Free Motion to Dismiss - Rule 12(b)(1) - District Court of Federal Claims - federal

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APPENDIX

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Appendix Item March May May 12, 19, 30, 2002 Offer in from in Compromise Ms. Caldera for to for $i0,000 Mr. Jordan Paqe(s) ....... ...... 1 5 7 ii

2003 2003

Letter Offer

Compromise from Ms.

$12,721 to Mr.

........ Jordan

December

8, 2003

Letter

Caldera

Authorization to Apply to Liability August 15, 2003 Letter

Offer in Compromise Deposit ..................... from Ms. Caldera to Mr. Jordan ....

13 14 16 17

Asset/Equity Income/Equity August 18, with 2,

Table Table

..................... ..................... to Ms. Caldera, .............. Mr. Jordan .....

2003 Letter from Mr. Jordan Chedk to IRS Enclosed 2004 16, Letter 2004 from ICS Case Ms. Seibel

18 21 24 25

March January July

to

History History

Transcript Listing

.......... .............

28,

2004

District Court, County of E1 Paso, State of Colorado Permanent Order in Case No. 97DR2019, dated November 29, 2000 ................ February to 23, 2005 Letter Plaintiff's from IRS Counsel Office of Appeals ................

26

28

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@ IRS Offer in Compromise
Department Treasury of the Internal Revenue Service www.irs.gov Form (Rev.5-2001) 656 Catalog Number 16728N Name Street Address BtemI --Taxpayer's Name and Home BusinessAddress or

IRS RECEIVED DATE

~ili~

~ (ff

~i~m~ lrom ~ov~) DATE RETURNED S~te ZiP Code

S~eetAddress Ci~

item 2 ~ Social Security Numbers

gtem ~ I/We submit 6 this offer for the reason(s) checked below: O Doubt to Liability ~ "1 do not believe I owe as this amount." Youmustinclude a detailed explanation the reason(s)why of . you believe youdo not owe tax in Item 9. the ,t~oubt as to Collectibility ~ "1 haveinsufficient assetsand - ~income pay the full amount.',Youmustinclude a complete to Collection InformationStatement, Form 433-A and/or Form 433-B. El EffectiveTaxAdministration "1 owethis amount have -and sufficient assetsto paythe full amount, dueto myexceptional but circumstances, requiring full payment wouldcause economic an hardshipor wouldbeunfair andinequitable." Youmustinclude a complete Collection InformationStatement, Form 433-A and/or Form 433BandcompleteItem 9. ~tem 7 I/We offer to payS 10, oE>C) (mustbe more than zero). Complete 10 to exl~lain where will obtainthe fundsto item you make offer. this sh the following: amount bepaid~,/in90 days less.) will or ,~k one ofOffer(Offered Balance bepaid in: O 10; El 30; 1:3 60; or/~90days to from wdttennotice of acceptance the offer. of O Short-TermDeferredPayment Offer (Offered amount will be paid in MORE than 90 daysbut within 24 months from written noticeof acceptance the offer.) of within days(not morethan 90 $. -- SeeInstructions Section, Determine YourPayment Terms) fromwdttennotice of acceptance the offer; and of month after written noticeof acceptance beginning the in on the day of each of the offer, $. month atotal of for months. (Cannotextend morethan 24 months wdttennotice of acceptance the offer.) from of El DeferredPayment Offer (Offered amount will be paid over thelife of the collection statute.) $. within days(not morethan 90 -- SeeInstructions Section, Determine Your Payment Terms) fromwdttennotice of acceptance the offer; and of beginning the first month in after written notice of acceptance of dayOf eachmonth theoffer, $. on the for a total of months.

(b) Secondary item 3 -- Employer Identif~n Number (included in offer)

item 4 -- OtherEmployer Ideptification Numbers (not included offer) in /

~tem5 -- To: Commissioner Internal Revenue of Service I/We(includes typesof taxpayers) all submit this offer compromise tax liabilities plus anyinterest, penalties,additions the to tax, andadditional amounts required law(tax liability) for the by tax type andperiodmarked below:(Pleasemark '~(" in the box an for the correctdescription fill-in the correcttax period(s), and ,~ing040/1120Income if --needed). I ¢~ ¢~ t ,,~ OC>C~ additional periods Tax Year(s) 941 Employer's QuarterlyFederalTax Return Quarterly -period(s) 940 Employer'sAnnualFederal Unemployment (FUTA)Tax Return Year(s) -Trust Fund Recovery Penalty as a responsiblepersonof (enter corporationname) for failure to paywithholding Federal and Insurance Contributions Taxes Act (SocialSecuritytaxes), for period(s) ending Q Other Federal Tax(es) [specify type(s) and period(s)] Note: If you needmorespace, use another sheet titled "Attachment to Form656 Dated ." Sign anddate the attachment following the listing of the tax periods.

NOTE: Signature(s)of taxpayerrequiredon last pageof Form 656

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lt~em8 -- By submitting this offer, l/we understand agreeto the following and conditions:

(a)

I/Wevoluntarily submitall payments made on this offer. '

(b) TheIRS will apply payments made under the termsof this offer in the best interest ..... of the government. , keep, and ¯ , o . .:,. ....(f) Th,e~l~RS~.will al_Lpayments credits IRS or the or (c) Ifthe rejectsreturns offer I/we made, received appliedto the total original or withdraw offer, IRS the the will return any tax liability before submission this offer. of amount with offer. I/we paid the If agree in TheI RSmaykeep any,proceeds from a writing, will IRS apply amount with the paid ¯ ~ levy ~erved p'ri~ t6 sdl~mission theoffer, of the offer theamount to owed. I/we If agree , ,, ,,but notreceived t,he,~time offer is ,0 at the to apply the payment, date the IRS the ¯ ~" submitted. lYv~6l~avean installment If receivedthe offer remittance will be agreement prior to submitting offer, the consideredthe date of payment.I/We I/we mustcontinue to make payments the understand the IRSwill not payinterest that as agreed while this offer is pending. on anyamount I/we submitwith the offer. Installment gr..~em.en,t .ments not a, pay ,will beapplied agair~t{he an~"our~t "offered. ~/Wewil~ comply with all provisions of. the BnternaB Revenue Coderelating to , o (g) As additiona~consideration beyond the filing my/ourreturns and payingmy/our amount my/our.0f.fpr,the ~RS of wil~ keep required taxesfor 5 yearsor until the anyrefund, includinginterest, dueto me/ offeredamount paid in fuBI, whichever is us because overpayment any tax or of of is longer.~nthe case a jointly submitted of otherliability, for tax,periods extending offer to compromise.joint liabilities, tax through calend~ar the year that the BRS ~/weunderstand ~hat default with respect acceptsthe offer. B/We maynot designate to the compliance provisionsdescribed an overpayn~ent ordinarily subjectto in this paragraph one by, pa,. ,rt~/to this refund,to which IRSis entitled, to be the agreement not result'in the default will appliedto estimated tax payments the for of the entire agreement. default The followingyear. This conditiondoesnot provisions described item 8(n) in applyif the offer is based Doubt on as , : this agre, ement will be appliedonly to Liability. ~'. to the party failing to comply with to any the requirements this paragraph. of (h) I/V~/~Wifl~retdrr~ the IRS refund This provisiondoesnot applyto offers -identified in (g) received after submission based Doubt to Liability. on as of this offer. Thisconditiondoesnot apply to offers based Doubt to Liability. on as (e) I/We waive andagree to the suspension of anystatutory periods limitation of (i) TheIRScannotcollect more than the full (timelimits provided bylaw) for the for amount the tax liability under of this offer. IRSassessment the tax liability for of the periodsidentified in Item 5. I/We (j) I/Weunderstand that I/we remain understand I/we havethe right not to that responsible the full amount the tax for of waive thesestatutory periodsor to limit liability, unless until the IRSaccepts and the waiver a certain lengthor to certain to the offer in writing andI/we havemetall the issues. I/We understand,however,that termsandconditionsof the offer. TheIRS will not remove original amount the tax the of .... theIRSmay consider offer if I/we not this ....- ............ refuseto waivethe statutory periodsfor liability fromits records until I/we have met assessment if weprovideonly a limited or all the terms the offer. of
NOTE: Signature(s) of taxpayer required on last page of Form656 2

waiver. Theamount any Federaltax due of for the periqds,c~escribe.d Item5 may in be assessed any time prior to the acceptance at of this offer or within oneyearof the rejectionof.this offer. ~.... .,,; ~,~,~-., ~

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Item 9 -- Explanation Circumstances of I am requesting offer in compromise the reason(s) an for listed below:

+.

Note: If you are requestingcompromise basedon doubt as to liability, explain whyyou don't believe you owethe tax. If you believe you havespecial circumstances affecting your ability to fully pay the amount due, explain your situation. Youmayattach additional sheets If necessary.

.~m ~ ~ SourCe of Funds I/we shall obtain the funds to makethis offer from the followingsource(s):

Btem If I/wesubmit offer ona substitute this form,I/we affirm that this formis a verbatim duplicateof the official Form 656, andI/we agree to bebound all the termsand by conditions forth in the official set Form656. Under penaltiesof perjury, I declarethat I haveexamined this offer, including accompanying schedules statements, to and and ~t beStmplet~kn°wledge and belief,~e, correct and

For Official UseOnly I accept waiver tiT@ the of statutoryperiod limitationsfor the of ~'"...... Intem.~lF~ve~l"ue Ser~ld'e./ L.~'~na'tur. v f Authorizef.~ d Internal Revenue " Service Offic' I

¯ it, e/
Date /

i

/ ,,

Date

~j/

11 (b) Signature Taxpayer of Date NOTE: Signature(s)of taxpayer requiredon last pageof Form 656

3

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(k) I/Weunderstand the tax I/we offer that to c, ompromjseand.will-remain is .a liability until I/wemeet theterms all and' c0nditiotis this ~ffet"~' If I/We"' of ¯ ¯ . ,,. ~,~file, bankru.p, tcy.be.fore the,terms, -,- . and condition~ this offer a, re. completed,. .of anyi'claJ'r~" IRS"fJl~s tl~e i~'the 6a~krup't~y proceeditlgs ~vill be ~tax"¢laim~ (I) Once IRS.acbepts offer the ihe .,:., writing,, lYv~e noright t6 Contest; have ¯ .-lri~cour,~.or- othenNise~ amount- the~ the of ~ y.. bjlit, ~.,. ,.. .. .......,, tax,[ia - ,~ . (m)Tied"offer id pendirt~.starti'ng the @i{h " datean authorized official-signs.this IRS form. Theoffer remains,p~nding until.an authorized Ia~;~ff'ioiai a~cep{~, rej6~i~"," ' ' ".'".-" ¯ rE~tei'r~s,or act~nowl6dges ~vithdrawal " of :.. theoffer,in writing.., I/we if ,appe. an,IRS a! :.. reject ,on, depision theoffer,.the IRS on willcontinue treat the offer as pending to Qntil the Appeals Office acceptsor rejects the offer in writing. If I/wedon'tfile a protest within 30 daysof the date the IR~notifie~; , " ~te~i'~ion, me/us therig~qt~,t,(; of I~rdidSt,,~th~ I/we waive right ~o'a!lle~ringbefore,' the the Appeals Office aboutthe offer in compromise. If (n) I/Wefail to meet of the termsand any conditions the offer andthe offer of defaults, then the IRSmay:
¯ ', ,,, ~, ~',. ,,.. 4 - ¯ .

~ immediately suit to collect an amount file ¯ :equal t0-th.e.origjn.al,amo,unt:o:( ~x.. the liabilit£ .as liquidating damages, any minus " pay~neht ali-~ad~,rE~ived" un(:J~r~hete~ms '° ~of this offer...... . " ¯ -" , .,.~ -. ¯ ~ disregard th amount the offer a~d ply of "~.11amb~nts already "p~i~l d~d~r 'offer th'e ' ¯, against originalamount thetax..liability the. ~f , filesuit -6i"lE;vy't6coIl&~t'tl~e origii~l ' - ~ ¯amount thetax Of liability; 'without,further, "notic .e:p.f.. any .kind,,~ -'-', ,, TheI1~ wifl contin~l~ addinterest, ~'s Section tO 6,601of~theIntemal,l~e~,enue requires, Co~e onthe amount IRSdet...er.rninesis dueafter the ~le~ault~ IRSwill addinterest fromth# "date Th# the bffer is defaulted until,l/we cSmpleteljZ safisfy the amou~ owed. ....

(o) TheIRSgenerallyfiles

a Noticeof Federal TaxLien to protect the Government's interest on deferredpayment offers. This tax lien will be released when the.paymentterms t~e of

file [] immediately suit to collect the entire unpaidbalance the offer of

(p) ~/Weunderstand that the IRS employees may contact third parties in orderto respond to this requestandI authorizethe IRSto make suchcontacts.Further, by authorizing the ~nternal Revenue Serviceto contact third parties,~ understand I wil~ not that receivenotice, pursuant section7602(c) to of the internalRevenue of third parties Code, contacted connection in with this request.

NOTE: Signature(s)of taxpayerrequiredon last page Form of 656

Z~,

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DEPARTMENT THE TRE~,~URY OF INTERNAL REVENUE SERVICE Washington, 20224 D.C.
SMALL BUSINESS/SELF-EMPLOYEDDIVISION

May 19, 2003 Dennis W. Jordan 360 W San Trap Lane Pueblo West, CO 81007 Dear Mr. Jordan We have reviewedthe financial information submittedin support of your offer in compromise and determined the following: Baseduponyour current financial condition, ~h a'c;le~'e.~,:~t, ~t r.~le~s,s~h ~(pa~y:a'b!~;~i~hi~ days). These figures represent your equity in assets plus your ability to makemonthly payments. Copies of our worksheetsare enclosed for your review. If you agree with the aboveanalysis, an amended Form656 is enclosedfor you to sign and return to the addressbelowwithin 14 days of the date of this letter. Please completeyour choice of paymentterms in item 7 on Form656, if not already completed. If the payment terms of your amended offer exceed ninety days, a notice of Federal Tax Lien will be filed. If you do not agree with the aboveanalysis, you mayprovide additional documentation showingthat the figures aboveare incorrect. You mayalso provide any other information you believe we should consider in makinga final determination as to whetherto accePtyour offer. As part of the newJanuary2000offer provisions, interest will no longer be chargedon the offer amount.Liens of record will only be released uponfull payment the offer. of Anyr{:.fund throughthe tax year 2003will be automatically offset to your tax liability and will n,~[ be applied ~o the offer amount.Also, if your offer is accepted,your compliance will be monitored 5 years. In that time, if you do not comply for with all filing andpaying requirements (i.e. fail to file a return or make federal ta;~ depositsand/or estimatedtax payments),your offer will be defaulted and all taxes will again become and owing. due

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2 If youdo not respond within 14 daysof the dateof this letter, youroffer cannot be recommended acceptance for and a Federal Tax Lien will be filed. When your offer is rejected youwill receiveinformationregarding to appeal rejection decisionto how the the IRSOffice of Appeals. If youwishto withdraw youroffer at this time, pleasesign andreturn the enclosed withdrawal statement. signing the withdrawal, forfeit all appeal In you rights pertaining to this offer. If a joint offer hasbeen submitted, partieson the offer must all sign the withdrawalstatement.A FederalTaxLien will be filed if you withdrawthis offer. If youwishto payyour account full, enter into an installmentagreement, haveany in or questions, pleasecontact meat (916) 974-5129. Please mail all written responses to: Internal Revenue Service Attn: M. Caldera 4330 Watt Avenue, SA-6213 North Highlands, CA95660

Sincerely,

M. Caldera Offer Specialist 68-10409 Enclosure(s): Pub 1 and 594 Asset/Liability Table Income/Expense Table Form 656 Withdrawal Statement

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Form 656

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IRS RECEIVED DATE

Offer in L, ompromise
Department Treasury of the Internal Revenue Service www.irs.gov =orrn656(Rev.5-2001) 3atalogNumber 16728N I~em1 -- Taxpayer's Name Home Business and or Address DennisWJordan Name Name Pc Box 9032 Straet Address Pueblo, CO81008 City

State

ZIP Code

MailingAddress different fromabove) (if Street Address DATE RETURNED City tom2 -- Social Security Numbers a)Primary b)Secondary tern 3 -- Employer Identification Number (Included offer) in State ZIP Code Item 6 -- I/Wesubmitthis offer for the reason(s) checked below: [] Doubt to Liability-- 'I do not believe I owe as this amount." mustinclude You a detailedexplanation the reason(s) youbelieveyoudonot owe tax of why the Item9. [] Doubt to Collectibility- "1 haveinsufficient assetsandincome pay the as to full amount." must You include a complete financial statement, Form 433-A and/or Form 433-B. [] Effective TaxAdministration--"lowe this amount havesufficient assetsto and paythe full amount, dueto my but exceptional circumstances, requiringfull payment wouldcause economic an hardship wouldbe unfair andinequitable." You or must include a complete CollectionInformationStatement, 433-A Form and/orForm 433B andcomplete 9. Item Item 7 INVe offer to pay$12,721.00 (mustbemore than zero). Complete 10 to explain item where will obtainthe funds make offer. you to this Check of the following: one [] Cash Offer (Offeredamount will be paid in 90 daysor less.) Balanceto be paid in: 10, 30, 60, or [] 90 days from written notice of acceptancethe offer. of [] Short Term Deferred Payment Offer (Offered amount will be paid in MORE than 90 daysbut within 24 months from written notice of acceptance the of offer.) within days (not morethan 90 - See Instructions Section, Determine Payment Your Terms) fromwritten notice of acceptance the offer; and of beginning the in offer, month after written noticeof acceptance the of on the dayof each month a total of for months. (Cannot extendmorethan 24 months from written noticeof acceptancethe offer.) of [] DeferredPayment Offer (Offered amount will be paid over the life of the collectionstatute.) within days(not morethan 90 - See Instructions Section, Determine Payment Your Terms) fromwritten notice of acceptance the offer; and of beginning the first month in after writtennotice acceptancetheoffer, of of on the ...... dayof each month a total of for months

:em4 ~ OtherEmployer Identification Numbers included in (Not ,ffer)

em ~ To: Commissioner Internal Revenue 5 of Service ~Ve (includes typesof taxpayers) all submit this offer to compromise the x liabilities plusany interest,penalties, additions tax, and to additional ~nounts required law(tax liability) for the tax typeand by period marked .=low:(Please an"X" in the boxfor the correctdescription fillmark and the correcttax period(s), adding additionalperiods needed.) if ~ 1040/1120 Income Tax-Year(s) 1999.2000, 3 941Employer's QuarterlyFederalTaxReturn- Quarterly .=riod(s) J 940 Employer'sAnnual Federal Unemployment (FUTA)Tax ;turn- Year(s) ] Trust Fund Recovery Penaltyas a responsible personof (enter rporation name) failure to paywithholding Federal and Insurance ,ntributions T~xes Act (SocialSecurity taxes),for period(s) ending ] OtherFederal Tax(es)[specify type(s) and period(s)] ,to: If youneed morespace,use anothersheettitled "Attachmentto Form656 Dated Sign anddate the attachment following the listing of the tax periods.

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item8 mBysubmitting this offer, I/we understand agreeto the following and conditions: made (a) I/we voluntarily submitall payments on thisoffer. made underthe (b) TheIRSwill apply payments terms this offer in thebestinterestof the of government. waiver. Theamount any Federaltax due of for the periodsdescribed Item 5 may in be assessed anytime prior to the acceptance at of this offer or withinoneyearof the rejection of theoffer

(c) If

theIRSrejectsor returns offer or I/we the withdraw offer, the IRSwill return any the amount with the offer. If I/we agree paid in writing, IRSwill applythe amount with paid the offer to the amount owed. l/we agree If to apply the payment, date the IRS the received offer remittance be the will considered date of payment. the I/we understand the IRSwill not payinterest that on anyamount submitwith the offer. I/we

(f) TheIRSwill

l/we will comply with all provisions the of Internal Revenue relating to filing Code my/ourreturns and payingmy/our required taxesfor 5 yearsor until the offeredamount paid in full, whichever is is longer.In the case a jointly of submitted offer to compromise tax joint liabilities, I/we understand default that with respectto the compliance provisions described this paragraph in by oneparty to this agreement notresult will in the defaultof the entire agreement. The default provisions described Item8(n) in of this agreement be appliedonlyto will the party failing to comply with the requirements this paragraph. of This provisiondoesnot applyto offers based onDoubt to Liability. as

keepall payments credits and made, received appliedto the total original or tax liability before submissionthis offer. of TheIRS maykeepany proceedsfrom a levy served prior to submission the offer, but of not received the timetheoffer is at submitted. I/we have installment If an agreement to submitting offer, I/we prior the mustcontinue to make payments the as agreed while this offer is pending. Installment agreement payments not be applied will againstthe amount offered.

(g)s additional consideration A beyond the

amount my/our of offer, the IRS will keep anyrefund,including interest; dueto me/usbecause overpayment any tax of of or otherliability, for tax periods extending through calendaryear that the IRS the accepts offer, l/We may designate the not an overpayment ordinarily subjectto refund, which IRSis entitled, to be to the appliedto estimated payments the tax for followingyear. This condition doesnot applyif the offer is based Doubt to on as Liability.

(e) I/we waiveandagreeto

the suspension of anystatutoryperiods limitation (timelimits of provided by law) for the IRSassessment for of thetax liability for theperiods identifiedin Item 5. l/we understand I/we have that the right not to waive thesestatutoryperiods or to limit thewaiver a certainlength to to or certain issues. I/Weunderstand, however, that the IRSmay consider offer if not this I/we refuseto waive statutoryperiodsfor the assessment if weprovideonly limited or

(h) I/Wewill return to the IRSanyrefund identified in (g) received after submission this offer. Thiscondition does applyto not offers based Doubt to Liability. on as collect more than the full (i) TheIRScannot amount thetax liability under offer. of this I/Weunderstand that I/we remain responsible the full amount the tax for of liability, unless until the IRS and accepts the offer in writing andl/we have all the met termsandconditionsof the offer. TheIRS will not remove original amount the tax the of liability fromits records until l/we have met all theterms theoffer. of

NOTE:Signature(s) of taxpayer required last page Form on of 656

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that (k) I/Weunderstand the tax I/we offer to compromiseandwill remain tax liability is a until I/we meet the termsandconditions all of this offer. If I/wefile bankruptcy before the terms conditions this offer are and of completed, claimthe IRSfiles in the any bankruptcy proceedings be a tax claim. will Once IRSaccepts offer in writing, I/we the the have right to contest,in courtor otherwise, no theamount thetax liability. of offer is pending starting with the datean (m) The authorized official signsthis form.The IRS offer remains pending until an authorized IRS official accepts, rejects,returnsor acknowledges withdrawal the offer in of writing. If I/we appeal IRSrejection an decision the offer, the IRSwill continue on to treat the offer as pending until the Appeals Officeaccepts rejectsthe offer in writing. If or I/wedon't file a protestwithin30 days the of datetheI RS notifies me/us the right to of protestthe decision,I/wewaive right to a the hearingbeforethe Appeals Office aboutthe offer in compromise.

immediately suit to collect an amount file equalto the original amount the tax of liability as liquidating damages, any minus payment already received underthe terms of this offer disregardthe amount the offer and of applyall amounts alreadypaid underthe offer againstthe original amount the tax of liability file suit or levyto collecttheoriginal amount thetax liability, without of further noticeof anykind. TheIRSwill continueto addinterest, asSection 6601of the Internal Revenue requires, on Code the amount the IRSdetermines dueafter of is default. The will addinterest fromthe date IRS the offer is defaulted until I/wecompletely satisfy the amount owed.

(o)TheIRSgenerallyfiles

(n) If

I/wefail to meet of the terms any and conditions the offer andthe offer defaults, of then the IRSmay: immediately suit to collect theentire file unpaid balance the offer of

a Noticeof Federal TaxLien to protect the Government's interest on deferred payment offers. Thistax lien will be releasedwhen payment the terms of the offer agreement been have satisfied.

(p)l/we

understandthat the IRS employees may contact third parties in order to respond this request, and I authorize to the IRS to makesuch contacts. Further, by authorizing the Internal Revenue Serviceto contactthird parties, ! understand that I will not receivenotice, pursuantto section 7602(c)of the Internal Revenue Code third parties contacted of in connectionwith this request.

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Item 9 - Explanation Circumstances of I am requesting offer in compromise the reason(s) an for listed below: based doubt as to liability, explain whyyou don~tbelieve youowe tax. on the Note: If you are requestingcompromise ff you believe you havespecial circumstances affecting your ability to fully paythe amount explain your situation. due, Youmay attachadditional sheetsif necessary.

Item 10 - Source of Funds I/We shall obtainthe funds make offer fromthe following to this source(s):

Item 11 If I/wesubmit offer ona substitute this form,I/weaffirmthat this form is a verbatim duplicate the official Form and of 656, I/we agree be to bound all the terms conditions forth in the official Form by and set 656. Under penalties perjury,I declare I have of that examined offer, this including accompanying schedules statements, to the best of and and my knowledge belief, it is true, correctandcomplete. and

For Official Use Only I accept waiver the statutory the of period limitations the Internal of for Revenue Service.

Signature authorized of IntemalRevenue Service Official

Title 11(a) Signature Taxpayer of Date 11(b) Signature Taxpayer of Date Date

10 NOTE:Signature(s) of taxpayer requir~ on last page of Form 656

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DEPARTMENT THE TREASURY OF INTERNAL REVENUE SERVICE Washington, 20224 DC
SMALL BUSINESS SELF-EMPLOYED / DIVISION

Date: December08, 2003

Dennis W Jordan Po Box 9032 Pueblo, CO 81008

Dear Mr. Jordan: Enclosedyou will find a form authorizing the Internal Revenue Service to apply your $12,721.00to back taxes. If you do not respondto this letter within 14 days from the date of this letter the amount will be refundedto you. Also enclosedis a copy of a letter sent to you August15, 2003stating you havethe ability to full pay your tax liability. Theletter also states that Noticeof FederalTaxliens will be filed. In responseto your letter dated August 18, 2003, the amountof $12,721.00was not agreed uponfor payment full of taxes for years 1999and 2000. The:etter you have in enclosed is an analysis letter. Theletter dated August15, 2003from the Internal Revenue Service, is the morecurrent letter as your financial situation changed.Since you did not respondto the letter dated August 15, 2003from the Internal Revenue Service, the Offer in Compromise be rejected. A letter explaining the rejection of your offer will be forth will coming. If you have any questions or needmore information, please contact meat the address or the telephone number listed below: Internal Revenue Service 4330 Watt Avenue North Highlands, CA 95660

Phone#: (916)974-5129 Fax#: 916.974-5901 Sincerely,

11

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M. Caldera Offer Specialist Employee ID#: 68-10409

D~. Authorization Appi, "{fer in Compromise 'sit to Liability to i
Name taxpayer of .Dennis WJordan Employer identification or social security number Address (Number, street, city, State, ZIPcode) Po Box 9032 Pueblo, CO81008

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Amount deposit of $12,721.00

tax amount deposited myoffer in compromise. on I consent the applicationagainstmyoutstandinc~ liability of the above to Address (Number, street, city, State, ZIPcode) Name personmaking of the offer DennisW. Jordan 347 Darlington Way ColoradoSprings, CA80906

I consent the applicationagainstthe outstanding liability to the taxpayer'saccounts, shown to tax as below,of the above amount depositedon the offer in compromise. Tax Return Form Number 1040 1040 Identifying Number 8 Taxable Period Ended 12/31/1999 12/31/2000 Amount Applied $12,721.00 $0.00

Signatureof personmaking offer the

Date

Address different fromthat shown (If above)

13 Form (CG)(Rev. Use issue 8;74,first 3040 10:80) and "Rev.

DepartmentTreasury,-Internal 0fthe Revenue Service