to the continuation 
The following criteria must be present in all erroneous levy         or compounding of the error that caused the bank fees; and 
cases:                                                               (3) Prior to the processing error, the taxpayer did not refuse  
(1) The Service acknowledges the levy was erroneous;                 (either orally or in writing) to timely respond to the Service’s  
                                                                     inquiries or provide sufficient information for the DDIA processing 
(2) The taxpayers must not have contributed to the                   change to be made. 
continuation  or compounding of the error; and 

In compliance with the Privacy Act of 1974, the following is provided. 

Solicitation of the information is authorized by Title 31 USC        We may disclose the information on this form relevant to  the 
3723; 31 CFR 3.20 et seq. Disclosure of the information is           processing of your claim or to any court proceedings resulting  
voluntary.                                                           from your claim. We may give the information to the Department  
                                                                     of Justice for the purpose of seeking legal advice or recommend- 
The principal purpose of this information will be for our internal   ing prosecutions for fraudulent claims or the making of false  
use in processing your claim under 31 USC 3723, or for any           statements. 
court proceedings which may ensue from the filing of this claim. 

Catalog Number 63488O                                           www.irs.gov                Form 8546 (Rev. 11-2024)