UNITED STATES TAX COURT WASHINGTON, DC 20217 , Petitioner(s) v. Docket No. COMMISSIONER OF INTERNAL REVENUE, Respondent NOTICE OF APPEAL Notice is hereby given that appeals to the United States Court of Appeals for the this Court entered in the above-captioned proceeding on the hereby Circuit from [that part of] the decision of day of [relating to ]. Date Party* or Counsel Date Additional Party* Post office address Counsel’s Tax Court Bar No. *If husband and wife are parties, then both must sign if both want to appeal. T.C. Form 17 (08/12) American LegalNet, Inc. www.FormsWorkFlow.com