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Form Publication 501 for Hollywood Florida: What You Should Know

Exercise of rights granted pursuant to this Form shall not be construed as the grant of the right to a tax deduction for amounts withheld from the payment of federal income tax, any state, or local income tax under any program or policy of the United States with respect to income tax. Any taxpayer who prepares a written request or an affidavit as described in this Form must pay the applicable fee listed below. The fee is payable to an employee-representative of the IRS who will file the original tax return. Exercise of Rights granted pursuant to this Form shall not be construed as a waiver or grant of any right, claim, or interest under the Internal Revenue Code of 1986, as amended, not prohibited by law, including, without limitation, any right to a deduction for federal income tax under any provision of the Code or the Internal Revenue Code of 1986, as amended, which relates to a qualified homestead exemption, or for medical or dental expenses and any other amount withheld or paid from the payment of federal income tax or any law requiring the payment of federal income tax.  Any payment received by the IRS shall be used in accordance with applicable Federal, State, and local law as if the same were made by the taxpayer or the taxpayer's authorized representative. Taxpayers who prepare this Form may not use any other person's title or trademark to represent the statement. The taxpayer's name and address should appear only as part of the statement, with the taxpayer's signature appearing on all parts of the form. The taxpayer or taxpayer's authorized representative is responsible for ensuring that all items listed are correct. The statement must be typed and completed on letterhead paper, typewritten, or in an electronic format. It should be printed in 8-point font and signed by a person authorized to sign on his or her behalf.  Taxpayers must make their completed Form (in 8-point font) or Affidavit (in electronic format) to the office where tax returns are filed. The filing office is a public agency, not the IRS. The taxpayer must deliver the statement directly to: P.O. Box 394 San Jose, CA 95129 The original statement and any additional information required should be retained until the date when the exemption from the standard deduction for each taxable year shall commence. On or before such date, the taxpayer may file Form 1040X or Form 1040 if claiming the additional exemption.

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