Userid: CPM Schema: Leadpct: 100% Pt. size: 10 Draft Ok to Print instrx AH XSL/XML Fileid: … ns/i9465/202407/a/xml/cycle01/source (Init. & Date) _______ Page 1 of 7 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. Department of the Treasury Internal Revenue Service Instructions for Form 9465 (Rev. July 2024) Installment Agreement Request (For use with Form 9465 (Rev. September 2020)) Section references are to the Internal Revenue Code installment agreement, later, for more information. In unless otherwise noted. certain circumstances, you can have longer to pay or you can establish an agreement for an amount that is less than Future Developments the amount of tax you owe. For the latest developments related to Form 9465 and its instructions, such as legislation enacted after they were However, before requesting a payment plan, you should published, go to IRS.gov/Form9465. consider other alternatives, such as getting a bank loan or using available credit, which may be less costly. If you What's New have any questions about this request, call 800-829-1040. Reduction in user fees for certain installment agree- Who should use this form? Use Form 9465 if you’re an ments. New installment agreement fees are effective July individual: 1, 2024. See Installment agreement user fees, later, for more information. • Who owes income tax on Form 1040 or 1040-SR; • Who is or may be responsible for a trust fund recovery Reminders penalty; • Who owes employment taxes (for example, as reported User fees for certain reinstated or restructured in- on Forms 941, 943, or 940) related to a sole proprietor stallment agreements. The user fee is $10 for business that is no longer in operation; or installment agreements reinstated or restructured through • Who owes an individual shared responsibility payment an online payment agreement (OPA). You must have under the Affordable Care Act (this payment isn’t established the reinstatement or restructuring of the assessed for months beginning after December 31, installment agreement through an OPA to qualify for the 2018). See section 5000A. reduced user fee. Low-income taxpayers may be reimbursed this fee under certain conditions. See Who should not use this form? Don’t use Form 9465 if: Requests to modify or terminate an installment agreement, later. • You can pay the full amount you owe within 180 days (if you plan to pay the taxes, interest, and penalties due in full Apply online at reduced fee. If the total amount you within 180 days, you can save the cost of the user owe isn't more than $50,000 (including any amounts you fee—see Can you pay in full within 180 days? next); owe from prior years), you may not need to file Form 9465; • You want to request a payment plan online, including an you can request an installment agreement online for a installment agreement (see Applying online for an reduced fee. For more information, see Applying online for installment agreement and other payment plans, later); or an installment agreement and other payment plans, later. • Your business is still operating and owes employment or Waiver and reimbursement of user fees for low-in- unemployment taxes. Instead, call the telephone number come taxpayers. For installment agreements entered on your most recent notice to request an installment into by taxpayers with adjusted gross income, for the most agreement. recent tax year available, at or below 250% of the federal Can you pay in full within 180 days? If you can pay the poverty guidelines, the IRS will waive or reimburse user full amount you owe within 180 days, you can avoid paying fees if certain conditions are met. For details, see the fee to set up an installment agreement by calling the Low-income taxpayer user fee waivers and IRS at 800-829-1040. If you owe $100,000 or less, you reimbursements, later. can apply for a short-term payment plan, if you can pay in Financial statement may be required. See Line 11b, full within 180 days, by using the OPA application at later, for more information about when a Form 433-F is IRS.gov/OPA. required. A Form 433-F, Collection Information Statement, Applying online for an installment agreement and may be downloaded at IRS.gov/Forms-Instructions. other payment plans. If your balance due isn’t more than $50,000, you can apply online for a payment plan instead of filing Form 9465. To do that, go to IRS.gov/OPA. General Instructions If you establish your installment agreement using the OPA Purpose of Form application, the user fee that you pay will be lower than it would be otherwise. Use Form 9465 to request a monthly installment agreement (payment plan) if you can’t pay the full amount Guaranteed installment agreement. You’re eligible for you owe shown on your tax return (or on a notice we sent a guaranteed installment agreement if the tax you owe you). Most installment agreements meet our streamlined isn’t more than $10,000 and: installment agreement criteria. See Streamlined • During the past 5 tax years, you (and your spouse if filing a joint return) have timely filed all income tax returns Apr 18, 2024 Cat. No. 58607N |
Page 2 of 7 Fileid: … ns/i9465/202407/a/xml/cycle01/source 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. and paid any income tax due, and haven’t entered into an Note. When you request an installment agreement, with installment agreement for the payment of income tax; certain exceptions the IRS is generally prohibited from • You agree to pay the full amount you owe within 3 years levying and the IRS's time to collect is suspended or and to comply with the tax laws while the agreement is in prolonged while the installment agreement is pending. effect; and See IRS.gov/filing/time-irs-can-collect-tax and Tax Topic • You’re financially unable to pay the liability in full when No. 202, Tax Payment Options, at IRS.gov/TaxTopics/ due. TC202 for additional information. Streamlined installment agreement. Generally, you're After approving your request. Each month, we will eligible for a streamlined installment agreement if: send you a notice showing the remaining amount you • Your assessed tax liability is $25,000 or less (for an owe, and the due date and amount of your next payment. individual, in-business with income tax only, or an But if you choose to have your payments automatically out-of-business taxpayer); or withdrawn from your checking account (also known as a • Your assessed tax liability is $25,001 to $50,000 (for an direct debit), you won’t receive a notice. Your checking individual or an out-of-business sole proprietorship) and account statement is your record of payment. We will send you agree to pay by direct debit or payroll deduction. you an annual statement showing the amount you owed at the beginning of the year, all payments made during the Your proposed payment amount must pay in full the year, and the amount you owe at the end of the year. assessed tax liability within 72 months or satisfy the liability in full by the Collection Statute Expiration Date By approving your request, we agree to let you pay the (CSED), whichever is less. The CSED is normally 10 tax you owe in monthly installments instead of years from the date of the assessment. However, it may immediately paying the amount in full. In return, you agree be suspended or extended for various reasons. For more to make your monthly payments on time. You also agree to information on the CSED, go to IRS.gov/filing/time-irs-can- meet all your future tax obligations. This means that you collect-tax. must have enough withholding or estimated tax payments Generally, a streamlined installment agreement does so that your tax obligation for future years is paid in full not require a financial statement or a Notice of Federal Tax when you timely file your return. Your request for an Lien to be filed. installment agreement will be denied if any required tax returns haven’t been filed. Any refund will be applied Partial payment installment agreement (PPIA). An against the amount you owe even if you have an installment agreement that will not pay in full the entire installment agreement. If your refund is applied to your balance before the CSED is called a PPIA. You will be balance, you’re still required to make your regular monthly required to complete a financial statement and provide installment payment. supporting financial information for a PPIA. If a PPIA is approved, your agreement is subject to future reviews to Installment agreement user fees. We charge a user confirm if your financial situation has changed. You may fee to set up an installment agreement. The amount of the be required to provide a new financial statement and user fee can vary depending on whether you use the supporting financial information during this review. The online payment application and how you propose to make financial information you provide may result in a reduction, your monthly payments. For details, see the table below an increase, or no change to your monthly installment with the fees in effect as of July 1, 2024. agreement amount. More on types of installment agreements and pay- Applicable Fee ment options. For more information about types of Payment Method Using the online Not using the online installment agreements, see Tax Topic No. 202, Tax payment application payment application Payment Options, at IRS.gov/TaxTopics/TC202. Also go to Direct debit $22* $107* IRS.gov/Payments for more information on payment Check, money order, $69* $178* options. credit card, or debit Bankruptcy or offer in compromise. If you’re in card bankruptcy or have a pending or accepted offer in * Low-income taxpayers should see Low-income taxpayer reduced compromise, don’t file this form. Instead, call installment agreement user fee and Low-income taxpayer user fee waivers 800-829-1040 to get the number of your local IRS and reimbursements, later. Insolvency function for bankruptcy or to get the number of the office to contact regarding your offer in compromise. How the Installment Agreement Note. If you request a payroll deduction agreement using Form 2159, Payroll Deduction Agreement, your user fee Works will be $178 beginning July 1, 2024. If you’re a low-income Requesting an installment agreement. We will usually taxpayer, see Low-income taxpayer reduced installment let you know within 30 days after we receive your request agreement user fee next for more details. whether it is approved or denied. However, if this request Low-income taxpayer reduced installment agreement is for tax due on a return you filed after March 31, it may user fee. If you establish an installment agreement that is take us longer than 30 days to reply. If we approve your not paid by direct debit, you may qualify to pay a reduced request, we will send you a notice detailing the terms of fee of $43 or for a reimbursement of your fee if you are a your agreement and requesting a user fee. low-income taxpayer, as defined below. See Low-income 2 Instructions for Form 9465 (Rev. 7-2024) |
Page 3 of 7 Fileid: … ns/i9465/202407/a/xml/cycle01/source 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. taxpayer user fee waivers and reimbursements next. The Payment methods. You can make your payments by IRS will let you know whether you qualify for the reduced direct debit, check or money order, credit card, debit card, fee. If the IRS doesn’t say you qualify for the reduced fee, or one of the other accepted payment methods. To be you can request that the IRS consider you for charged a lower fee, you may want to set up an OPA “low-income” status using Form 13844, Application For and/or agree to make your payments by direct debit. For Reduced User Fee For Installment Agreements. more information on the accepted payment methods, go Low-income taxpayer user fee waivers and reim- to IRS.gov/Payments, see your tax return instructions, or bursements. For installment agreements entered into on call 800-829-1040. or after April 10, 2018, by low-income taxpayers, defined Requests to modify or terminate an installment next, the IRS will waive or reimburse the user fees if agreement. After an installment agreement is approved, certain conditions are met. If you’re a low-income taxpayer you may submit a request to modify or terminate your and you agree to make electronic payments through a installment agreement. You may modify your payment debit instrument by entering into a direct debit installment amount or due date by going to IRS.gov/OPA. You may agreement (DDIA), the IRS will waive the user fees for the also call 800-829-1040 to modify or terminate your installment agreement. See Lines 13a, 13b, and 13c, later, agreement. for further details. If you’re a low-income taxpayer and Generally, the fee is $89 to modify your installment you’re unable to make electronic payments through a debit agreement ($43 if you are a low-income taxpayer). instrument by entering into a DDIA, the IRS will reimburse However, the user fee is $10 for installment agreements the reduced $43 user fee that you paid for the installment reinstated or restructured through an OPA. This user fee agreement upon completion of the installment agreement. applies only if the reinstatement or restructuring of the See Line 13c, later, for more details. installment agreement is completed through an OPA. Definition of low-income taxpayer. A low-income taxpayer is a taxpayer with adjusted gross income, for the The IRS will waive or reimburse the fee for low-income most recent tax year available, at or below 250% of the taxpayers if certain conditions are met. See Low-income federal poverty guidelines. For more information on how to taxpayer user fee waivers and reimbursements, earlier. determine if your adjusted gross income is at or below By approving your request, we agree to let you pay the 250% of the federal poverty guidelines, see the tax you owe in monthly installments instead of instructions for Form 13844. immediately paying the amount in full. In return, you agree to make your monthly payments on time. You agree to The only payment option that will qualify the provide updated financial information when requested. CAUTION agreement user fee is their agreement to make ! low-income taxpayer for a waiver of the installment You also agree to meet all your future tax obligations. electronic payments through a debit instrument by This means that you must have enough withholding or entering into a DDIA. See Lines 13a, 13b, and 13c, later, estimated tax payments so that your tax obligation for for more details. future years is paid in full when payment is due. And you agree to timely file your return. Other costs. You will be charged interest and a late What happens if the taxpayer doesn’t comply with payment penalty on any tax not paid by its due date, even the terms of the installment agreement? If you don’t if your request to pay in installments is granted. Interest make your payments on time or don’t timely pay a balance and any applicable penalties will be charged until the due on a return you file later, you will be in default on your balance is paid in full. But see Topic 653, IRS Notices and agreement and we may terminate the agreement. Before Bills, Penalties, and Interest Charges, at IRS.gov/ we terminate the agreement, you may be entitled to file an TaxTopics/TC653 for additional information. To limit appeal under the Collection Appeals Program (CAP). We interest and penalty charges, file your return on time and may take enforcement actions, such as filing an NFTL or pay as much of the tax as possible with your return or issuing an IRS levy, to collect the entire amount you owe. notice. All payments received under the installment To ensure that your payments are made timely, you should agreement will be applied to your account in the best consider making them by direct debit. See Lines 13a, 13b, interests of the United States. and 13c, later. What happens if the taxpayer owes a shared respon- An installment agreement may be terminated if sibility payment (SRP)? The SRP amount that you owe ! you provide materially incomplete or inaccurate is the assessed payment for not having minimum essential CAUTION information in response to an IRS request for a health coverage for you and, if applicable, your financial update or if you provide such information to dependents per section 5000A. The SRP isn’t assessed obtain the installment agreement. For more information for months beginning after December 31, 2018. However, about what you need to do if your installment agreement is even after that date, you may continue to owe the SRP terminated, go to IRS.gov/CP523. assessed for months that began before December 31, 2018. The SRP amount that you owe isn’t subject to penalties or to Notice of Federal Tax Lien (NFTL) or levy Note. We may have filed an NFTL against your property. enforcement actions. However, interest will continue to If so, you may be able to get the notice of lien withdrawn. accrue until you pay the total SRP balance due. We may To learn more about lien withdrawals and to see if you apply your federal tax refunds to the SRP amount that you qualify, go to IRS.gov/businesses/small-businesses-self- owe until it’s paid in full. employed/understanding-a-federal-tax-lien. Instructions for Form 9465 (Rev. 7-2024) 3 |
Page 4 of 7 Fileid: … ns/i9465/202407/a/xml/cycle01/source 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. An NFTL may be filed to protect the government’s For all taxpayers except those filing Form 1040 or 1040-SR with ! interests until you pay in full. However, an NFTL Schedule(s) C, E, or F for any tax year for which this installment CAUTION generally isn’t filed with a guaranteed installment agreement is being requested agreement or streamlined installment agreement, but can be in certain situations. We won’t file an NFTL for the IF you live in . . . THEN use this address . . . individual shared responsibility payment under the Alaska, Arizona, Colorado, Affordable Care Act. Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Illinois, Department of the Treasury You may be entitled to file an appeal through the CAP Maine, Maryland, Massachusetts, Internal Revenue Service before and after the NFTL is filed. You are entitled to file Montana, Nevada, New 310 Lowell St. an appeal regarding an NFTL filing through Collection Due Hampshire, New Jersey, New Stop 830 Process (CDP) only for the first filing of an NFTL for the Mexico, North Dakota, Oregon, Andover, MA 01810 Rhode Island, South Dakota, unpaid tax liabilities shown on that NFTL. Tennessee, Utah, Vermont, IRS collection process and taxpayer rights. For Washington, Wisconsin, Wyoming additional information on the IRS collection process and Alabama, Florida, Georgia, Department of the Treasury what to do if you cannot pay your taxes in full, see Pub. Kentucky, Louisiana, Mississippi, Internal Revenue Service 594, The IRS Collection Process. You can find more North Carolina, South Carolina, P.O. Box 47421 information about the collection process, taxpayer rights, Texas, Virginia Stop 74 and appealing a collection decision at IRS.gov/ Doraville, GA 30362 businesses/small-businesses-self-employed/collection- Arkansas, California, Indiana, Department of the Treasury procedures-for-taxpayers-filing-and-or-paying-late. Iowa, Kansas, Michigan, Internal Revenue Service Minnesota, Missouri, Nebraska, Taxpayer Advocate Service (TAS). TAS is an New York, Ohio, Oklahoma, Stop P-4 5000 Kansas City, MO 64999-0250 independent organization within the IRS that helps Pennsylvania, West Virginia taxpayers and protects taxpayer rights. TAS strives to ensure that every taxpayer is treated fairly and that you know and understand your rights under the Taxpayer Bill of Rights. TAS can help you if your tax problem is causing For taxpayers filing Form 1040 or 1040-SR with Schedule(s) C, a financial difficulty; you've tried and been unable to E, or F for any tax year for which this installment agreement is resolve your issue with the IRS; or you believe an IRS being requested system, process, or procedure isn’t working as it should. IF you live in . . . THEN use this address . . . The service is free. Your local advocate’s number is at TaxpayerAdvocate.IRS.gov/Contact-Us and in your local Connecticut, Maine, Department of the Treasury directory. You can also call TAS toll free at 877-777-4778. Massachusetts, New Hampshire, Internal Revenue Service New York, Rhode Island, Vermont P.O. Box 480 For more information about TAS and your rights under the Stop 660 Taxpayer Bill of Rights, go to TaxpayerAdvocate.IRS.gov. Holtsville, NY 11742-0480 Where To File Alabama, Arkansas, Georgia, Illinois, Indiana, Iowa, Kansas, Attach Form 9465 to the front of your return and send it to Kentucky, Louisiana, Michigan, Department of the Treasury the address shown in your tax return booklet. If you have Minnesota, Mississippi, Missouri, Internal Revenue Service already filed your return or you’re filing this form in Nebraska, New Jersey, North P.O. Box 69 response to a notice, file Form 9465 by itself with the Dakota, Ohio, Oklahoma, Stop 811 Internal Revenue Service Center using the address in the Pennsylvania, South Dakota, Memphis, TN 38101-0069 table below that applies to you. Tennessee, Texas, West Virginia, Wisconsin Alaska, Arizona, California, Department of the Treasury Colorado, Hawaii, Idaho, Internal Revenue Service Montana, Nevada, New Mexico, P.O. Box 9941 Oregon, Utah, Washington, Stop 5500 Wyoming Ogden, UT 84409 District of Columbia, Delaware, Department of the Treasury Florida, Maryland, North Carolina, Internal Revenue Service South Carolina, Virginia Stop 4-N31.142 Philadelphia, PA 19255-0030 4 Instructions for Form 9465 (Rev. 7-2024) |
Page 5 of 7 Fileid: … ns/i9465/202407/a/xml/cycle01/source 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. “United States Treasury.” Don’t send cash. Be sure to For all taxpayers living outside the 50 states, for any tax year for which the installment agreement is being requested include the following. • Your name, address, SSN/EIN, and daytime phone IF you live in . . . THEN use this address . . . number. A foreign country, U.S. territory*, Department of the Treasury • The tax year and tax return (for example, “2023 Form or use an APO or FPO address, Internal Revenue Service 1040”) for which you’re making this request. or file Form 2555 or 4563, or are a 3651 South I-H 35 dual-status alien 5501AUSC Line 9 Austin, TX 78741 Subtract line 8 from line 7 and enter the result. * For all taxpayers who are bona fide residents of American Samoa, Puerto Rico, Guam, the U.S. Virgin Islands, or the Northern Mariana Islands, see Generally, to qualify for a streamlined installment Pub. 570, Tax Guide for Individuals With Income From U.S. Territories. ! agreement, if the total amount you owe is greater CAUTION than $25,000 but not more than $50,000, you must either (1) complete lines 13a and 13b and agree to make payments by direct debit; or (2) check box 14 to make your payments by payroll deduction and attach a Specific Instructions completed, signed Form 2159. Part I If the total amount you owe isn’t more than TIP $50,000 (including any amounts you owe from Line 1a prior years), you don’t need to file Form 9465; you If you’re making this request for a joint tax return, show the can request an installment agreement online. For more names and social security numbers (SSNs) in the same information, see Applying online for an installment order as they appear on your tax return. agreement and other payment plans, earlier. If you have a foreign address, enter the city name on the appropriate line. Don’t enter any other information on Line 11a that line, but also complete the spaces below that line. Enter on line 11a the amount you can pay each month. Don’t abbreviate the country name. Follow the country’s Make your payments as large as possible to limit interest practice for entering the postal code and the name of the and penalty charges. The charges will continue to accrue province, county, or state. until you pay them in full. If you have an existing installment agreement, this amount should represent your Line 1b total proposed monthly payment amount for all your If the address you provided on line 1a is new since you liabilities. If no payment amount is listed on line 11a (or filed your last tax return, check the box on line 1b. 11b), a payment will be determined for you by dividing the balance due by 72 months. If the proposed payment Line 2 amount entered does not pay in full the amount of tax Show the name and employer identification number (EIN) owed by the CSED, your request may be considered for a of your business (which must no longer be operating). PPIA. See Partial payment installment agreement, earlier, for more information. Line 5 Enter the total amount you owe as shown on your tax After we review your completed form, we may contact return(s) or notice(s). The amount you owe could include you for additional information. For example, we may amounts from more than 1 tax year. request a Form 433-F to be completed. Line 6 Line 11b If you have additional balances due that are not reflected Follow the steps in the bullet below that applies to you. on line 5, list the total here (even if they are included in an • If the amount on line 11a is less than the amount on existing installment agreement). Any adjustments or other line 10 and you’re able to increase your payment to an charges that are not reported on a tax return or notice amount that is equal to or greater than the amount on should be listed on this line. line 10, enter your revised monthly payment proposal on line 11b. Line 7 • If the amount on line 11a is less than the amount on line 10 and you’re unable to increase your payment to the Add lines 5 and 6 and enter the result. amount on line 10, check the box below the line 11b entry Line 8 line and complete and attach Form 433-F. Even if you can’t pay the full amount you owe now, you • If the amount on line 11a (or 11b, if applicable) is equal to or greater than the amount on line 10 but the amount should pay as much as possible to limit the penalty and you owe (line 9) is greater than $25,000 but not more than interest charges. If you’re filing this form with your tax $50,000, you must complete either line 13 or 14 if you return, make the payment with your return. For details on don’t want to complete Form 433-F. how to pay, see your tax return instructions. • If you have defaulted on an installment agreement If you’re filing this form by itself, such as in response to within the last 12 months, the amount you owe is greater a notice, attach a check or money order made payable to than $25,000 but not more than $50,000, and the amount Instructions for Form 9465 (Rev. 7-2024) 5 |
Page 6 of 7 Fileid: … ns/i9465/202407/a/xml/cycle01/source 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. on line 11a (11b, if applicable) is less than the amount on Sample Check—Lines 13a and 13b line 10, you must complete Part II on page 2 of Form 9465. Paul Maple 1234 • If the amount on line 9 is greater than $50,000, Roberta Maple SAMPLE 15-0000/0000 123 Pear Lane complete and attach Form 433-F. Anyplace, VA 20000 PAY TO THE Line 12 ORDER OF $ Routing Account You can choose the day of each month your payment is number number DOLLARS (line 13a) (line 13b) due. This can be on or after the 1st of the month, but no ANYPLACE BANK Anyplace, VA 20000 Don’t include the check number. later than the 28th of the month. For example, if your rent For or mortgage payment is due on the 1st of the month, you | | :202020"'86".:250250025 1234 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. The routing and account numbers may be in TIP different places on your check. If we haven’t replied by the date you chose for your first payment, you can send the first payment to the Internal Revenue Service Center at the address shown earlier that Line 13c. Low-income taxpayers who are unable to make applies to you. See Line 8, earlier, for details on what to electronic payments through a DDIA by providing their write on your payment. Or you can submit this payment information on lines 13a and 13b are eligible to receive electronically. Go to IRS.gov/Payments for payment reimbursement of their installment agreement user fees. If options. you’re a low-income taxpayer and you checked the box on line 13c, your installment agreement user fee will be Lines 13a, 13b, and 13c reimbursed upon completion of your installment To pay by direct debit from your checking account at a agreement. See Low-income taxpayer user fee waivers bank or other financial institution (such as a mutual fund, and reimbursements, earlier, for more information. brokerage firm, or credit union), fill in lines 13a and 13b. If you don’t check the box on line 13c (and don’t Check with your financial institution to make sure that a provide the information on lines 13a and 13b), you’re direct debit is allowed and to get the correct routing and indicating that you’re able but choosing not to make account numbers. electronic payments by establishing a DDIA. As such, your Making your payments by direct debit will help user fee is not eligible for reimbursement upon completion TIP ensure that your payments are made timely and of your installment agreement. you don’t default on this installment agreement. Line 14 Low-income taxpayers who complete lines 13a and If you want to make your payments by payroll deduction, 13b will receive a waiver of their installment agreement check the box on line 14 and attach a completed and user fees. See Low-income taxpayer user fee waivers and signed Form 2159. Ask your employer to complete and reimbursements, earlier, for more information. sign the employer’s portion of your Form 2159. Line 13a. The routing number must be nine digits. The Part II first two digits of the routing number must be 01 through If you have defaulted on an installment agreement within 12 or 21 through 32. Use a check to verify the routing the last 12 months, the amount you owe is greater than number. On the Sample Check, later, the routing number $25,000 but not more than $50,000, and the amount on is 250250025. But, if your check is payable through a line 11a (line 11b, if applicable) is less than line 10, financial institution different from the one at which you complete Part II on page 2 of Form 9465. have your checking account, don’t use the routing number on that check. Instead, contact your financial institution for Lines 21 and 22 the correct routing number. Complete lines 21 and 22 relating to income earned by Line 13b. The account number can be up to 17 your spouse if you are married and meet either of the characters (both numbers and letters). Include hyphens following conditions. but omit spaces and special symbols. Enter the number • You live with and share household expenses with your from left to right and leave any unused boxes blank. On spouse. Even if only one spouse is liable for the taxes the Sample Check, later, the account number is owed, the total household income and expenses are 20202086. Don’t include the check number. relevant in determining the liable spouse’s ability to pay the taxes owed. The direct debit from your checking account won’t • You live in a community property state. In a community ! be approved unless you (and your spouse if filing property state, the income of a non-liable spouse may be CAUTION a joint return) sign Form 9465. factored into the other spouse’s ability to pay the taxes owed. You should complete lines 21 and 22 whether your filing status is married filing jointly or married filing separately. Privacy Act and Paperwork Reduction Act Notice. Our legal right to ask for the information on this form is sections 6001, 6011, 6012(a), 6109, and 6159 and their 6 Instructions for Form 9465 (Rev. 7-2024) |
Page 7 of 7 Fileid: … ns/i9465/202407/a/xml/cycle01/source 8:33 - 18-Apr-2024 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. regulations. We will use the information to process your confidential, as required by section 6103. However, we request for an installment agreement. The reason we may give this information to the Department of Justice for need your name and social security number is to secure civil and criminal litigation, and to cities, states, the District proper identification. We require this information to gain of Columbia, and U.S. commonwealths and territories to access to the tax information in our files and properly carry out their tax laws. We may also disclose this respond to your request. You aren’t required to request an information to other countries under a tax treaty, to federal installment agreement. If you do request an installment and state agencies to enforce federal nontax criminal agreement, you’re required to provide the information laws, or to federal law enforcement and intelligence requested on this form. Failure to provide this information agencies to combat terrorism. may prevent processing your request; providing false information may subject you to fines and/or penalties. The average time and expenses required to complete and file this form will vary depending on individual You aren’t required to provide the information requested circumstances. For the estimated averages, see the on a form that is subject to the Paperwork Reduction Act instructions for your income tax return. unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must If you have suggestions for making this form simpler, be retained as long as their contents may become we would be happy to hear from you. See the instructions material in the administration of any Internal Revenue law. for your income tax return. Generally, tax returns and return information are Instructions for Form 9465 (Rev. 7-2024) 7 |