Complete your protest and mail it to the IRS address on the letter that explains your appeal rights. This form is to be used to request an Appeals review upon completion of an examination (audit) if you do not agree with our proposed changes from the audit.Parties dissatisfied with their Administrative decision may wish to file an appeal with the Arizona Tax Court. Before submitting an appeal form, please see Appeals Process for time periods when these forms are accepted. Purpose of this form: You can use this form to appeal a Letter 4890 Notice of Denial or a Letter 5015 Notice of Revocation of your IRS-approved. Financial Aid Forms. See A.R.S. 42-11154(1) . Attach IRS form 12661. The IRS audit reconsideration form 12661 is the official letter that taxpayers can fill out to request a reconsideration. How insurers justify denials.