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It's probably worth the effort to complete a Form 433 and send that back in response to the latest letter from the IRS. On that he will list his assets and his income. I'd also list the nursing home expense, but I wouldn't worry about details of any other expenses.

The IRS will probably put him in Currently Not Collectible status. That will stop the letters until he gets close to the expiration of the statute of limitations on collection (which is 10 years from the time the return was filed). Then he'll have to give them an updated Form 433, and if nothing has changed they'll likely just let the statute expire.

There is a separate statute of limitations for each tax year. So he'll probably hear from the IRS about once a year until the newest return gets to be 10 years old.

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