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Form 12509 for Pittsburgh Pennsylvania: What You Should Know

To send the Form 12509, write on the line, “FOR THE UNITED STATES” in the circle box and fill in everything in the next box. Fill in line 4a with the amount of tax you are requesting, the total amount of your assessment which you do NOT include on line 4b. If you have a child or dependent, you also need to add to line 4a the amount of the tax which would be applicable to the child or dependent. The amount of the assessment shown will be increased or decreased by a percentage determined by the following formula: % Increase/Decrease = 1 + % When asked to pay the total amount of your assessment from an original due date and payment due date, mail Form 12509 with the IRS statement of your disagreement to the address shown on line 9. Do NOT remit your Form 12509 until the due date indicated on the IRS form. The Form is returned to the sender and there is no further action required.

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