Enlarge image
4
6
OIC 100 NORTH CAROLINA DEPARTMENT OF REVENUE PRINT CLEAR
Web-Fill
3-19 OFFER IN COMPROMISE
1) Name and Address of Taxpayer(s)
Name Date
Trading As Account ID
Address SSN/FEIN
City State Zip Code
2) Outstanding Liability
Mark an “X” in the box for the correct tax type. Fill in the corresponding tax period(s) and amount(s) due.
Tax Type Period (s) Amount of Liability*
Individual Income
Sales & Use
Withholding
Other (specify)
*Include tax, penalty, and interest. TOTAL $
3) Basis For Compromise: (G.S. 105-237.1 authorizes compromises in the following situations. Mark an “X” in the
appropriate box(es).)
There is reasonable doubt as to the amount of the liability of the taxpayer under the law and the facts.
The taxpayer is insolvent and the Secretary probably could not otherwise collect an amount equal to or in excess of the amount
offered in compromise. A taxpayer is considered insolvent only in one of the following circumstances. (check one):
a. It is plain and indisputable that the taxpayer is clearly insolvent and will remain so in the reasonable future.
b. The taxpayer has been determined to be insolvent in a judicial proceeding.
Collection of a greater amount than that offered in compromise is improbable, and the funds or a substantial portion
of the funds offered in the settlement come from sources from which the Secretary could not otherwise collect.
A federal tax assessment arising out of the same facts has been compromised with the federal government on the
same or a similar basis as that proposed to the State and the Secretary probably could not collect an amount equal
to or in excess of that offered in compromise.
Collection of a greater amount than that offered in compromise would produce an unjust result under the circumstances.
The taxpayer is a retailer or a person under Article 5 of this Chapter; the assessment is for sales or use tax the retailer
failed to collect or the person failed to pay on an item taxable under G.S. 105-164.4(a)(10) and (a)(11), and the retailer
or person made a good-faith effort to comply with the sales and use tax laws. This subdivision expires for assessments
issued after July 1, 2020.
The assessment is for sales tax the taxpayer failed to collect or use tax the taxpayer failed to pay as a result of the change
in the definition of retailer or the sales tax base expansion to (i) service contracts, (ii) repair, maintenance, and installation
services, or (iii) sales transactions for a person in retail trade. The Secretary must determine that the taxpayer made a
good-faith effort to comply with the sales and use tax laws. This subdivision applies to assessments for any reporting period
beginning March 1, 2016, and ending December 31, 2022.
4) Has any period listed above been compromised with the Internal Revenue Service? _________ If yes, attach a
copy of the agreement.
5) Amount of Offer:
see page 2
