Department of the Treasury - Internal Revenue Service
Form 9423 
    (August 2014)                             Collection Appeal Request 
                                              (Instructions are on the reverse side of this form)
1. Taxpayer’s name                                               2. Representative (Attach a copy of Form 2848, Power of Attorney)

3. SSN/EIN                       4. Taxpayer’s business phone    5. Taxpayer’s home phone    6. Representative’s phone

7. Taxpayer’s street address

8. City                                 9. State                                      10. ZIP code

11. Type of tax (Tax form)              12. Tax periods being appealed                13. Tax due

Collection Action(s) Appealed
14. Check the Collection action(s) you are appealing
     Federal Tax Lien                         Levy or Proposed Levy                   Seizure
     Rejection of Installment Agreement       Termination of Installment Agreement    Modification of Installment Agreement

Explanation
15. Explain why you disagree with the collection action(s) you checked above and explain how you would resolve your tax problem. 
    Attach additional pages if needed. Attach copies of any documents that you think will support your position. Generally, the Office of 
    Appeals will ask the Collection Function to review, verify and provide their opinion on any new information you submit. We will 
    share their comments with you and give you the opportunity to respond.

Under penalties of perjury, I declare that I have examined this request and any accompanying documents, and to the best of my knowledge and belief, 
they are true, correct and complete. A submission by a representative, other than the taxpayer, is based on all information of which the representative 
has any knowledge.
16.     Taxpayer’s  or     Authorized Representative’s signature (Only check one box) 17. Date signed

                                                    IRS USE ONLY
18. Revenue Officer's name              19. Revenue Officer's signature               20. Date signed

21. Revenue Officer's phone             22. Revenue Officer's email address           23. Date received

24. Collection Manager’s name           25. Collection Manager’s signature            26. Date signed

27. Collection Manager’s phone          28. Collection Manager’s email address        29. Date received

Form 9423 (Rev. 8-2014)  Catalog Number 14169I      www.irs.gov             Department of the Treasury - Internal Revenue Service

                          Instructions for Form 9423, Collection Appeal Request
For Liens, Levies, Seizures, and Rejection, Modification or Termination of Installment Agreements 
  
A taxpayer, or third party whose property is subject to a collection action, may appeal the following actions under the Collection Appeals 
  Program (CAP): 
  a. Levy or seizure action that has been or will be taken. 
  b. A Notice of Federal Tax Lien (NFTL) that has been or will be filed. 
  c. The filing of a notice of lien against an alter-ego or nominee's property.  
  d. Denials of requests to issue lien certificates, such as subordination, withdrawal, discharge or non-attachment. 
  e. Rejected, proposed for modification or modified, or proposed for termination or terminated installment agreements. 
  f. Disallowance of taxpayer's request to return levied property under IRC 6343(d). 
  g. Disallowance of property owner's claim for return of property under IRC 6343(b). 
  
How to Appeal If You Disagree With a Lien, Levy, or Seizure Action 
1. If you disagree with the decision of the IRS employee, and wish to appeal, you must first request a conference with the employee's 
  manager. If you do not resolve your disagreement with the Collection manager, submit Form 9423 to request consideration by 
  Appeals. Let the Collection office know within two (2) business days after the conference with the Collection manager that you plan 
  to submit Form 9423. The Form 9423 must be received or postmarked within three (3) business days of the conference with the 
  Collection manager or collection action may resume.  
  NOTE: If you request an appeal after IRS makes a seizure, you must appeal to the Collection manager within 10 business days after 
  the Notice of Seizure is provided to you or left at your home or business. 
  
2. If you request a conference and are not contacted by a manager or his/her designee within two (2) business days of making the 
  request, you can contact Collection again or submit Form 9423. If you submit Form 9423, note the date of your request for a 
  conference in Block 15 and indicate that you were not contacted by a manager. The Form 9423 should be received or postmarked 
  within four (4) business days of your request for a conference as collection action may resume. 
  
3. On the Form 9423, check the collection action(s) you disagree with and explain why you disagree. You must also explain your 
  solution to resolve your tax problem. Submit Form 9423 to the Collection office involved in the lien, levy or seizure action. 
  
4. In situations where the IRS action(s) are creating an economic harm or you want help because your tax problem has not been 
  resolved through normal channels, you can reach the Taxpayer Advocate Service at 877-777-4778. 
  
How to Appeal An Installment Agreement Which Has Been Rejected, Proposed for Modification or Modified, or Proposed for 
Termination or Terminated 
1. If you disagree with the decision regarding your installment agreement, you should appeal by completing a Form 9423, Collection 
  Appeal Request. 
2. You should provide it to the office or revenue officer who took the action regarding your installment agreement, within 30 calendar 
  days. 
  NOTE: A managerial conference is not required. However, it is strongly recommended a conference be held with the manager 
  whenever possible. 
  IMPORTANT: Never forward your request for an Appeals conference directly to Appeals. It must be submitted to the office which 
  took the action on your installment agreement. 
  
What Will Happen When You Appeal Your Case 
Normally, we will stop the collection action(s) you disagree with until your appeal is settled, unless we have reason to believe that 
collection or the amount owed is at risk. 
  
You May Have a Representative 
You may represent yourself at your Appeals conference or you may be represented by an attorney, certified public accountant or a 
person enrolled to practice before the IRS.  If you want your representative to appear without you, you must provide a properly 
completed Form 2848, Power of Attorney and Declaration of Representative. You can obtain Form 2848 from your local IRS office, by 
calling 1-800-829-3676, or by going to www.irs.gov. 
  
Decision on the Appeal 
Once Appeals makes a decision regarding your case, that decision is binding on both you and the IRS. You cannot obtain a judicial 
review of Appeals' decision following a CAP. However, there may be other opportunities to obtain administrative or judicial review of the 
issue raised in the CAP hearing.  For example, a third party may contest a wrongful levy by filing an action in district court. See 
Publication 4528, Making an Administrative Wrongful Levy Claim Under Internal Revenue Code (IRC) Section 6343(b).      
  
  Note: Providing false information, failing to provide all pertinent information or fraud will void Appeals' decision. 
  
Refer to Publication 594, The IRS Collection Process, and Publication 1660, Collection Appeal Rights, for more information regarding 
the Collection Appeals Program.  Copies of these publications can be obtained online at www.irs.gov.

                                                            Privacy Act
The information requested on this Form is covered under Privacy Acts and Paperwork Reduction Notices which have already been 
provided to the taxpayer.
Form 9423 (Rev. 8-2014)  Catalog Number 14169I              www.irs.gov              Department of the Treasury - Internal Revenue Service