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Get Ivy Tech Tax Offset Getting Money Back Form

IVY TECH COMMUNITY COLLEGE Tax Offset Appeal Form Our records indicate that you owe a balance to the College. Indiana Code 6 8. 1 9. 5 authorizes Ivy Tech Community College as a Claimant Agency to report the debt to the Indiana Department of Revenue for possible offset from a future Indiana income tax refund due to you. As such the Department of Revenue Services will garnish intercept your State of If you feel this debt is not valid you have the right to request a hearing via an appeal process with Ivy Tech. Your written appeal below and documentation must be received at Ivy Tech Community College within 30 days of the date of your notification letter. Failure to provide a written request for a hearing or proof of prior payment will constitute acknowledgement of the debt owed* If you have any questions please call us at 1 888 489 5463. PLEASE PRINT Student Name First Middle Last Telephone Date of Birth Student ID C Current Street Address Last 4 digits of SSN xxx xx City State Zip Code Campus Attended E Mail Address In the space below please describe why the outstanding balance is inaccurate. ATTACH DOCUMENTATION SUBSTANTIATING ANY INACCURACY. Student Signature Date Send completed form and documentation to Ivy Tech Community College ATTN Tax Appeal Review Board 50 W* Fall Creek Parkway N* Dr. As such the Department of Revenue Services will garnish intercept your State of If you feel this debt is not valid you have the right to request a hearing via an appeal process with Ivy Tech. Your written appeal below and documentation must be received at Ivy Tech Community College within 30 days of the date of your notification letter. Your written appeal below and documentation must be received at Ivy Tech Community College within 30 days of the date of your notification letter. Failure to provide a written request for a hearing or proof of prior payment will constitute acknowledgement of the debt owed* If you have any questions please call us at 1 888 489 5463. Failure to provide a written request for a hearing or proof of prior payment will constitute acknowledgement of the debt owed* If you have any questions please call us at 1 888 489 5463. PLEASE PRINT Student Name First Middle Last Telephone Date of Birth Student ID C Current Street Address Last 4 digits of SSN xxx xx City State Zip Code Campus Attended E Mail Address In the space below please describe why the outstanding balance is inaccurate. PLEASE PRINT Student Name First Middle Last Telephone Date of Birth Student ID C Current Street Address Last 4 digits of SSN xxx xx City State Zip Code Campus Attended E Mail Address In the space below please describe why the outstanding balance is inaccurate. ATTACH DOCUMENTATION SUBSTANTIATING ANY INACCURACY. Student Signature Date Send completed form and documentation to Ivy Tech Community College ATTN Tax Appeal Review Board 50 W* Fall Creek Parkway N* Dr..

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