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Illinois Department of Revenue

ICB-1 Request for Informal Conference Board Review

In order for your request for ICB review to be considered, you
Read this information first
must complete this form and attach any required documents
Use this form to request that the Informal Conference Board or forms with this application, as stated below, within 60 days
(ICB) conduct of the “datean informalof issuance“ shownreviewonofthethenoticeproposedyou received.adjustments
you received from the Illinois Department of Revenue’s √ Steps 1, 3, 4, and 5 of this ICB-1 must be completed.
(IDOR) Audit Bureau, before a statutory notice is issued.
√ Step 2 must be completed and Form IL-2848, Power of
Do not use this form if Attorney, must be attached if someone will represent you
• you did not receive one of the following proposed audit during the informal conference process.
result notices, informing you of the option to request a √ Step 4 must be completed If you are requesting an
review by ICB. in-person or telephone conference with the ICB.
· Notice of Proposed Deficiency
√ Complete and attach Form ICB-2, Offer of Disposition of a
· Notice of Proposed Tax Liability Proposed Assessment or Claim Denial, if you are making
· Notice of Proposed Claim Denial an offer to settle the tax dispute. Note: This is not an offer
· Notice of Proposed Tax Liability and Claim Denial in compromise.
• you want to request an offer in compromise based on - You must attach copies of all notices you want
an inability to pay an undisputed tax liability. An offer in ICB to review.
compromise must be made by filing a petition with the
- You cannot request ICB review for any notice
Board of Appeals after a final determination of tax has been
issued. that does not offer your rights to ICB.

Step 1: Identify yourself, your business or organization
1 Taxpayer’s name ________________________________ 5 For businesses or organizations, only.
a. Contact person _______________________________
2 Current address ________________________________
Street address b. Daytime phone number (_____)_________________
c. Cell phone number (_____)_________________
________________________________
City State ZIP d. Fax number (_____)_________________
3 Phone numbers and email e. Email address _______________________________
a. Daytime phone number (_____)_________________
6 Corporate income tax audits only: Complete the
b. Cell phone number (_____)_________________ following information if you filed as a member of a
unitary group or the auditor proposed that you should
c. Fax number (_____)_________________
have been a member of a unitary group.
d. Email address ________________________________
a. Schedule UB designated agent’s name:
4 Enter the taxpayer ID shown on the notice you received
_____________________________________________
(i.e., FEIN, Illinois Business Tax number (IBT), Social
Security number). b. Schedule UB designated agent’s FEIN:
______________________________________ ___ ___ - ___ ___ ___ ___ ___ ___ ___

Step 2: Identify your representative (if applicable)
Complete all the information requested in this step if someone will represent you during the informal conference process.
Note: A properly executed Form IL-2848, Power of Attorney, must be attached.
1 Representative’s name ___________________________
2 Representative’s address 4 Check this box if all correspondence from ICB
should be sent to your representative’s address.
____________________________________
Street address Note: If you check the box, all correspondence
____________________________________ from ICB will be mailed to this address.
City State Zip If you did not check the box, all
3 Phone numbers and email correspondence from ICB will be mailed to
the address provided in Step 1.
a. Daytime phone number (_____)_________________
b. Cell phone number (_____)_________________ 5 Check this box if correspondence from ICB should
be sent electronically to all email addresses
c. Fax number (_____)_________________ provided on this form.
d. Email address ________________________________
ICB-1 (R-06/22) Printed by the authority of the State of Illinois - Electronic only Disclosure of this information is VOLUNTARY. Page 1 of 3

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                                                Step 3:  Provide the following audit or examination information 
                                                Note:  You must attach a copy of the notice and any attachments you received from us. 
                                                Use the information from your notice with proposed adjustments to provide the following information.
                                                       A                                 B                                    C                                       D              E 
                                                                        Date of Issuance on your                                              Total                           Total 
                                                                                       notice                      Tax Type                   Amount of                       Amount of 
                                                     Audit ID                           (mm/dd/yyyy)                                          Deficiency                      Claim Denial

                                                Step 4:  Provide the grounds for your request
                                                1 State the specific reasons for your objection to the proposed assessment or denial of claim for refund (attach additional sheets, 
                                                  if necessary). Describe the specific issues contained in the audit with which you disagree. Provide in detail the legal authority 
                                                  which supports your position. If you are disputing the calculation of a tax proposed to be assessed, you must show why this 
                                                  calculation is incorrect. Attach any additional information or documentation that supports your position.  
                                                  ____________________________________________________________________________________________________________
                                                  ____________________________________________________________________________________________________________
                                                  ____________________________________________________________________________________________________________
                                                  ____________________________________________________________________________________________________________
                                                  ____________________________________________________________________________________________________________
                                                  ____________________________________________________________________________________________________________
                                                2  ICB decides the outcome of your case based on the information contained and provided with this application. However, you 
                                                  may also request either an “in-person” or “telephone” conference with ICB. If you wish to have a conference with ICB, mark 
                                                  the appropriate box.
                                                  a.  Are you requesting an in-person conference with the ICB?                                  Yes                     No    
                                                  b.  If you answered “yes,” select your preferred location for the conference.                 Chicago                   Springfield
                                                  c.  If you answered “no,” are you requesting a telephone conference?                          Yes                     No  
                                                3  Are you submitting an offer to settle the tax dispute?                                      Yes                      No   
                                                  NOTE:     If yes, you must complete and attach Form ICB-2, Offer of Disposition of a Proposed Assessment or Claim 
                                                  Denial.

                                                Step 5:  Sign the waiver of statute of limitations
                                                The following waiver of statute of limitations must be signed by the taxpayer, a duly authorized corporate officer, partner, or 
                                                fiduciary of the taxpayer, or by the taxpayer’s representative under a valid power of attorney.  
                                                In order to allow ICB time to review this proposed assessment or claim denial, the undersigned expressly agrees to extend the 
                                                running of any and all statutes of limitations regarding the assessment of any tax, penalty, or interest, or claims for refund for 
                                                the tax periods at issue to which the request is directed. This waiver shall run from the date this request for review is received 
                                                and accepted by ICB through 180 days after ICB issues its action decision or memorandum in the matter. This waiver applies 
                                                only to the tax periods at issue and has no effect on closed tax periods or tax periods for which assessments have been issued 
                                                and for which the liability is final. 
                                                __________________________________   ____________________  ___________________________________  ____/_____/_____
signature (if married, filing jointly)          Taxpayer’sTitle                                                             Spouse’s                                          Date                      , ifsignatureapplicable 

                                                __________________________________  ____________________                    _____/_____/_____       *Representative must be duly authorized
                                                Taxpayer’s representative’s signature*        Title, if applicable                   Date
                                                                                                                                                                        under a valid power of attorney.
                                                __________________________________  _____/_____/_____
                                                Director of Revenue                           Date                                            Send this form and all supporting documents to: 
                                                                                                                                              Mail:
                                                               You must include copies of                                                     INFORMAL CONFERENCE BOARD 
                                                               •    All proposed audit result notices;                                        ILLINOIS DEPARTMENT OF REVENUE
                                                               •    Documents to support your argument;                                       555 W MONROE
                                                                                                                                              CHICAGO IL 60661
                                                               •    Completed and signed Form IL-2848 if you have a
                                                                    representative acting on your behalf; and                                 Email: REV.ICB@illinois.gov
                                                               •    Form ICB-2, if you intend to offer to settle the tax dispute.
                                                Page 2 of 3                                                                                                                             ICB-1 (R-06/22)
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Form ICB-1 Instructions
Step 1: Identify yourself, your business or envelope date, you must attach a legible copy of the face of
the envelope showing the date.
organization
Column C — Tax Type — Enter the type of tax that is the
Line 1 — Writesubject. your nameof theas itauditappearsor examinationon the notice(e.g , Retailers’you Occupation
received showing proposed audit results: Tax, Income Tax, Withholding).
• Notice of Proposed Deficiency Columns D and E— Enter the total amount of the proposed
• Notice of Proposed Tax Liability assessment (Column D) or claim denial (Column E), as shown
• Notice of Proposed Claim Denial on your notice.
• NoticeNote: You must attach a copy of the notice and any of Proposed Tax Liability and Claim Denial
Line 2 — Enter your current mailing address. Unless you attachments you received from us.
designate otherwise in Step 2, all correspondence from
the Informal Conference Board (ICB) will be mailed to this Step 4: Provide the grounds for your
address. request
Line 3 — Enter the applicable phone number and email Line 1 — Use this space to
address where you can be easily contacted. • provide specific reasons for your disagreement with the
Line 4 — If you are a business or an organization, enter the proposed assessment or claim denial.
name of the contact person, a daytime phone number, and fax • identify and outline each of the specific issues in the
number. proposal with which you disagree.
Line 5 — Enter the taxpayer ID from the notice showing your • provide, in detail, your arguments and any legal authority
proposed audit results. If this request for review is for Illinois to support your position that the proposed amounts
Individual Income Tax, and your filing status is Married, Filing contained in the notice from IDOR are wrong for each of
Jointly, enter both spouses’ taxpayer ID numbers from the the issues you have identified.
notice. • explain why you believe the calculation of any tax
Line 6a and 6b — If you are a corporation and you filed as proposed to be assessed is incorrect.
a member of a unitary group, or you did not file as a member Attach additional sheets if you need more space. Any
of a unitary group but in the audit it was determined that additional information or documentation supporting your
you should, write the name and FEIN of the Schedule UB’s position must be included with this request and referenced in
designated agent on the appropriate lines. your explanation.
Step 2: Identify your representative Line 2 — ICB will decide your case based on your written
request and supporting documentation. An in-person
Lines 1 through 3 — Complete all the information conference is not required. However, if you wish to have an
requested if someone will represent you during the informal “in-person” or “telephone conference,” select your preference
conference process. You may be represented by any person by checking the “yes” box to either “in-person” or “telephone
of your choice during the informal conference process. Your conference.”
representative need not be an attorney. If you check yes to an in-person conference, indicate if you
Note: Your representative must attach a properly prefer Springfield or Chicago for the meeting location. ICB
executed Form IL-2848, Power of Attorney. Effective will mail a written notice of the time, date, and location of the
September 11, 2020, you may also need to file Forms in-person conference to you or your representative.
IL-2848-A, Power of Attorney Additional Information, or
IL-2848-B, Power of Attorney Specific Authority Granted. Line 3 — If you will be submitting a formal request to settle
your tax dispute with IDOR, you must
Line 4 — Check the box if you would like all correspondence • check “Yes” on this line.
to be directed to your representative’s address. If you do not
check the box, all correspondence from the ICB will be mailed • complete and attach Form ICB-2, Offer of Disposition of a
to the address provided in Step 1. Proposed Assessment or Claim Denial. See Form ICB-2
and instructions for more information.
Step 3: Provide the following audit or
Step 5: Sign the waiver of statute of
examination information
limitations
Complete the information in the table as noted in the Complete this step by following the instructions on the form.
column headings. Most information is available on the
notice showing the proposed results. If you need additional assistance or information
Column A — If you need help completing this form or have any questions,
contact us at the phone number or email shown below.
Audit ID — Enter the Audit ID from your notice in the space
below the heading. Call: 217 785-6587 Email: REV.ICB@illinois.gov
Column B — Enter the issue date on your letter or the For more information about ICB, see 86 Ill. Adm. Code
postmark date from notice’s envelope. If you are using the Part 215, Informal Conference Board. These regulations are
available on our website at tax.illinois.gov.
ICB-1 (R-06/22) Printed by the authority of the State of Illinois - Electronic only Page 3 of 3

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