Form 0919-A

(Rev. October 2012)

Department of Feelings
Internal Regulation Service

Application for Approval of Crush or Infatuation or Other Quick-Onset Feelings of Attraction

File this form with Internal Regulation Service

Section references are to the Internal Regulation Code unless otherwise noted.

Instructions for completing this form are available at http://www.feelings.irs.gov.

1a. Name of applicant. Address, City, State, Zip.

1b. Applicant’s telephone number.

1.c. Emotional Identification Number (EIN)

2. Type of Applicant:
◊ Hopeless Romantic
◊ Confirmed Bachelor/Bachelorette
◊ Skeptic

3a. Name of Object. (required) Address, City, Zip (if known)

3b. Object’s telephone number (if known)

3c. Objects’s EIN (if known)

4. Quick-onset feeling characteristics (mark all that apply)
◊ Giddy or Excited         ◊ Hopeful
◊ Curious                        ◊ Confused
◊ Bemused                     ◊ Nervous
◊ Other _______________________________

5. Interaction types completed or planned (mark all that apply)
◊ Phone call
◊ Text message
◊ Brief in person meeting
◊ Sustained in person meeting
◊ Extended in person meeting
◊ Letter
◊ Social Media or other messaging app
◊ Other _______________________________

6. Level of minute-to-minute distraction
◊ Mild
◊ Moderate
◊ Severe
◊ Extreme

Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.

Signature ________________________

Date _____________________________

For Privacy Act and Heartbreak Reduction Act, see Form 09-19A Instructions



crush approved

Drawing by Yael Kisel

7 thoughts on “#71

      1. nice!
        Dude this is the first time I’ve seen that you replied to me. I didn’t get any notifications. Have you been replying to my other comments and I was ignorantly ignoring you??

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