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The document outlines a form for individuals claiming financial disability, which allows for the suspension of the statute of limitations on tax obligations. It includes sections for detailing the period of financial disability, identifying authorized representatives, and requesting information from the Internal Revenue Service (IRS). Additionally, it requires a physician's affidavit to confirm the individual's physical or mental impairment that hindered their ability to manage financial affairs.

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Click ‘Get Form’ to open the print disabled PDF in the editor.
Begin by entering your personal information in the designated fields, including your name, Social Security Number, and address. Ensure accuracy as this information is crucial for processing.
In Part I, specify the tax year(s) during which you were financially disabled. Fill in the period of time you were unable to manage your financial affairs by entering the start and end dates.
For Part II, indicate whether a spouse or another person was authorized to act on your behalf during your impairment. If yes, provide their details including name, relationship, and authorization dates.
In Part III, confirm if you made a request with the IRS regarding your financial disability. Attach any necessary documentation as specified.
Finally, ensure that all required signatures are completed at the bottom of the form before submitting it.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (70 Votes)
2004	4.3 Satisfied (284 Votes)

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