15104

Status of the Taxpayer Levy

Agency
IRS
Revision
June 2017
Fillable fields
15
Pages
1
Official source
IRS form page
Checked
October 21, 2026
Fill 15104 online
Page 1 of form 15104

Form 15104: Status of the Taxpayer Levy

Form 15104, Status of the Taxpayer Levy, is a one-page IRS form completed by an employer. It identifies the employer by name and employer identification number (EIN) and the taxpayer by name and Social Security number (SSN), then asks which of three statements applies: the employer sent the amount, does not owe the taxpayer any money, or no longer employs the taxpayer.

The form says to complete it if you already mailed the amount required or don't owe any money to the taxpayer, and to return it to the IRS in the enclosed envelope. It also says the information can be given by phone at the number listed on the attached letter. The form itself prints no phone number or mailing address.

You can fill out Form 15104 free in your browser on this page and download it without an account.

What's on Form 15104

Employer and taxpayer

The employer's name and EIN, and the taxpayer's name and SSN.

Item 1: We sent the amount to you

The date mailed, the amount mailed and the address it was mailed to.

Item 2: We don't owe this taxpayer any money

A space to explain why no money is owed to the taxpayer.

Item 3: We no longer employ this taxpayer

The taxpayer's last known address, telephone number and current employer, if known, or any information to help the IRS locate the taxpayer.

Additional information

An open space at the bottom of the form for any other details.

How to fill out Form 15104

  1. 1

    Names and numbers

    Enter the employer's name and EIN, then the taxpayer's name and SSN.

  2. 2

    Pick the statement that applies

    The form lists three numbered statements. Complete the one that matches the employer's situation.

  3. 3

    Item 1

    If the amount was already sent, enter the date mailed, the amount mailed and the address it was mailed to.

  4. 4

    Item 2 or item 3

    For item 2, explain why no money is owed. For item 3, list the taxpayer's last known address, telephone number and current employer, if known.

  5. 5

    Return it

    The form says to return it in the enclosed envelope, or to give the information by phone at the number listed on the attached letter.

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Where it goes and what the form leaves out

Where to send it

The form says to return it to the IRS in the enclosed envelope. It prints no mailing address of its own.

By phone instead

The form says that if you prefer to give the information by phone, call the number listed on the attached letter. No phone number is printed on the form.

No separate instructions

Form 15104 has no separate instructions and prints no deadline. The attached letter it mentions is the reference it points to.

Related forms

Who fills out Form 15104?

  • Employers

    The first lines ask for the employer's name and EIN. The statements are written from the employer's side, for example "We no longer employ this taxpayer."

  • Employers that already sent the amount

    Item 1 is for an employer that already mailed the amount, with the date mailed, the amount mailed and the address it was mailed to.

  • Employers that owe the taxpayer nothing

    Item 2 is for an employer that does not owe the taxpayer any money, with space to explain.

  • Former employers

    Item 3 is for an employer that no longer employs the taxpayer, with space for the taxpayer's last known address, phone number and current employer, if known.

  • The taxpayer named on the form

    The taxpayer is listed by name and SSN only. The form has no lines for the taxpayer to complete.

The employer named at the top completes the form and returns it to the IRS. The form refers to an attached letter and an enclosed envelope.

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Questions about Form 15104

Who completes Form 15104?

The employer named at the top of the form. It asks for the employer's name and EIN, and its statements are written as the employer, for example "We sent the amount to you."

Where is Form 15104 sent?

The form says to return it in the enclosed envelope. It prints no address, so the envelope and the attached letter are the references.

Can the information be given by phone?

Yes. The form says that if you prefer to give the information by phone, call the number listed on the attached letter.

What if the taxpayer no longer works for the employer?

Item 3 covers that. It asks for the taxpayer's last known address, phone number and current employer, if known, or any information to help locate the taxpayer.

Does the taxpayer fill out this form?

The form has no lines for the taxpayer to complete. The taxpayer is listed by name and SSN only.