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26 U.S.C. § 7203
Individual - Failure to Pay Tax
Venue in District of Service Center 1

IN THE DISTRICT COURT OF THE UNITED STATES

FOR THE ____________ DISTRICT OF ____________

UNITED STATES OF AMERICA

    v.

_______________________

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)
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No. __________________
26 U.S.C., § 7203

The United States Attorney charges:

That during the calendar year2 19___, [Defendant's Name], who was a resident of [City], [State], had and received taxable income of $_________, on which taxable income there was owing to the United States of America an income tax of $_________; that he [she] was required by law on or before April 15, 19___,3 to pay said income tax to the Director, Internal Revenue Service Center, at [City], [State], in the _________________ District of __________________, or to the District Director of the Internal Revenue Service for the Internal Revenue District of _____________, at ____________,1 or other proper officer of the United States; and that well-knowing and believing all of the foregoing, he [she] did willfully fail to pay the said income tax to said Director of the Internal Revenue Service Center, to said District Director of the Internal Revenue Service, or to any other proper officer of the United States.

In violation of Title 26, United States Code, Section 7203.

_________________________
United States Attorney


NOTES

1. If venue is to be placed in the judicial district of the District Director, modify this form in accordance with language at Forms - 33.

2. If fiscal year is involved, substitute "fiscal year ended ____________, 19___".

3. If April 15th fell on a Saturday, Sunday, or legal holiday, the appropriate date in the information would be the next succeeding day that was not a Saturday, Sunday, or legal holiday. 26 U.S.C., § 7503. Note that fiscal year individual returns must be filed on or before the 15th day of the fourth month after the end of the fiscal year. 26 U.S.C., § 6072(a).


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