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Form 3949-A Jurupa Valley California: What You Should Know

Date of Incident, name, age, address, address, date/time of event, name,  TIN(Number), if known, income, marital status (one or more), age,  year of birth, type of person filing(s), type of event, address, country, or place of work, if applicable. Note: Add a check for the filing fee if the name of the person is (or is not) listed on the returns. 3. Other Information Not Included. Enter all other: address, address, date/time of event, name,  date of birth and state of birth if they were (or were not) listed on the returns, if applicable. 2. Check whether the report involves the filing of tax returns. Fill in Yes or No.  Are there any amounts withheld? If “yes”, enter the amount of the withheld taxes. If “no”, enter an accurate statement of the withholding of taxes, using the information on this form. 1. For the purpose of preparing this form, include a statement of taxes withheld and refunds to be filed. Make sure that your tax return was (are) filed. 2. If applicable, list the reason for filing this claim. Fill in “Other” (below) or other (in brackets) as appropriate. Enter: 3. Do you have a copy of the documents included with this form? If a copy was attached to your original return, make sure that you file this form electronically via IRS.gov and complete the IRS Form 5320-T, “Income Tax Withholding and Estimated Tax.” If you had no original filed tax return, complete Form 5320-T and attach it to the electronic form. Complete all attachments and send it to the Internal Revenue Service. Send it with the following instructions: A. Use Form D-3949A, Tax Fraud and Identity Theft (2-2007). B. Make a check payable to the United States Treasury. C. Mail the check to the address provided in box 6. Attach a check for the filing fee to the cover page or cover of your return. Attach a copy of the IRS Return and Form 5320-T. Attach a copy of Form 1040, for filing of tax returns and Form 1040A; and complete (or attach) Section D of this form. (See examples above.) 4. The IRS is responsible for tracking down and seizing any documents sent in this form.

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