This civil action is intended to be filed in Federal District Court in order that a Citizen may recover proceeds from the Request for Refund Affidavit featured in section 14.8 of this document. It is to be filed no sooner than 6 months after filing for refund with the IRS. The filing fee is generally $150. You must pay any tax owed BEFORE filing, and exhaust every administrative remedy available and demonstrate a good faith effort to resolve all issues with the IRS at the administrative level BEFORE filing in Federal District Court. Your case will be thrown our if you don’t observe this. You should also ensure that you effect proper service of process on the U.S. Government when you file this suit. See section 10.13 entitled “Proper Service of Legal Process on the U.S. Government” for more details.

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<<NAME>>

<<ADDRESS>>

<<CITY>>, <<STATE>> <<ZIP>>

<<PHONE>>

Email: <<EMAIL ADDRESS>>

In propria persona

DISTRICT COURT OF THE UNITED STATES
[ ] DISTRICT OF [NAME OF STATE]

[Name] Plaintiff v. UNITED STATES GOVERNMENT Respondent

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Case No.: CIVIL ACTION FOR REFUND OF ERRONEOUSLY WITHHELD PRIVATE EARNINGS 28 U.S.C. §1346 26 U.S.C. §6402 26 C.F.R. §301.6402-1,2 26 U.S.C. §7422

This is a Civil action to recover an overpayment of income taxes for the years _______ to _________.

JURISDICTION

1. The Court has jurisdiction based upon 28 U.S.C. §1346, 26 U.S.C. §6402, 26 C.F.R. §301.6402-1,2, 26 U.S.C. §7422, CIVIL ACTION FOR REFUND, and its implementing regulations. Venue is appropriate in this court under 28 U.S.C. §1402(a).

PARTIES

2. Plaintiff(s) is/are a natural born Citizen or Citizens of one of the union American States and are domiciled in ____________________(state).

3. Respondent is the UNITED STATES GOVERNMENT.

CLAIM FOR REFUND FOR OVERPAYMENT OF PRIVATE EARNINGS

4. Plaintiff(s) incorporate(s) by reference the allegations set forth in ¶1-3 above.

5. Pursuant to 26 C.F.R. ¶301.6402-1,2 and 26 U.S.C. ¶7422, Plaintiff(s) filed an “REQUEST FOR REFUND AFFIDAVIT,” which was attested, signed and Certified under penalties of perjury, attached as “ADDENDUM A,” and included by reference herein. Said Claim was for the total amount of $____________ and was filed on ______________, more than six months ago.

6. Such Claim(s) for refund(s) was/were made within the three-year statute of limitation period, imposed by 26 U.S.C. §6511(a) and 26 C.F.R. §301.6511(a)-1.

7. There has been no disallowance of this Claim.
NOTE: [If the IRS did send a Notice of Disallowance, or a Claim that the Return was frivolous, include a copy, along with your Rebuttal.]

8. Respondent has denied none of the points on the Affidavit, attached as “ADDENDUM A” and no refund has been received by Plaintiff(s).

9. Plaintiff(s), hereby, attest(s) and affirm(s) that all amounts on said CLAIM belong to Plaintiff(s) and are being unlawfully detained by Respondent, against Plaintiff(s)’ consent.

10. Respondent is, thereby, wrongfully, interfering with Plaintiff(s)’ Constitutional Right to the possessory interest of property belong to him/her/them.

11. Respondent’s unlawful refusal to honor Plaintiff(s)’ Claim and their deliberate and malicious interference with Plaintiff(s)’ property rights, has caused Plaintiff(s) extreme mental suffering and personal inconvenience.

THEREFORE, absent a denial of each element contained in Plaintiff’s certified “REQUEST FOR REFUND AFFIDAVIT,” accompanied by a preponderance of evidence rebutting Plaintiff(s) claim, he/she request(s) that the court enter a judgment in favor of Plaintiff(s) and against Respondent.

a) For amount of Claim, totaling $___________________.

b) For emotional damages and family hardship in the amount of $______________.

c) For interest, as allowed, pursuant to the mandates of section 6621 of the Internal Revenue Code of 1986 and 28 U.S.C. §2410.

d) For court costs and post-judgment interest;

e) For unwarranted fines and penalties assessed against Plaintiff(s) by Respondent in the course of prosecuting this claim in the amount of $___________.

I/We hereby affirm and attest, under the penalties of perjury, that, to the best of my/our knowledge and belief, the above information is true, correct, and complete.

__________________________ _________________________

Plaintiff Plaintiff

VERIFICATION

1. I, ______________________ am party to this action. I have read the foregoing, ‘Request for a Judicial Review’ and know its contents. The matters stated therein are true of my own knowledge, except those matters which are stated on information and belief, and as to those matters, I believe them to be true.

2. I am the Petitioner(s) in this action, propria persona, and I make this verification, to attest to the truth of the matters herein stated.

I declare under the penalty of perjury under the laws of _____________[state] that the foregoing is true and correct.

Executed on the _______month of ____________20__, at _____________[city], _______________________[state].

/s/___________________________(signature)

AFFIDAVIT OF POINTS AND AUTHORITIES

28 U.S.C. §2410. “In any judgment of any court rendered (whether against the United States, a collector or deputy collector of the Internal Revenue, a former collector of deputy collector, or the personal representative in case of death), for any overpayment in respect of any internal revenue tax, interest shall be allowed at the overpayment rate established under section 6621 of the Internal Revenue Code of 1986 upon the amount of the overpayment, from the date of the payment of collection thereof to a date preceding the date of the refund check by not more than thirty days, such days to be determined by the Commissioner of Internal Revenue. The Commissioner is authorized to tender by check payment of any such judgment, with interest as herein provided, at any time after such judgment becomes final, whether or not a claim for such refund check is excepted by the judgment creditor.”

26 U.S.C. §6402, AUTHORITY TO MAKE CREDITS OR REFUNDS. 26 C.F.R. 301.6402-1,2

“(a) GENERAL RULE.-(a) In the case of any overpayment, the Secretary, within the applicable period of limitations, may credit the amount of such overpayment, including any interest allowed thereon, against any liability in respect of an internal revenue tax on the part of the person who made the overpayment and shall, subject to subsections (c) and (d), refund any balance due.”

26 U.S.C. §7422. CIVIL ACTION FOR REFUND

“(a) No suit or proceeding shall be maintained in any court for the recovery of any internal revenue tax alleged to have been erroneously or illegally assessed or collected, or of any penalty claimed to have been collected without authority, or of any sum alleged to have been excessive in any manner wrongfully collected, until a claim for refund or credit has been duly filed with the Secretary, according to the provision of law in that regard, and the regulations of the Secretary established pursuance thereof.

(b) Such action or proceeding may be maintained whether or not such tax, penalty, or sum has been paid under protest or duress.”