Claim For Refund And Request For Abatement

Form

(Rev. August 2011) Department of the Treasury Internal Revenue Service

843

Claim for Refund and Request for Abatement
OMB No. 1545-0024
▶

See separate instructions.

Use Form 843if your claim or request involves: (a) a refund of one of the taxes (other than income taxes or an employer’s claim for FICA tax, RRTA tax, or income tax withholding) or a fee, shown on line 3, (b)an abatement of FUTA tax or certain excise taxes, or (c) a refund or abatement of interest, penalties, or additions to tax for one of the reasons shown on line 5a. Do not use Form 843 if your claim orrequest involves: (a) an overpayment of income taxes or an employer’s claim for FICA tax, RRTA tax, or income tax withholding (use the appropriate amended tax return), (b) (c)
Name(s)
SILVER LINETRANSPORT 7 CORP Address (number, street, and room or suite no.) P.O BOX 541416 City or town, state, and ZIP code

a refund of excise taxes based on the nontaxable use or sale of fuels, or anoverpayment of excise taxes reported on Form(s) 11-C, 720, 730, or 2290.
Your social security number Spouse’s social security number Employer identification number (EIN)

FLUSHING, NY., 11354-7416 Name andaddress shown on return if different from above

20-4978454 Daytime telephone number
(917) 945-0082

1 3

4 5a

Period. Prepare a separate Form 843 for each tax period or fee year. 2 Amountto be refunded or abated: From to $ 01/01/2008 12/31/2008 216.91 Type of tax or fee. Indicate the type of tax or fee to be refunded or abated or to which the interest, penalty, or addition to tax isrelated. Employment Estate Gift Excise Income Fee Type of penalty. If the claim or request involves a penalty, enter the Internal Revenue Code section on which the penalty is based (see instructions).IRC section: Interest, penalties, and additions to tax. Check the box that indicates your reason for the request for refund or abatement. (If none apply, go to line 6.) Interest was assessed as a...