Printable blank Form 12153

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1. What is a 12153 Form?

The fillable Form 12153 (Request for a Collection Due Process or Equivalent Hearing) is a federal tax form designed by the IRS (Internal Revenue Service) and issued by the IRS Office of Appeals to let you request a CDP (Collection Due Process) or an alternative hearing in case you receive a notice of levy or lien. Attach Form 433B (business) or 433A (personal) to discuss a Collection Alternative. 

2. What I need the 12153 Form for?

  • It’s used for requesting a different way to pay off your debt and receive an official chance to avoid the levy;
  • If you want to avoid the issuing of a levy notice but have already received a notice of lien;
  • File this form if you didn’t manage to request a CDP until the established deadline for the current year, but want to apply for another hearing option. 

3. How to fill out Form 12153? 

Only pages 1-2 are fillable. They require the following information:

  • your name, TIN (Taxpayer ID), address, contact phone number;
  • the same information for the second taxpayer if you are filing jointly;
  • tax information from the received lien or levy notice, including tax type, number, and period;
  • the right hearing request basis (both can be chosen);
  • confirmation of the equivalent hearing necessity (optional);
  • the reason for disagreement with the received levy, lien, or both (alternative written explanations are acceptable;
  • signatures of both spouses (if filing jointly) and the representative (if there is any). 

To download Form 12153 latest version for free, just click on the download button on our website. Alternatively, you can use the PDFLiner’s online PDF blank editor and print the form after you complete it digitally. 

4. Organizations that work with Form 12153

  • The IRS Office of Appeals;
  • Internal Revenue Service. 

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