Tax Credit Claim Correction Request Form
Use this form to submit a correction request for a previously filed tax credit claim and explain the issue clearly.
Claimant Information
Claimant Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Original Claim Details
Original claim reference or case number
*
Tax year of original claim
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Tax credit name or type
*
Correction Details
Correction Category
*
Please Select
Wrong Amount
Incorrect Eligibility Details
Missing Documentation
Wrong Dependent Information
Other Claim Data Issue
Description of Error
*
Requested Correction
*
Submit Correction Request
Should be Empty: