FORM         ALABAMA DEPARTMENT OF                   REVENUE
                                        INCOME TAX ADMINISTRATION DIVISION
PWR
     9/20         Request for Waiver of Penalty

TAXPAYER NAME                                       FEIN OR SOCIAL SECURITY NUMBER

ADDRESS

CITY                                                STATE                             ZIP

TAX TYPE                                            PERIOD COVERED

AMOUNT OF PENALTY                                   DATE THE TAX WAS PAID

                                                    Note:Tax and interest must be paid before penalty waiver will be considered.

Penalties shall be waived upon a determination of reasonable cause. Reasonable cause shall include, but not be limited to, those instances
in which the taxpayer has acted in good faith. The burden of providing reasonable cause shall be on the taxpayer (§40-2A-11).

Explain the reasons for the delinquent return or late payment of tax. Include any documentation that supports your request.
(Attach additional sheets if necessary.)

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Has the Department of Revenue previously granted a Request for Waiver of Penalty?
6    Yes    6 No
Note: If an unpaid balance remains on your account, interest will continue to accrue until the account is paid in full.

__________________________________________________    __________________________________________________
                  TAXPAYER SIGNATURE                                     SPOUSE’S SIGNATURE (IF JOINT)

__________________________________________________    __________________________________________________
                  TITLE (FOR BUSINESS ENTITY)                                     DATE

__________________________________________________    __________________________________________________
                  REPRESENTATIVE’S NAME                                  REPRESENTATIVE’S SIGNATURE

__________________________________________________    __________________________________________________
                  TELEPHONE NUMBER                                                DATE

                  Your completed form may be submitted for consideration to the address listed on the billing notice.
                  Please attach a copy of the billing notice to your request.

                                       ALABAMA DEPARTMENT OF                   REVENUE

                                       Instructions for Form PWR
                                       Request for Waiver of Penalty

Complete all sections of this petition.

1. Include the taxpayer’s complete legal name.

2. Provide the taxpayer’s Federal Identification Number (FEIN) or Social Security Number.

3. Provide the mailing address for the Taxpayer. 

4. Include the type of tax on which the penalty was assessed.

5. Indicate the tax period on which the penalty was assessed. 

6. Include the amount of the penalty assessed.

7. Tax and interest must be paid before penalty waiver will be considered.  Provide the date the tax and/or interest was paid.

8. Explain the facts and conditions that led to the assessed penalty and include the reason(s) that the penalty should be waived.  In-
clude any documentation that supports your request.  

9. Indicate whether the Department has previously granted a waiver of penalty. 

10. Sign and date the petition.

11. Mail the form and documentation to the appropriate department:

Pass Through Entity                    Withholding Tax            Business Privilege Tax          Special Audit and Compliance
PO Box 327444                          PO Box 327483              PO Box 327320                   PO Box 327442
Montgomery, AL 36132-7444              Montgomery, AL 36132-7483  Montgomery, AL 36132-7320       Montgomery, AL 36132-7442
Phone: (334) 242-1033                  Phone: (334) 242-1300      Phone: (334) 353-7923           Phone: (334) 242-1500

Corporate Income Tax                   Individual Income Tax      Financial Institution Excise Tax
PO Box 327435                          PO Box 327460              PO Box 327439
Montgomery, AL 36132-7435              Montgomery, AL 36132-7460  Montgomery, AL 36132-7439
Phone: (334) 242-1200                  Phone:  (334) 353-0602     Phone:  (334) 242-1200

Note:  If an unpaid balance remains on your account, interest will continue to accrue until the account is paid in full.