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WARNING!!!
The attached Form 656 is not a stand-alone form and is intended for tax professional use only. Individuals
requesting consideration of an offer must use Form 656‐ B, Offer in Compromise, which may be found under
the Forms and Pubs tab on www.irs.gov. Completed financial statements and required application fee and
initial payment must be included with your Form 656. Failure to include the required information will delay
consideration of your offer.
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Department of the Treasury — Internal Revenue Service
Form 656
(April 2024) Offer in Compromise
To: Commissioner of Internal Revenue Service IRS Received Date
In the following agreement, the pronoun "we" may be assumed in place of "I" when there are joint liabilities and both (COIC use only)
parties are signing this agreement.
I submitattachment.this offer to compromise the tax liabilities plus any interest, penalties, additions to tax, and additional amounts
requiredNote: by lawIf youfor theneedtaxmoretypespace,and period(s)use attachmentmarked inandSectiontitle it1“Attachmentor Section 2tobelow.Form 656 dated .” Make sure to sign and date the
Did you use the Pre-Qualifier tool prior to filling out this form? Locate the tool on our website at IRS.gov/OICtool
or by scanning the QR code on your smart device.Other Federal Tax(es) [specify type(s) and period(s)]
Yes No
Note: The use of the Pre-Qualifier tool is not mandatory before sending in your offer. However, it is recommended.
Attention:Form You940mustEmployer'ssubmitAnnualseparateFederaloffersUnemploymentif either spouse(FUTA)has separateTax Returntax liabilities.- [e.g., 12-31-2018]
Include the $205 fee and initial payment with your Form 656 unless you qualify for the Low-Income Certification. Fill out
either Section 1 or Section 2, but not both.
Form 941 Employer's Quarterly Federal Tax Return - [e.g., 03-31-2019]
Form 1120 U.S. Corporate Income Tax Return - [e.g., 12-31-2019]
Business Tax Periods
Section 1 Individual Information (Form 1040 filers)(If Your Offer is for Business Tax Debt Only) List all years/periods owed
If you are a-1040, U.S. Individual Income Tax Return, filer, an individual with personal liability for Excise tax, individual responsible( ) for Trust-Fund
Recovery(EIN)Penalty, self-employed individual, or individual personally responsible for partnership liabilities, you should fill out Section 1.
YourEmployerfirst name,IdentificationmiddleNumber initial, last nameName and title of primary contact Social Security Number (SSN), Individual TaxpayerTelephoneor Identificationnumber
Number (ITIN) (if applicable)
Business mailing address (street, city, state, ZIP code) - -
If a joint offer, spouse's first name, middle initial, last name Social Security Number (SSN), Individual Taxpayer or Identification
Number (ITIN) (if applicable)
Business physical address (street, city, state, ZIP code) - -
Your home physical address (street, city, state, ZIP code, county of residence)
Business name
include all required documentation including the Form 433-B (OIC), a $205 application fee, and initial payment.
If your business is a Corporation, Partnership, LLC, or LLP and you want to compromise those tax debts, you must complete this section. You must also
Section 2Your home mailing address (if different from above or post office box number) Business Information (Form 1120, 1065, etc., filers)
For each additional person, add $12,850 $16,075 $14,775
8 $126,400 $158,050 $145,350
Is this a new address7 since your last filed tax return $113,550 $141,975 $130,575Yes No
If yes, would you like6 us to update our records to this address$100,700 $125,900 $115,800Yes No
Your Employer Identification5 Number (if applicable) $87,850 $109,825 $101,025
- 4 $75,000 $93,750 $86,250
Individual3 Tax Periods(For Individual$62,150or Sole-Proprietor Tax Debt Only)$77,675List all years/periods owed$71,475
2 $49,300 $61,600 $56,700
Form 1040 U.S. Individual Income Tax Return [e.g., 12-31-2018]
1 $36,450 $45,525 $41,925
TrustSizeFundof familyRecoveryunitPenalty as48a responsiblecontiguouspersonstates,ofD.C.,(enterandbusinessU.S.name)Territories Alaska Hawaii
will not be returned and will be applied to the tax liability in the best interest of the government.for failure to pay withholding and Federal Insurance Contributions Act taxes (Social Security taxes), for period(s) ending [e.g., 03-31-2019]
IF YOU QUALIFY FOR THE LOW-INCOME CERTIFICATION DO NOT INCLUDE ANY PAYMENTS WITH YOUR OFFER. Generally these payments
the table below.Form 941 Employer's Quarterly Federal Tax Return - Quarterly period(s)
I qualify for the Low-Income Certification because my household's size and gross monthly income x 12 is equal to or less than the income shown in
the table below.
IFormqualify940forEmployer'sthe Low-IncomeAnnualCertificationFederal Unemploymentbecause my adjusted(FUTA) TaxgrossReturnincome- Year(s)for my household's[e.g., 12-31-2018]size is equal to or less than the amount shown in
and size of your family qualify you for the Low-Income Certification.
Note:OtherBy checkingFederaloneTax(es)of the[specifyboxestype(s)belowandyouperiod(s)]are certifying that your adjusted gross income or your household’s gross monthly income x 12
qualifyNote: for Low-IncomeIf you needCertification.more space,TheuseIRSattachmentwill verifyandwhethertitle ityou“Attachmentqualify fortoLow-IncomeForm 656 datedCertification. .” Make sure to sign and date the
duringattachment.the consideration of your offer. If your business is other than a sole proprietor or the offer is being filed for a deceased individual, you do not
based on your family size and where you live. If you qualify, you are not required to submit any payments or the application fee upon submission or
returnWarning(Form: The1040)IRS willor yournot compromisehousehold’sanygrossamountsmonthlyofincomerestitutionfromassessedForm 433-A(OIC)by the IRS.x 12,Anyisliabilityequal toarisingor lessfromthanrestitutionthe amountis excludedshown infromthe chartthis offer.below
Also, the IRS will not compromise any liability for which an election under IRC § 965(i) is made; such liabilities are excluded from this offer. Any offer Do you qualify for Low-Income Certification? You qualify if your adjusted gross income, as determined by your most recently filed Individual Income Tax
containing a liability for which payment is being deferred under IRC § 965(h)(1) can only be processed for investigation if an acceleration of payment
under section 965(h)(3) and the regulationsLow-IncomethereunderCertification has occurred and(Individualsno portion ofandtheSoleliabilityProprietorsto be compromisedOnly)resulted from entering into a
transfer agreement under section 965(h)(3).
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Catalog Number 16728N www.irs.gov Form 656 (Rev. 4-2024)
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Section 3 Reason for Offer
Select only ONE of the three check boxes below.
Doubt as to Collectibility - I do not have enough in assets and income to pay my full tax liability. I have offered the minimum offer amount
calculated on Form 433-A(OIC) and/or Form 433-B(OIC).
Note: If you have special circumstances which would prevent you from paying the minimum offer amount calculated on Form 433-A (OIC) due to
economic hardship attach a detailed explanation.
Effective Tax Administration - Economic Hardship - I have enough in assets and income to pay my full tax liability but due to my special
circumstances, requiring full payment would cause an economic hardship. I owe this tax liability. (Only individuals qualify for this consideration).
Attach a detailed explanation.
Effective Tax Administration - Public Policy or Equity - I have enough in assets and income to pay my full tax liability but collection of the full
liability could be viewed as inequitable. I owe this tax liability. The amount I am offering is based on my exceptional circumstances, not economic
hardship. Example: A payroll service provider misappropriated taxes withheld from my employees. Attach a detailed explanation.
Section 4 Payment Terms
Check only one of the payment options below to indicate how long it will take you to pay your offer in full. You must
offer more than $0. The offer amount should be in whole dollars only.
Lump Sum
Check here if you will pay your offer in 5 or fewer payments within 5 or fewer months from the date of acceptance:
Enclose a check for 20% of the offer amount (waived if you met the requirements for Low-Income Certification) and fill in the amount(s) of your
future payment(s).
Total offer amount - 20% initial payment = Remaining balance
$ - $ = $
You may pay the remaining balance in one payment after acceptance of the offer or up to five payments, but cannot exceed 5
months.
Amount of payment $ payable within Month after acceptance
Amount of payment $ payable within Months after acceptance
Amount of payment $ payable within Months after acceptance
Amount of payment $ payable within Months after acceptance
Amount of payment $ payable within Months after acceptance
Periodic Payment
Check here if you will pay your offer in full in 6 to 24 months
Enter the amount of your offer $
Note: The total months may not exceed a total of 24. For example, if you are requesting your payments extend for 24 months then your
first payment is considered to be month 1 and your last payment is considered month 24. There will be 22 payments between the first
and last month.
Enclose a check for the first month's payment (waived if you met the requirements for Low-Income Certification).
The first monthly payment of $ is included with this offer then $ will be paid on the (pick number 1-28)
day of each month thereafter for months with a final payment of $ to be paid on the day of the
month.
You must continue to make these monthly payments while the IRS is considering the offer (waived if you met the requirements for Low-
Income Certification). Failure to make regular monthly payments until you have received a final decision letter will cause your offer to be
returned with no appeal rights. If you qualified under the Low-Income Certification and are not required to submit payments while the
offer is under consideration, your first payment will be due 30 calendar days after acceptance of the offer, unless another date is agreed
to in an amended offer.
Catalog Number 16728N www.irs.gov Form 656 (Rev. 4-2024)
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Section 5 Designation of Payment and Electronic Federal Tax Payment System (EFTPS)
Designation of Payment
If you want your payment to be applied to a specific tax year and a specific tax debt, such as employment taxes or a Trust Fund Recovery Penalty,
tell us the tax period/quarter . If you are not specific with your designation we will apply any money you send to the government's
best interest. If you want to designate any future payments not included with this Form 656 while the offer is pending [see section 7(j) below] with
the IRS, you must include the specific tax year and type of tax at the time each payment is made. However, you cannot designate the application
fee or any payment after the IRS accepts the offer.
Note: Payments submitted with your offer cannot be designated as estimated tax payments for a current or past tax year.
Electronic Federal Tax Payment System (EFTPS)
List offer payments made through Electronic Federal Tax Payment System (EFTPS) below.
Offer application fee Date Electronic funds transfer number (15 digits)
Offer payment Date Electronic funds transfer number (15 digits)
Note: Any Offer Application Fee or initial payment made electronically must be made the same date your offer is mailed.
Section 6 Source of Funds, Making Your Payment, Filing Requirements, and Tax Payment Requirements
Source of Funds
Tell us where you will obtain the funds to pay your offer
Making Your Payment
Include separate checks for the payment and application fee.
Make checks payable to the “United States Treasury” and attach to the front of your Form 656, Offer in Compromise. All payments must be in U.S.
dollars. Do not send cash. Send a separate application fee with each offer; do not combine it with any other tax payments, as this may delay
processing of your offer. You may also make payments electronically through Electronic Federal Tax Payment System (EFTPS). Your offer will be
returned to you if the application fee and the required payment are not included, or if your check is returned for insufficient funds.
Filing Requirements
I have filed all required tax returns and have included a complete copy of any tax return filed within 12 weeks of this offer submission
I was not required to file a tax return for the following years
Note: Do not include original tax returns with your offer. You must either electronically file your tax return or mail it to the appropriate
IRS processing office before sending in your offer.
Tax Payment Requirements (check all that apply)
I have made all required estimated tax payments for the current tax year
I am not required to make any estimated tax payments for the current tax year
I have made all required federal tax deposits for the current quarter and two preceding quarters
I am not required to make any federal tax deposits for the current quarter and two preceding quarters
Section 7 Offer Terms
By submitting this offer, I have read, understand and agree to the following terms and conditions:
Terms, Conditions, and Legal a) I request that the IRS accept the offer amount listed in this offer application as payment of my outstanding tax
Agreement debt arising under Title 26 (including interest, penalties, and any additional amounts required by law) as of the
date listed on this form. I authorize the IRS to amend Section 1 or Section 2 if I failed to list any of my assessed
tax debt or tax debt assessed before acceptance of my offer. By submitting a joint offer, both signers grant
approval to the Internal Revenue Service to disclose the existence of any separate liabilities owed.
b) I also authorize the IRS to amend Section 1 or Section 2 by removing any tax years on which there is currently
no outstanding liability. I understand that my offer will be accepted, by law, unless the IRS notifies me otherwise,
in writing, within 24 months of the date my offer was received by our IRS centralized offer in compromise unit,
located in Memphis/Brookhaven. See mailing instructions on page 29 of Form 656-B. The 24-month period for a
deemed acceptance will not begin to run until the correct site receives the offer. I also understand that if any tax
debt that is included in the offer is in dispute in any judicial proceeding that tax debt will not be included in
determining the expiration of the 24-month period. I instruct the IRS to disregard any period on my Form 656 for
court ordered restitution or under the jurisdiction of the Department of Justice.
Catalog Number 16728N www.irs.gov Form 656 (Rev. 4-2024)
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Section 7 (Continued) Offer Terms
IRS will keep my payments, c) I voluntarily submit the payments made on this offer and understand that they will not be returned even if I
fees, and some refunds. withdraw the offer or the IRS rejects or returns the offer. Unless I designate how to apply each required payment
in Section 5, the IRS will apply my payment in the best interest of the government, choosing which tax years and
tax debts to pay off. The IRS will also keep my application fee unless the offer is not accepted for processing.
d) I understand that if I checked the Low-Income Certification in Section 1, then no payments are required. If I
qualify for the Low-Income Certification and voluntarily submit payments, all money will be applied to my tax debt
and will not be returned to me.
e) Treas. Reg. section 301.7122(e)(5) states, in part, that acceptance of an offer in compromise will conclusively
settle the liability for the tax periods specified in the offer. To enforce the regulation as a contract term, I agree
that I cannot file an amended return for the tax years listed on Form 656 after the offer is accepted. Further, I
agree that I will not file an amended return for the tax years listed on Form 656 after I have submitted my offer
and while my offer remains pending [see section 7(j) below] with the Service. The filing of the amended return
could be considered grounds for termination. In addition, any refunds related to an amended return filed for a tax
year which has an ending date prior to offer acceptance will be offset to the tax liability. If I receive a refund prior
to offer acceptance, or based on an amended return for any tax periods extending to the date my offer is
accepted, I will return the refund within 30 days of receiving the refund. The IRS will keep any refund, including
interest, that I might be due for tax returns filed through the date the IRS accepts my offer. Systemic offset of
overpayments will continue in accordance with IRC 6402(a) prior to the offer acceptance date. I understand that
my tax refund may be offset to the tax liability while the offer is pending, but that assistance could be available for
taxpayers (other than businesses) facing an economic hardship.
f) I understand that the amount I am offering may not include part or all of an expected or current tax refund,
money already paid, funds attached by any collection action, or anticipated benefits from a capital or net operating
loss.
g) The IRS will keep any monies it has collected prior to this offer. Under section 6331(k), the IRS may levy on my
property and rights to property up to the time that the IRS official signs and acknowledges my offer as pending.
The IRS may keep any proceeds arising from such a levy. No levy will be issued on individual shared
responsibility payments. However, if the IRS served a continuous levy on wages, salary, or certain federal
payments under sections 6331(e) or (h), then the IRS could choose to either retain or release the levy.
h) The IRS will keep any payments that I make related to this offer. I agree that any funds submitted with this offer
will be treated as a payment. I also agree that any funds submitted with periodic payments made after the
submission of this offer and prior to the acceptance, rejection, or return of this offer will be treated as payments.
i) If my offer is accepted and my final payment is more than the agreed amount, the IRS will not return the
difference, but will apply the entire payment to my tax debt.
Pending status of an offer and j) Once an authorized IRS official signs this form, my offer is considered pending as of that signature date and it
right to appeal remains pending until the IRS accepts, rejects, or returns my offer, or I withdraw my offer. An offer is also
considered pending for 30 days after any rejection of my offer by the IRS, and during the time that any rejection of
my offer is being considered by the Appeals Office. An offer will be considered withdrawn when the IRS receives
my written notification of withdrawal by personal delivery or certified mail or when I inform the IRS of my
withdrawal by other means and the IRS acknowledges in writing my intent to withdraw the offer.
k) I waive the right to an Appeals hearing if I do not request a hearing in writing within 30 days of the date the IRS
notifies me of the decision to reject the offer.
I must comply with my future l) As both an express condition and as a contractual promise, I will strictly comply with all provisions of the internal
tax obligations and understand revenue laws, including requirements to timely file tax returns and timely pay taxes for the five year period
I remain liable for the full beginning with the date of acceptance of this offer and ending through the fifth year. I agree to promptly pay any
amount of my tax debt until all liabilities assessed after acceptance of this offer for tax years ending prior to acceptance of this offer that were not
terms and conditions of this otherwise identified in Section 1 or Section 2 of this agreement. I also understand that during the five year period I
offer have been met. cannot request an installment agreement for unpaid taxes incurred before or after the accepted offer. I understand
that I cannot request an offer for a tax liability during the five year period. If this is an offer being submitted for joint
tax debt, and one of us does not comply with future obligations, only the non-compliant taxpayer will be in default
of this agreement. An accepted offer will not be defaulted solely due to the assessment of an individual shared
responsibility payment. I understand failure to pay any restitution-based assessments will provide basis for the
default of my offer acceptance for administrative tax periods included on this Form 656.
m) I agree that I will remain liable for the full amount of the tax liability, accrued penalties and interest, until I have
met all of the terms and conditions of this offer. Penalties and interest will continue to accrue until all payment
terms of the offer have been met. If I file for bankruptcy before the terms and conditions of the offer are met, I
agree that the IRS may file a claim for the full amount of the tax liability, accrued penalties and interest, and that
any claim the IRS files in the bankruptcy proceeding will be a tax claim.
n) Once the IRS accepts my offer in writing, I have no right to challenge the tax debt(s) in court or by filing a
refund claim or refund suit for any liability or period listed in Section 1 or Section 2, even if the IRS defaults or
rescinds the offer.
Catalog Number 16728N www.irs.gov Form 656 (Rev. 4-2024)
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Section 7 (Continued) Offer Terms
I understand what will happen if o) If I fail to meet any of the terms of this offer, the IRS may revoke the certificate of release of federal tax lien and
I fail to meet the terms of my file a new notice of federal tax lien; levy or sue me to collect any amount ranging from one or more missed
offer (e.g., default). payments to the original amount of the tax debt (less payments made) plus penalties and interest that have
accrued from the time the underlying tax liability arose. The IRS will continue to add interest, as required by
section 6601 of the Internal Revenue Code, on the amount the IRS determines is due after default. I agree that if I
provide false information or documents in conjunction with this offer or conceal my assets or my ability to pay,
then the IRS may reopen my offer and exercise its discretion in the further treatment of the offer, including a
termination of the offer contract. If the IRS terminates my offer contract, I will be liable for the full amount of the
tax liability, accrued penalties and interest.
I agree to waive time limits p) To have my offer considered, I agree to the extension of the time limit provided by law to assess my tax debt
provided by law. (statutory period of assessment). I agree that the date by which the IRS must assess my tax debt will now be the
date by which my debt must currently be assessed plus the period of time my offer is pending plus one additional
year if the IRS rejects, returns, or terminates my offer or I withdraw it. (Paragraph (j) of this section defines
pending and withdrawal.) I understand that I have the right not to waive the statutory period of assessment or to
limit the waiver to a certain length or certain periods or issues. I understand, however, that the IRS may not
consider my offer if I refuse to waive the statutory period of assessment or if I provide only a limited waiver. I also
understand that the statutory period for collecting my tax debt will be suspended during the time my offer is
pending with the IRS, for 30 days after any rejection of my offer by the IRS, and during the time that any rejection
of my offer is being considered by the Independent Office of Appeals. By submitting this offer I immediately
withdraw any pending installment agreement that is on file for all tax periods and I understand a pending
installment agreement (an installment agreement that has been accepted for processing but the IRS has not
accepted its terms) will not be automatically reinstated after the offer is closed.
I understand the IRS may file a q) The IRS may file a Notice of Federal Tax Lien during consideration of the offer or for offers that will be paid
Notice of Federal Tax Lien on over time. If the offer is accepted, the tax lien(s) for the periods and taxes listed in Section 1 will generally be
my property. released within 45 days after the final payment has been received and verified. The time it takes to transfer funds
to the IRS from commercial institutions varies based on the form of payment. If I have not finished paying my offer
amount, then the IRS may be entitled to any proceeds from the sale of my property. The IRS will not file a Notice
of Federal Tax Lien on any individual shared responsibility debt.
Correction Agreement r) I authorize the IRS, to correct any typographical or clerical errors or make minor modifications to my Form 656
that I signed in connection to this offer.
I authorize the IRS to contact s) By authorizing the IRS to contact third parties, I understand that I will not be notified of which third parties the
relevant third parties in order to IRS contacts as part of the offer application process, including tax periods that have not been assessed, as stated
process my offer. in §7602 (c ) of the Internal Revenue Code. In addition, I authorize the IRS to request a consumer report on me
from a credit bureau.
I am submitting an offer as an t) I understand if the liability sought to be compromised is the joint and individual liability of myself and my co-
individual for a joint liability. obligor(s) and I am submitting this offer to compromise my individual liability only, then if this offer is accepted, it
does not release or discharge my co-obligor(s) from liability. The United States still reserves all rights of collection
against the co-obligor(s).
I understand the IRS Shared u) If your offer includes any shared responsibility payment (SRP) amount that you owe for not having minimum
Responsibility Payment (SRP). essential health coverage for you and, if applicable, your dependents per Internal Revenue Code Section 5000A
- Individual shared responsibility payment, it is not subject to penalties (except applicable bad check penalty) or to
lien and levy enforcement actions. However, interest will continue to accrue until you pay the total SRP balance
due. We may apply your federal tax refunds to the SRP amount that you owe until it is paid in full.
I understand the IRS is required v) The IRS is required to make certain information, such as taxpayer name, city/state/zip, liability amount, and
to make certain information offer terms, available for public inspection and review for one year after the date of offer acceptance.
public.
Secure Messaging w) By sending and receiving encrypted messages through the IRS Secure Messaging platform, I agree to accept
offer final determination letters on this platform.
Catalog Number 16728N www.irs.gov Form 656 (Rev. 4-2024)
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Section 8 Signatures
Under penalties of perjury, I declare that I have examined this offer, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct and complete.
Signature of Taxpayer/Corporation Name Phone number Today's date (mm/dd/yyyy)
By checking this box you are authorizing the IRS to contact you at the telephone number listed above and leave detailed messages concerning
this offer on your voice mail or answering machine.
Signature of Spouse/Authorized Corporate Officer Phone number Today's date (mm/dd/yyyy)
By checking this box you are authorizing the IRS to contact you at the telephone number listed above and leave detailed messages concerning
this offer on your voice mail or answering machine.
Section 9 Paid Preparer Use Only
Signature of Preparer Phone number Today's date (mm/dd/yyyy)
By checking this box you are authorizing the IRS to contact you at the telephone number listed above and leave detailed messages concerning
this offer on your voice mail or answering machine.
Name of Paid Preparer Preparer's CAF no. or PTIN
Firm's name (or yours if self-employed), address, and ZIP code
If you would like to have someone represent you during the offer investigation, attach a valid, signed Form 2848 with this application or a
copy of a previously filed form. Form 2848 allows for representation and receipt of confidential information. You should also include the
current tax year on the form, in the list of applicable years or periods.
Form 8821 allows a third party to receive confidential information but they cannot represent you before the IRS in a Collection matter. If you
would like a third party to receive confidential information on your behalf attach a copy if previously filed and include the current tax year on
the form.
IRS Use Only. I accept the waiver of the statutory period of limitations on assessment for the Internal Revenue Service, as described in Section 7(p).
Signature of Authorized Internal Revenue Service Official Title Date (mm/dd/yyyy)
Privacy Act Statement
We ask for the information on this form to carry out the internal revenue laws of the United States. Our authority to request this information is section §
7801 of the Internal Revenue Code.
Our purpose for requesting the information is to determine if it is in the best interests of the IRS to accept an offer. You are not required to make an offer;
however, if you choose to do so, you must provide all of the taxpayer information requested. Failure to provide all of the information may prevent us from
processing your request.
If you are a paid preparer and you prepared the Form 656 for the taxpayer submitting an offer, we request that you complete and sign Section 9 on Form
656, and provide identifying information. Providing this information is voluntary. This information will be used to administer and enforce the internal
revenue laws of the United States and may be used to regulate practice before the Internal Revenue Service for those persons subject to Treasury
Department Circular No. 230, Regulations Governing the Practice of Attorneys, Certified Public Accountants, Enrolled Agents, Enrolled Actuaries, and
Appraisers before the Internal Revenue Service. Information on this form may be disclosed to the Department of Justice for civil and criminal litigation.
We may also disclose this information to cities, states and the District of Columbia for use in administering their tax laws and to combat terrorism.
Providing false or fraudulent information on this form may subject you to criminal prosecution and penalties.
Catalog Number 16728N www.irs.gov Form 656 (Rev. 4-2024)
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