1. Petitioner(s) hereby file(s) a (PLACE AN "X" IN THE APPROPRIATE BOX):

Petition for Redetermination of a    Deficiency	Petition for Redetermination of Relief    from Joint and Several Liability on a    Joint Return
Petition for Lien or Levy ACtion    (Collection Action)	Petition for Redetermination of    Employment Status (Worker    Classification

       2. Petitioner(s) disagree(s) with the determination contained in the notice issued by the Internatl Revenue Services for the year(s) or period(s)..............., as set forth in such notice dated ........................, A COPY OF WHICH IS ATTACHED. DO NOT ATTACH ANY OTHER DOCUMENTS TO THIS PETITION.

      3. Petitioner(s)' taxpayer identification (e.g., Social Security) number(s) is (are)
..............................................................................................................................................................................................

      4. Set forth the relief requested and the reasons why you believe you are entitled to such relief.
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      Petitioner(s) request(s) that this case be conducted under the "small tax case" procedures. The amount in dispute or any overpayment claimed is $50,000 or less. A decision in a "small tax case" is final and cannot be appealed to a Court of Appeals by the Internal Revenue Service or the Petitioner(s). If you do NOT want this case conducted as a "small tax case", place an "X" in the following box.  

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Signature of Petitioner                      Date	(Print) Mailing Address
	...................................................................................
	City, State, Zip Code, (Area Code) Telephone No.
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Signature of Petitioner (e.g., spouse)           Date (If Named in the Final Notice)	(Print) Mailing Address
	...................................................................................
	City, State, Zip Code, (Area Code) Telephone No.

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Signature,  name,  address,  telephone number,  and Tax Court Bar Number of counsel,  if retained by petitioner(s)