0320 Form 14017 (PDF) — verbatim text

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f14017.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

14017 Form (March 2020)	Department of the Treasury - Internal Revenue Service Application for Fast Track Settlement
Submitted to IRS Independent Office of Appeals Date Location	Submitted to IRS Independent Office of Appeals Date Location	Submitted to IRS Independent Office of Appeals Date Location	Submitted to IRS Independent Office of Appeals Date Location	From LB&I SB/SE TE/GE Other	From LB&I SB/SE TE/GE Other	From LB&I SB/SE TE/GE Other	Type of tax	Type of tax
Taxpayer name	Taxpayer name	Taxpayer name	Taxpayer name	Taxpayer name	Representative name(if applicable)	Representative name(if applicable)	Representative name(if applicable)	Representative name(if applicable)
Taxpayer TIN/EIN	Taxpayer TIN/EIN	Tax years	Tax years	Tax years	Name of firm	Name of firm	Name of firm	Name of firm
Address	Address	Address	Address	Address	Address	Address	Address	Address
City	City	State	Zip code	Zip code	City	State	State	Zip code
Telephone number	Telephone number	Fax number	Fax number	Fax number	Telephone number	Fax number	Fax number	Fax number
Examination Group/Team Manager	Examination Group/Team Manager	Examination Group/Team Manager	Examination Group/Team Manager	Examination Group/Team Manager	Examination Group/Team Manager	Source_(FE/OE, etc.)_	Source_(FE/OE, etc.)_	Source_(FE/OE, etc.)_
City	City	State	Zip code	Zip code	Telephone number	Fax number	Fax number	Fax number

Other Participants (if applicable)

Name Position or Affiliation Telephone Number

Signatures

The undersigned request assistance from the IRS Independent Office of Appeals in the Fast Track Settlement (FTS) process. The issues for which this assistance is requested are described in the Form(s) 5701, Summary of Issues, or Form 886-A, Explanation of Items, or similar documents and the taxpayer’s written response, and are attached to this application. By signing this application, taxpayer consents, pursuant to section 6103(c) of the Code, to the disclosure of the taxpayer’s returns and return information pertaining to the issues being considered in the FTS process to those persons named on the application as participants in the process. The prohibition against ex parte communications between Appeals personnel and other Service employees provided by section 1001(a) of the Internal Revenue Service Restructuring and Reform Act of 1998 does not apply to the communications arising in FTS because Appeals personnel, in facilitating an agreement between the taxpayer and the other Service Operating Division, are not acting in their traditional Appeals settlement role. IRS employees, taxpayer and persons invited to participate by the IRS or taxpayer will not voluntarily disclose information regarding any communication made during the FTS session, except as provided by statute.

Taxpayer signature				Date signed
Taxpayer Spouse's signature_(if related to a joint return)_	Taxpayer Spouse's signature_(if related to a joint return)_	Taxpayer Spouse's signature_(if related to a joint return)_	Taxpayer Spouse's signature_(if related to a joint return)_	Date signed
Taxpayer(s) Representative signature	Taxpayer(s) Representative signature	Taxpayer(s) Representative signature	Taxpayer(s) Representative signature	Date signed
IRS Group/Team Manager Signature	IRS Group/Team Manager Signature	IRS Group/Team Manager Signature	IRS Group/Team Manager Signature	Date signed
Approving Operating Division Official_(signature and title)_	Approving Operating Division Official_(signature and title)_	Approving Operating Division Official_(signature and title)_	Approving Operating Division Official_(signature and title)_	Date signed
Accepted by Appeals Official_(Appeals Team Manager signature)_	Accepted by Appeals Official_(Appeals Team Manager signature)_	Accepted by Appeals Official_(Appeals Team Manager signature)_	Accepted by Appeals Official_(Appeals Team Manager signature)_	Date signed
Accepted by Appeals Official_(Appeals Program Manager signature)_	Accepted by Appeals Official_(Appeals Program Manager signature)_	Accepted by Appeals Official_(Appeals Program Manager signature)_	Accepted by Appeals Official_(Appeals Program Manager signature)_	Date signed
MFT	PBC	Potential Joint Committee Yes No	Listed transaction Yes No	Listed transaction Yes No
LB&I practice area	LB&I practice area	Preferred conference site	Fast Track end date	Fast Track end date