AGENT QUESTIONNAIRE TO: IRS Agent____________________ IRS Building__________________ ____________________________ ____________________________

Dear Sir, 1. Since you have contacted me, I feel that I should know more about you, your duties and powers so I can understand my obligations. I am not an attorney and would like a detailed explanation to the questions asked below. 2. What is your full legal name, your office address, your telephone number and name of your immediate supervisor? What is the specific nature of your duties, your job title, job description, areas of responsibilities, powers, obligations, and duties? What is your education, formal and on-the-job? 3. Please furnish copies of all laws or regulations pertaining to your contact with me. What is the name and address of the Ethical Grievance Committee or Board to which I might report any misconduct on your part? How long have you been employed with your agency, how long is this position? What was your previous employment? What is the name, job title and authority of the person that instructed you to contact me? 4. If I give you information, records, or statements, what will they be used for? Who specifically and by name and by position will see them? What other agencies, whether Federal, State or Foreign can and may receive copies of any documents or materials furnished by me? 5. The Privacy Act of 1974, 5 U.S.C. 552a, in sub-section (e)(3), your agency regulations and the IRS Publication 876 mandate certain procedures on your part, such as:

FROM: ____________________________ ____________________________ ____________________________ ____________________________

(3) Inform each individual who it asks to supply information, on the form which it uses to collect the Information or on a separate form that can be retained by the individual(A) the authority (whether granted by statute, or by executive order of the President) which authorizes the solicitation of the information and whether disclosure of such information is mandatory or voluntary;

(B) the principal purpose or purposes for which the information is intended to be used; (C ) the routine uses which may be made of the information, as published pursuant to paragraph (4)(D) of this subsection; and (D) the effects on him, if any, of not providing all or any part of the requested information.

6. I want a detailed explanation to the above, not just another copy of your publication. Regardless of the reason you contacted me, I expect a complete answer to the above request. 7. The Federal Court of Appeals has ruled that you must furnish me with this information. Your agency regulations require that you answer these questions. Do not contact me by telephone; always correspond with me by writing with your signature on the response. Date: ______________________________ Yours, __________________________________ Requestor