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December 2013) explain how to claim a refund or request an abatement of certain taxes, interest, penalties, fees, and additions to tax. The guidance clarifies what Form 843 can and cannot be used for, including restrictions on income tax, Additional Medicare Tax, and various employment and payroll tax refunds or abatements. It also provides specific mailing addresses and filing-location changes effective August 28, 2014 for cases tied to Letter 4658 and Letter 5067C, including required wording on the form.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/instructions-for-form-843-claim-for-refund-and-request-for-abatement/303494/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/instructions-for-form-843-claim-for-refund-and-request-for-abatement/303494.png","ImageObject",442,249,{"name":88,"@type":89},"Aria","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-27","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":76},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is Form 843 used for?","Question",{"text":108,"@type":109},"Form 843 is used to claim a refund or request an abatement of certain taxes, interest, penalties, fees, and additions to tax.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When must you not use Form 843?",{"text":113,"@type":109},"Do not use Form 843 to request a refund of income tax or Additional Medicare Tax, and employers generally cannot use it for FICA, RRTA, or income tax withholding refunds or to amend previously filed income or employment tax returns.",{"name":115,"@type":106,"acceptedAnswer":116},"What address change applies to Form 843 filed in response to Letter 5067C?",{"text":117,"@type":109},"Effective August 28, 2014, an IRS mailing address is added to the Where To File table for Form 843 filed in response to Letter 5067C, and the form top must include the specified wording to ensure proper processing.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},303494,1790225289,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":76,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":73},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","Note: Instructions for Form 843 (Rev. December 2013) begins on the  \nnext page.  \nEffective August 28, 2014 , if you are filing Form 843 in response to Letter 5067C (Annual Fee on Health Insurance Providers Final fee), note that the following address is being added to the Where To File table in the Instructions for Form 843 (Rev.  \nDecember 2013) . The address to mail Form 843 in this case is:  \nInternal Revenue Service Mailstop 4921 IPF 1973 Rulon White Blvd.  \nOgden, UT 84201  \nThe above address is effective ONLY if you are filing Form 843 in  \nresponse to Letter 5067C (Annual Fee on Health Insurance Providers Final Fee) . Please see the modifications to the Where to File Table below.  \nWhere To File  \n\n| IF you are filing Form 843... | THEN mail the form to... |\n| --- | --- |\n| In response to an IRS notice regarding a tax or fee related to certain taxes such as income, employment, gift, estate, excise, etc. | The address shown in the notice. |\n| For penalties, or for any other reason other than an IRS notice (see above) or Letter 4658 or 5067C (see below) | The service center where you would be required to a file a current year tax return for the tax to which your claim or request relates. See the instructions for the return you are filing. |\n| In response to Letter 4658 (Notice of Branded Prescription Drug Fee)\u003Cbr>Note. To ensure proper processing, write “Branded Prescription Drug Fee” across the top of Form 843. | Internal Revenue Service Mail Stop 4921 BPDF 1973 Rulon White Blvd. Ogden, UT 84201\u003Cbr>Caution. Use this address only if you are claiming a refund of the branded prescription drug fee. |\n| In response to Letter 5067C (Annual Fee on Health Insurance Providers Final Fee)\u003Cbr>Note. To ensure proper processing, write “Annual Fee on Health Insurance Providers Final Fee” across the top of Form 843. | Internal Revenue Service Mail Stop 4921 IPF 1973 Rulon White Blvd. Ogden, UT 84201\u003Cbr>Caution. Use this address only if you are claiming a refund of the health insurance provider fee. |\n| The service center where you filed your most recent return. | For requests of a net interest rate of zero |\n\nThis change will be reflected in the next revision of the Instructions for Form 843.  \nInstructions for Form 843  \n(Rev. December 2013)  \n(For use with Form 843 (Rev. August 2011))  \nClaim for Refund and Request for Abatement  \nDepartment of the Treasury  \nInternal Revenue Service  \nSection references are to the Internal Revenue Code unless otherwise noted.  \nGeneral Instructions  \nFuture Developments  \nFor the latest information about developments related to Form 843 and its instructions, such as legislation enacted after they were published, [go to](go to www.irs.gov/form843)[ www.irs.gov/form843](go to www.irs.gov/form843) .  \nPurpose of Form  \nUse Form 843 to claim a refund or request an abatement of certain taxes, interest, penalties, fees, and additions to tax.  \nNote. If you are filing Form 843 to claim a refund of the branded prescription drug fee, please write “Branded Prescription Drug Fee” across the top of Form 843.  \nDo not use Form 843 to request a refund of income tax or Additional Medicare Tax. Employers cannot use Form 843 to request a refund of Federal Insurance Contributions Act (FICA) tax, Railroad Retirement Tax Act (RRTA) tax, or income tax withholding. Also do not use Form 843 to amend a previously filed income or employment tax return. Do not use Form 843 to claim a refund of agreement fees, offer-in-compromise fees, or lien fees.  \nNote. You cannot use Form 843 to request an abatement of income, estate, or gift taxes. Employers cannot use Form 843 to request abatement of FICA tax, RRTA tax, or income tax withholding.  \nUse Form 843 to claim or request the following.  \n A refund of tax, other than a tax for which a different form must be used. (See Do not use Form 843 when you must use a different tax form, next.)  \n An abatement of tax, other than income, estate, or gift tax. Employers cannot use Form 843 t","cbCaijItZqaAyugV","https://ap.wps.com/l/cbCaijItZqaAyugV","pdf",184148,6,"English","# Where To File\n## Mailing address rules for specific filing situations\n# General Instructions\n## Future Developments\n## Purpose of Form\n## When to use Form 843\n## When not to use Form 843","[{\"question\":\"What is Form 843 used for?\",\"answer\":\"Form 843 is used to claim a refund or request an abatement of certain taxes, interest, penalties, fees, and additions to tax.\"},{\"question\":\"When must you not use Form 843?\",\"answer\":\"Do not use Form 843 to request a refund of income tax or Additional Medicare Tax, and employers generally cannot use it for FICA, RRTA, or income tax withholding refunds or to amend previously filed income or employment tax returns.\"},{\"question\":\"What address change applies to Form 843 filed in response to Letter 5067C?\",\"answer\":\"Effective August 28, 2014, an IRS mailing address is added to the Where To File table for Form 843 filed in response to Letter 5067C, and the form top must include the specified wording to ensure proper processing.\"}]","Instructions for Form 843 - Claim for Refund and Request for Abatement | PDF",1789804288]