You object to relief being granted to your spouse or former spouse.
If you feel that relief should not be allowed, complete Form 12509, Statement of Disagreement (PDF), to explain why. Please remember you have 30 days from the date of the letter to complete Form 12509 requesting your appeal.
Tips for preparing your statement when completing Form 12509
It’s easier to understand your information if you present it in chronological order and give specific dates. Include facts and details about your situation such as:
- If you are separated, provide the date(s).
- Explain who handled your finances during your marriage.
- Your education level and occupation.
- Education level and occupation of spouse or former spouse.
- A current phone number where you can be reached during the day.
Your completed Form 12509 and any additional information needs to be sent to the office that sent you the preliminary determination letter. Do not send your completed form to an Appeals Office. This will delay the processing of your case.