Userid: SD_796CB schema instrx Leadpct: 0% Pt. size: 8.5 Draft Ok to Print PAGER/XML Fileid: ...rms, Inst. & Pubs\T All 2011\9465-FS\2 Instructions\2011 I 9465-FS.xml (Init. & date) Page 1 of 3 Instructions for Form 9465-FS 13:48 - 23-DEC-2011 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. Department of the Treasury Instructions for Form Internal Revenue Service 9465-FS (December 2011) Installment Agreement Request Section references are to the Internal Revenue Code unless agreement instead of filing Form 9465-FS. To do that, go to otherwise noted. IRS.gov and click on “More...” under Tools. Bankruptcy or offer-in-compromise. If you are in bankruptcy or General Instructions weInstead,havecallaccepted1-800-829-1040your offer-in-compromise,to get the numberdoofnotyourfilelocalthis form.IRS Insolvency function for bankruptcy or Technical Support function for Purpose of Form offer-in-compromise. Use Form 9465-FS to request a monthly installment plan if your liability is greater than $25,000 but not more than $50,000 and you How the Installment Agreement Works cannot pay the full amount you owe shown on your tax return (or on We will usually let you know within 30 days after we receive your a notice we sent you). Though Form 9465-FS is meant to be used request whether it is approved or denied. However, if this request is by taxpayers with liabilities greater than $25,000 but not more than for tax due on a return you filed after March 31, it may take us $50,000, it can be used by all taxpayers to request an installment longer than 30 days to reply. If we approve your request, we will agreement. Generally, you can have up to 72 months to pay. In send you a notice detailing the terms of your agreement and certain circumstances, you can have longer to pay or your requesting a fee of $105 ($52 if you make your payments by agreement can be approved for an amount that is less than the electronic funds withdrawal). However, you may qualify to pay a amount of tax you owe. reduced fee of $43 if your income is below a certain level. The IRS If you use this form you must file it on paper and attach it to the will let you know whether you qualify for the reduced fee. If the IRS front of your return; mailing it to the address shown in your tax does not say you qualify for the reduced fee, you can request the return booklet. If you have already filed your return and you are reduced fee using Form 13844, Application For Reduced User Fee sending in Form 9465-FS on its own, mail it to the address shown For Installment Agreements. in these instructions for the type of return filed. However, before requesting an installment agreement, you should consider other You will also be charged interest and may be charged a late less costly alternatives, such as getting a bank loan or using payment penalty on any tax not paid by its due date, even if your available credit on a credit card. If you have any questions about request to pay in installments is granted. Interest and any this request, call 1-800-829-1040. applicable penalties will be charged until the balance is paid in full. To limit interest and penalty charges, file your return on time and Use Form 9465-FS if you are an individual: pay as much of the tax as possible with your return (or notice). All • Who owes income tax on Form 1040, payments received will be applied to your account in the best • Who may be responsible for a Trust Fund Recovery Penalty, interests of the United States. • Who was self-employed and owes self-employment or unemployment taxes and is no longer operating the business, By approving your request, we agree to let you pay the tax you • Who is personally responsible for a partnership liability and the owe in monthly installments instead of immediately paying the partnership is no longer operating, or amount in full. In return, you agree to make your monthly payments • Owner who is personally responsible for taxes in the name of a on time. You also agree to meet all your future tax liabilities. This limited liability company (LLC) and the LLC is no longer operating. means that you must have enough withholding or estimated tax payments so that your tax liability for future years is paid in full Do not use Form 9465-FS if: when you timely file your return. Your request for an installment • You can pay the full amount you owe within 120 days (see Can agreement will be denied if all required tax returns have not been you pay in full within 120 days?), or filed. Any refund due you in a future year will be applied against the • You want to request an online payment agreement (see Applying amount you owe. If your refund is applied to your balance, you are online for a payment agreement). still required to make your regular monthly installment payment. Guaranteed installment agreement. Your request for an installment agreement cannot be turned down if the tax you owe is Payment methods. You can make your payments by check, not more than $10,000 and all three of the following apply. money order, credit card, or one of the other payment methods • During the past 5 tax years, you (and your spouse if filing a joint shown next. The fee for each payment method is also shown. taxreturn)due,haveandtimelyhave notfiledenteredall incomeintotaxan installmentreturns andagreementpaid any incomefor Payment method Applicable fee payment of income tax. Check, money order, or credit card $105 • The IRS determines that you cannot pay the tax owed in full when it is due and you give the IRS any information needed to Electronic funds withdrawal $ 52 make that determination. Payroll deduction installment $105 • You agree to pay the full amount you owe within 3 years and to agreement comply with the tax laws while the agreement is in effect. A Notice of Federal Tax Lien may be filed to protect the For details on how to pay, see your tax return instructions, visit CAUTION! government’s interests until you pay in full. IRS.gov, or call 1-800-829-1040. canCanyourtheamountfeeapplyyourequesttoyoupaysetonline.owetoupinpayfullanwithinininstallmentwithinfull.120If120days,youagreement.days?cancalldo1-800-829-1040this,If youInsteadyoucancanpayofavoidcalling,totheestablishfullpayingyouamountshowingwillpaymentspayment.Afternot receiveofwetheWeautomaticallyyourreceiveremainingwillanextnotice.alsoeachpayment.sendamountwithdrawnYourpayment,youbankButyouaniffromannualwestatementowe,youwillyourchooseandsendstatementcheckingtheisyouyourtoduehavearecordshowingdatenoticeaccount,yourandoftheyou Applying online for a payment agreement. If your balance due amount you owed at the beginning of the year, all payments made is not more than $50,000, you can apply online for a payment during the year, and the amount you owe at the end of the year. Dec 23, 2011 Cat. No. 58659P |
Page 2 of 3 Instructions for Form 9465-FS 13:48 - 23-DEC-2011 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. If you do not make your payments on time or do not pay any For taxpayers filing Form 1040 with Schedule(s) C, E, or F for any tax balance due on a return you file later, you will be in default on your year for which this installment agreement is being requested. agreementof a Notice andof Federalwe mayTaxtakeLienenforcementor an IRS levyactions,action,suchto collectas the filingthe IF you live in . . . THEN use this address . . . entire amount you owe. To ensure that your payments are made Alabama, Arkansas, Georgia, Illinois, WhilewithdrawalAftertimely,requestRequestsrequestantheyouwilltoinstallmentIRSmodifyto(seeshouldnotmodifyconsiderssuspendtheorconsideragreementinstructionsterminateor terminateyourthemakingstatuterequestanisforapproved,installmentanlinesthemoftoinstallmentlimitationsmodify11abyyouelectronicandagreement.ormayon11b,terminateagreement.collection.submitlater).fundsThisthea Virginia,Dakota,Oklahoma,Mississippi,Jersey,Louisiana,Indiana,NorthTennessee,Iowa,WisconsinMichigan,Pennsylvania,Missouri,Dakota,Kansas,Texas,Minnesota,Nebraska,Ohio,Kentucky,SouthWestNewDepartmentMemphis,Internal RevenueTNof the38101–0069P.O.TreasuryStopServiceBox81169 agreement.installmentTIP Anmateriallyinstallmentagreement,incompleteagreementyou mustor inaccuratecomplymay bewithterminatedinformationthe existingifinyouresponseprovide Alaska,Hawaii,Washington,New Mexico,Idaho,Arizona,WyomingOregon,Montana,California,Utah,Nevada,Colorado, DepartmentInternalOgden,RevenueofP.O.theStopUTTreasuryBoxService8440999415500 to an IRS request for a financial update. Pub.For594,additionalThe IRSinformationCollectiononProcess.the IRS collection process, see Connecticut,New Hampshire,Maine,NewMassachusetts,York, Rhode DepartmentInternal RevenueofP.O.the TreasuryBoxService480 Island, Vermont Stop 660 Where To File Holtsville, NY 11742–0480 FormAttachyouraddressreturn9465-FSFormshownor9465-FSyoubyinitselfyouraretofilingtaxwiththereturnthisthefrontformInternalbooklet.of yourin responseRevenuereturnIf youandhavetoServiceasendnotice,alreadyitCentertofilefiledthe Carolina,ofDelaware,Columbia,VirginiaFlorida,NorthMaryland,Carolina, SouthDistrict Philadelphia,DepartmentInternal RevenueStopPAof19255–0030the4–N31.142TreasuryService using the address in the table below that applies to you. A foreign country, American Samoa, For all taxpayers except those filing Form 1040 with Schedule(s) C, E, or Puerto Rico (or are excluding or F for any tax year for which this installment agreement is being income under Internal Revenue Code Department of the Treasury requested. section 933), or use an APO or FPO Internal Revenue Service address, or file Form 2555, 2555-EZ, 3651 South I-H 35, 5501AUSC IF you live in . . . THEN use this address . . . or 4563, or are a dual-status alien or Austin, TX 78741 Carolina,Alabama,VirginiaLouisiana,SouthFlorida,Mississippi,Carolina,Georgia,NorthTexas,Kentucky, DepartmentInternalDoraville,RevenueP.O.of theBoxGATreasuryStopService303624742174 *the9465-FS.nonpermanentPermanentVirgin Islands*residentsresidentofofGuamGuamororthe Virgin Islands cannot use Form Alaska, Arizona, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Illinois, Department of the Treasury Maine, Maryland, Massachusetts,Montana, Nevada, New Hampshire, Internal Revenue Service310 Lowell St. Specific Instructions New Jersey, New Mexico, North Stop 830 Dakota, Oregon, Rhode Island, South Andover, MA 01810 Part I Dakota, Tennessee, Utah, Vermont, Washington, Wisconsin, Wyoming Line 1a Missouri,Oklahoma,Kansas,Arkansas,VirginiaMichigan,Nebraska,California,Pennsylvania,Minnesota,NewIndiana,York,WestIowa,Ohio, KansasDepartmentInternalCity, MORevenueofStopthe64999–0250TreasuryP-4Service5000 LineIfandtaxyoureturn.socialare2 makingsecuritythisnumbersrequest(SSNs)for a jointin thetaxsamereturn,ordershowastheonnamesyour A foreign country, American Samoa, If you are requesting an installment agreement for a business tax or Puerto Rico (or are excluding liability, enter the business name and employer identification income under Internal Revenue Code Department of the Treasury number on this line. section 933), or use an APO or FPO Internal Revenue Service address, or file Form 2555, 2555-EZ, 3651 South I-H 35, 5501AUSC Line 7 ornonpermanentthe4563,VirginorIslands*areresidenta dual-statusof Guamalienoror Austin, TX 78741 Enternotice(s)).the total amount you owe as shown on your tax return(s) (or * Permanent residents of Guam or the Virgin Islands cannot use Form If the total amount you owe is greater than $25,000 but not 9465-FS. ! more than $50,000, you must complete Part II and agree to CAUTION a Direct Debit Installment Agreement (DDIA) to qualify for an IA without completing a financial statement. If you do not agree to a DDIA, you must complete Form 433-F, Collection Information Statement, and mail it with this form. If the amount you owe is greater than $50,000, you must complete Form 433-F and mail it with this form. You can download Form 433-F at IRS.gov or order it by calling 1-800-TAX-FORM (1-800-829-3676). If the total amount you owe is not more than $50,000 TIP (including any amounts you owe from prior years), you do not need to file Form 9465-FS; you can request an installment agreement online. For more information see Applying online for a payment agreement, earlier. -2- |
Page 3 of 3 Instructions for Form 9465-FS 13:48 - 23-DEC-2011 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. Line 8 The electronic funds withdrawal from your checking account TIP will not be approved unless you (and your spouse if filing a Even if you cannot pay the full amount you owe now, you should joint return) sign Form 9465-FS. pay as much as possible to limit penalty and interest charges. If you are filing this form with your tax return, make the payment with your Sample Check—Lines 11a and 11b return. For details on how to pay, see your tax return instructions. If you are filing this form by itself, such as in response to a notice, attach a check or money order payable to the “United States Paul Maple 1234 Treasury.” Do not send cash. Be sure to include: Roberta Maple SAMPLE 15-0000/0000¶ • Your name, address, SSN/EIN, and daytime phone number. 123 Pear Lane Anyplace, VA 20000 • The tax year and tax return (for example,“ 2009 Form 1040”) for which you are making this request. PAY TO THE ORDER OF $ Line 9 Routing Account Enter on line 9 the amount you can pay each month. Make your number number DOLLARS (line 11a) (line 11b) payments as large as possible to limit interest and penalty charges. ANYPLACE BANK Do not include Anyplace, VA 20000 The charges will continue until you pay in full. If a payment amount the check number. is not shown on line 9, one will be determined for you by dividing For the balance due by 72 months. | :250250025 | :202020"'86".1234 § Line 10 TIP Youcanthe month.becanonchooseorForafterexample,thetheday1stofifofyoureachtherentmonth,monthor mortgagebutyournopaymentlaterpaymentthanis due.theis28thdueThisonof Theon yourroutingcheck.and account numbers may be in different places the 1st of the month, you may want to make your installment payments on the 15th. When we approve your request, we will tell you the month and day that your first payment is due. Part II If we have not replied by the date you chose for your first payment, you can send the first payment to the Internal Revenue Lines 12—24 Service Center at the address shown earlier that applies to you. Complete Part II only if your balance due is greater than $25,000 See the instructions for line 8 above for details on what to write on but not more than $50,000. your payment. Privacy Act and Paperwork Reduction Act Notice. Our legal Lines 11a and 11b right to ask for the information on this form is sections 6001, 6011, 6012(a), 6109, and 6159 and their regulations. We will use the Making your payments by electronic funds withdrawal will information to process your request for an installment agreement. TIP help ensure that your payments are made timely and that The reason we need your name and social security number is to you are not in default of this agreement. secure proper identification. We require this information to gain accountyournumbers.withdrawalbrokerageTofinancialpayatbyfirm,aisbankallowedelectronicinstitutionor creditor otherandfundstounion),tomakefinancialgetwithdrawalfillthesureininstitutioncorrectlinesthatfroman11aroutingelectronic(suchyourand 11b.andcheckingas mutualfundsaccountCheckfund,with toyouraccessrequiredprovidingagreement.providerequest.totofalsethethisprovideIfYoutaxyouinformationinformationinformationdoaretherequestnotinformationrequiredmaymayinanpreventoursubjectinstallmentrequestedtofilesrequestprocessingyouandtoagreement,properlyonanfinesthisinstallmentyourorform.respondpenalties.request;youFailureareto You are not required to provide the information requested on a If the total amount you owe is greater than $25,000 but not form that is subject to the Paperwork Reduction Act unless the form CAUTION! more than $50,000, you must agree to a Direct Debit displays a valid OMB control number. Books or records relating to a Installment Agreement (DDIA) to qualify for an IA without form or its instructions must be retained as long as their contents completing a financial statement. If you do not agree to a DDIA, you may become material in the administration of any Internal Revenue must complete Form 433-F, Collection Information Statement, and law. Generally, tax returns and return information are confidential, mail it with this form. as required by section 6103. However, we may give this information Line 11a. The routing number must be nine digits. The first two to the Department of Justice for civil and criminal litigation, and to digits of the routing number must be 01 through 12 or 21 through cities, states, the District of Columbia, and U.S. commonwealths 32. Use a check to verify the routing number. On the sample check and possessions to carry out their tax laws. We may also disclose on this page, the routing number is 250250025. But if your check is this information to other countries under a tax treaty, to federal and payable through a financial institution different from the one at state agencies to enforce federal nontax criminal laws, or to federal which you have your checking account, do not use the routing law enforcement and intelligence agencies to combat terrorism. number on that check. Instead, contact your financial institution for The average time and expenses required to complete and file the correct routing number. this form will vary depending on individual circumstances. For the Line 11b. The account number can be up to 17 characters (both estimated averages, see the instructions for your income tax return. numbers and letters). Include hyphens but omit spaces and special If you have suggestions for making this form simpler, we would symbols. Enter the number from left to right and leave any unused be happy to hear from you. See the instructions for your income tax boxes blank. On the sample check below, the account number is return. 20202086. Do not include the check number. Note. We may have filed a notice of federal tax lien against your property. If so, you may be able to get the notice of lien withdrawn. To learn more about lien withdrawals and to see if you qualify, visit IRS.gov and enter ‘‘lien withdrawal’’ in the search box. -3- |