OIC Checklist  Rev. 03/22                                                                             

                           N.C. DEPARTMENT OF REVENUE                                                    
                                                                                                         
                           OFFER IN COMPROMISE CHECKLIST                                                 
                                                                                                         
   This checklist lists all documents that may be needed with your Offer In Compromise                   
   submission. Ensure that you read the      OIC-101 Offer in Compromise Instruction Booklet             
   in its entirety to determine what information is needed based upon your statutory basis               
   for compromise.                                                                                       
 
ITEMS: 

     1.   Form OIC-100 Offer In Compromise, completed and signed with an offer amount                 
           greater than $0.00.                                                                        
                                                                                                      
     2.  20% Down Payment made by credit card or in certified funds payable to NCDOR.                 
          (Exceptions to this requirement are allowed if you submit a Form OIC-102 Third Party        
          Affirmation, or if your gross income is below the Federal Poverty Guidelines.)              
                                                                                                      
     3.  Form OIC-102 Third Party Affirmation                                                         
                                                                                                      
     4.  Form RO-1062 Collection Statement for Individuals. Include all documents listed under        
             the signature line of the form, including mortgage and vehicle loan statements.          
                                                                                                      
     5.  Form RO-1063 Collection Statement for Businesses (All business offers are required to        
          submit a Form RO-1062 for each officer, partner, or member.) Include all documents listed   
          under the signature line of the form, including mortgage and vehicle loan statements.       
                                                                                                      
   ____ 5a. RO-1062 for each officer, partner, or member. Include all documents listed under          
            the signature line of the form, including mortgage and vehicle loan statements.           
                                                                                                      
     6.  Worksheet for Offer In Compromise:  OIC 101-A (Individual), OIC 101-B (Business              
          Entities), or OIC 101-C (Self-Employed Individuals)                                         
                                                                                                      
     7.  Copy of last two (2) years Federal Income Tax returns, if required to file.                  
   ____ 7a. If not required to file, then attach a signed and dated, written explanation.             
                                                                                                      
     8. Copy of the federal account transcript for all periods if you claim to also owe the IRS.      
                                                                                                      
     9.  Copy of last three (3) months paycheck stubs, if applicable.                                 
                                                                                                      
    10.  Copy of last three (3) months bank account statements for all accounts.                      
                                                                                                      
    11.  Verification of any claimed health issue or disability.                                      
                                                                                                      
    12.  Verification documents showing the computation of the claimed corrected tax due and          
           documents supporting your claim. (If statutory basis of compromise is reasonable doubt.)     
                                                                                                      
    Additional information may be requested after the initial review of the Offer In Compromise.