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OIC-101 
(03/2022) 

                                      Offer In Compromise 

                                      Instruction Booklet 

                                      State of  North Carolina 

                                      Department of  Revenue 

Help Preparing an Offer In            What is an Offer in Compromise? 
Compromise                            The  North  Carolina  Offer  In    Compromise      purpose  of  delaying  collection  or  otherwise 
  This Booklet provides              program  allows    qualifying,  financially  dis-  jeopardizing  the  Department’s  ability  to   
   instructions for taxpay-           tressed  taxpayers  the  opportunity  to  put      collect the tax debt.  
                                      overwhelming tax liabilities behind them by 
   ers preparing an Offer In                                                             Forced  collection  actions,  such  as  garnish-
                                      paying a lump sum amount in exchange for 
   Compromise.                                                                           ments, in effect at the time you submit your 
                                      the liability being settled in full. The law pro-
  Additional instructions                                                               offer,  will  not  automatically  be  suspended 
                                      vides specific requirements for accepting an 
                                                                                         during the review period.  Interest and penal-
   and web-fill versions of           offer.  The goal of the Offer In  Compromise 
                                                                                         ty will continue to accrue on any unpaid tax 
   forms are available on             program is to  resolve a liability in a manner 
                                                                                         debt while the offer is being considered.   
   the Department’s web-              that is in the best interest of both the State 
   site at www.ncdor.gov.             and the taxpayer.                                  This booklet provides the basic instructions, 
                                                                                         forms and other materials you will need to 
                                      You are required to provide reasonable doc-
  Contact a Customer                                                                    submit a request for an Offer In Compromise.   
   Service agent at 1-877-            umentation,  as  outlined  below,  with  your 
                                      request for an Offer In Compromise.                If you have questions, or need additional 
   252-3052 for assis-
                                                                                         assistance, please contact the Department 
   tance with specific ques-          An  offer  will  not  be  considered  if  it  is        
                                                                                         at 1-877-252-3052 or visit our website at: 
                                      determined  that  the  offer  was  filed  for  the 
   tions.                                                                                www.ncdor.gov .  
Contents 
Statutory Basis for an Offer in Compromise and Basic Qualifications                                                                  2 
What Do I Send with My Offer?                                                                                                        3 
Determining the Amount of Your Offer & Required Down Payment 
                                                                                                                                     4 
How Does the  Department Calculate the RCP? 
Does Offering the RCP Guarantee Acceptance of My Offer? 
                                                                                                                                     5 
Will Offers for My Interest Only in a Joint Income Tax Liability Be Considered?  
What Happens After My Offer Is Submitted?  
Will Collection Actions Stop?  
                                                                                                                                     6 
If Your Offer Is Accepted  
If Your Offer Is Denied 
OIC Checklist                                                                                                                        7 
Form OIC-100  Offer In Compromise                                                                                                8 9 -   
Form OIC 101-A  for Individuals: Calculating the RCP and Down Payment - Individuals                                                10 
Form OIC 101-B for Businesses: Calculating the RCP and Down Payment - Business Entities                                            11 
Form OIC 101-C for Self-Employed Individuals: Calculating the RCP and Down Payment - Self-Employed Individuals & Proprietorships   12 
Form OIC-102  Third Party Affirmation                                                                                              13

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OIC-101 Page 2
(03/2022)

Statutory Basis for an Offer in Compromise
NC General Statute 105-237.1 provides the authority for the Secretary of Revenue to entertain an
offer in compromise:
§ 105-237.1.Compromise of liability.
a) Authority. – The Secretary may compromise a taxpayer's liability for a tax that is collectible under
NC G.S. 105-241.22 when the Secretary determines that the compromise is in the best interest
of the State and makes one or more of the following findings:
1) There is a reasonable doubt as to the amount of the liability of the taxpayer under the
law and the facts.
2) 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 consid-
ered insolvent only in one of the following circumstances:
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.
3) 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.
4) 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 could probably not collect an amount equal to or in excess of that offered in
compromise.
5) Collection of a greater amount than that offered in compromise would produce an unjust
result under the circumstances.
6) 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) through (a)(15), 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.
7) 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 subdivi-
sion applies to assessments for any reporting period beginning March 1, 2016, and end-
ing December 31, 2022.
b) Written Statement - When the Secretary compromises a tax liability under this section and the
amount of the liability is at least one thousand dollars ($1,000), the Secretary must make a writ-
ten statement that sets out the amount of the liability, the amount accepted under the compro-
mise, a summary of the facts concerning the liability, and the findings on which the compromise
is based. The Secretary must sign the statement and keep a record of the statement. If the com-
promise settles a dispute that is in litigation, the Secretary must obtain the approval of the Attor-
ney General before accepting the compromise, and the Attorney General must sign the statement
describing the compromise.

Basic Qualifications
1. The period is collectible under NC G.S. 105-241.22. 3. You are not the subject of an open or active bankruptcy
case.
2. You have filed all tax returns and reports as required
by statute. 4. You are not the subject of an open or active North Caro-
lina Department of Revenue criminal investigation.

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OIC-101 Page 3
(03/2022)

What Do I Send with My Offer?
1. If your statutory basis for compromise is anything other than reasonable doubt as to the amount of liability,
a complete financial analysis will be completed on your account. Financial documentation must be submit-
ted that reflects your financial situation for the three months immediately preceding the date you submit
your Offer In Compromise.
Documentation Required (additional documentation may be requested after an initial review of the offer):
a. A completed and signed OIC-100.
b. A 20%, non-refundable, down payment made by credit card or by certified funds.
 Exceptions to this requirement are allowed if you submit a Form OIC-102 Third Party Affir-
mation, or if your gross income is below the federal poverty guidelines.
c. A completed and signed NCDOR Financial Statement based upon your entity type:
See page 7
 RO-1062 (Collection Information Statement for Individuals or Sole Proprietorships).
OIC
Checklist.  RO-1063 (Collection Information Statement for Businesses) . All business offers are re-
quired to attach an RO-1062 for each officer, partner, or member.
d. Supporting Documentation:
Keep  If wage earner, last 3 months paystubs
Copies!  Complete copies of last 3 bank statements for all accounts

You should  Complete copies of last 2 federal income tax returns (if required to file)
make copies  If you claim to also owe the IRS, you must include a current federal account transcript for
each outstanding period and tax schedule.
of all
 Substantiation for any claims of special circumstances made in section 8 of OIC-100 Expla-
documents nation of Circumstances (copies of actual monthly expenses, court ordered payments, out-
of-pocket medical expenses, physician’s statements detailing illness, etc.)
submitted to
 A completed worksheet calculating your Reasonable Collection Potential based upon your
the entity type:
Department ○ OIC 101-A (Individuals)
for your ○ OIC 101-B (Businesses)
records. ○ OIC 101-C (Sole Proprietorships and Self-Employed Individuals)
e. Substantiation of claimed mortgages, vehicle liens and any other claimed judgments or liens.
Do not send 2. If your basis for compromise is reasonable doubt as to the amount of liability, a financial analysis will not
original be conducted, however, you need to provide documents to support your claim.
copies with Documentation Required:
a. A completed and signed OIC-100..
your offer in
b. A 20%, non-refundable, down payment made by credit card or by certified funds.
compromise
 Exceptions to this requirement are allowed if you submit a Form OIC-102 Third Party Affir-
to the mation, or if your gross income is below the federal poverty guidelines.
Department c. An explanation of the basis of reasonable doubt along with verifying documentation.
since they d. A computation of the claimed corrected tax due along with an explanation of how you arrived at
that amount.
will not be

returned.
Offers should be submitted to: NC Department of Revenue, Attn: Offer In Compromise Unit, 1500 Pinecroft
Rd., Suite 300, Greensboro, NC 27407-3724

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OIC-101                                                                                                                      Page 4 
(03/2022) 

                            Determining the Amount of Your Offer & Required Down Payment 

                            All offer amounts must exceed zero.                 If  the  Department’s  financial  analysis  indicates 
                                                                                that you have the ability to pay the tax liability in 
                            Your offer amount must equal or exceed your 
                                                                                full, either immediately or through an installment 
                            Reasonable       Collection Potential    (RCP) 
                                                                                payment  agreement,  or  you  can  pay  a  greater 
                            amount.  Your    RCP should  be  calculated  us-
                                                                                amount  than  that  offered  in  compromise,  your 
                            ing the OIC 101-A,OIC 101-B , or OIC 101-C       
                                                                                offer will be denied.  
                            worksheet that is included in your OIC pack-
The Department will         et. These worksheets will help  you  estimate       The Department requires a 20% down payment 
                            your RCP, and determine your minimum offer          of the offer amount. This will be applied towards 
provide you an              amount  and  required  down  payment.  Elec-        your  tax  liability  and  will  not  be  refunded.  Pay-
electronic template for     tronic versions of these worksheets are avail-      ment must be submitted in certified funds or by 
                            able  upon  request  and  on  our  website  at      credit  card.  Offers  received  without  the  down 
completing the              www.ncdor.gov    . Exceptions can exist to offer-   payment will not be processed. If your gross in-
Collection Statement        ing the RCP (see pg. 5.)                            come  falls  below  the Federal Poverty Guidelines, 
                                                                                or if you attach a Form OIC-102 Third Party Affir-
and RCP/down-               The RCP equals the net equity of your assets 
                                                                                mation with your offer, then you may be exempt 
                            plus  the  amount  the  Department  projects  it 
                                                                                from this requirement. 
payment calculations        could collect from your future income.   
upon request. 

How Does the Department Calculate the RCP? 

The OIC  101-A,OIC  101-B   ,  and    OIC    Purchased  vehicle  and  other  licensed     Standards  provided  by  the  IRS  for 
101-C  worksheets  are  used  to  calcu-     asset value is calculated using the NA-      housing  and  utilities,  food,  clothing  & 
late the RCP.                                DA  value  multiplied  by  the  80% QSV      other  items,  vehicle  operating  costs, 
                                             discount  minus  any  outstanding  loan      public  transportation  costs,  vehicle 
Each form begins with the total of your 
                                             balance.  The  most  current  loan  state-   loans,  and  medical  costs  as  well  as 
liquid  assets  which  includes  cash  on 
                                             ments for each vehicle/ licensed asset       actual alimony, child support, day care 
hand,  average  bank  balance,  invest-
                                             owned  must  be  submitted  with  the        expense,  health  and  life  Insurance 
ment account balances and cash value 
                                             offer for the loan to be allowed.            expense,  IRS  and  estimated  tax  pay-
of  all  insurance  policies.  You  must  in-
                                                                                          ments,  and  any  court-ordered  pay-
clude  your  last  3  months  statements  Asset  values  minus  any  liens  superior 
                                                                                          ments.  
for all accounts (checking and savings)  to  the  Department’s,  such  as  those 
and  insurance  policy  statements  with  arising  from  lRS  or  county  tax  debts,     The  calculated  monthly  disposable 
your offer.                                  will  equal  your  total  equity  in  assets income is multiplied by 60 months and 
                                             held.                                        added to total equity in assets held to 
The worksheets also assist in calculat-
                                                                                          determine your RCP.  
ing equity in all property owned by us-      Next, the worksheets assist in calculat-
ing  the  Quick  Sale  Asset  Value  (QSV)  ing monthly disposable income by sub-         Each  taxpayer  is  also  allowed  up  to 
method. The   QSV is calculated by mul-      tracting  monthly  allowable  expenses       $2,000 in accounting/legal fees when 
tiplying the asset’s value by a discount  from  total  monthly  income.  Calculate        documentation is provided. This allow-
factor.  The  Department  allows  you  to  total  monthly  income  using  the  aver-      ance is solely for the preparation of the 
discount property values to 80%. Real  age of 3 months of paystubs, monthly               Offer  In  Compromise,  and  not  for  ac-
property  asset  value  is  calculated  us-  pensions,  social  security,  dividends,     counting fees accrued as a part of nor-
ing  the county  tax  value multiplied  by  profit  from  business,  alimony,  child      mal personal and business filings. The 
80%  QSV  discount  minus  any  out-         support,  commissions  or  any  other        accounting/legal  fees  are  subtracted 
standing mortgage balances. The most  income sources.                                     from  the  reasonable  collection  poten-
current mortgage statements must be                                                       tial in order to determine the net RCP.  
                                             Total  allowable  monthly  expenses  are 
submitted with the offer for the loan to 
                                             calculated  using  Collection  Financial 
be allowed.

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OIC-101                                                                                                                Page 5 
(03/2022) 

Does Offering the RCP Guarantee Acceptance of My Offer? 

No.  The  Department  performs  an         Insufficient  Documentation -  If  docu-    sales  or  employee  withholding  taxes, 
analysis  of  your  financial  condition   mentation  for  outstanding  mortgage       the offer may not be accepted.  
during  the  review  process.  Failure  to and  loan  balances  for  real  and  per-
                                                                                       Earned Income   – If an attachment of 
provide  documentation  to  support        sonal  property  is  not  provided,  the 
                                                                                       earned  income  will  collect  more  over 
income, expenses, and loan balances        loan  balances  will  not  be  allowed.  In 
                                                                                       the statutory period of collection than 
can impact the Department’s calcula-       addition, claimed expenses for alimo-
                                                                                       the amount offered, your offer may be 
tion of the RCP and may result in the      ny, child support, day care, health and 
                                                                                       denied.  
Department’s inability to process your     life insurance, IRS and  estimated tax 
offer.                                     payments, and any court-ordered pay-        Installment  Payment  Agreement  –    If 
                                           ments  should  be  provided  or  the        the  current  installment  payment 
The following are factors used during 
                                           claimed expenses will be disallowed.        agreement will pay more over the stat-
the  Department’s  financial  analysis 
                                                                                       utory  period  of  collection  than  the 
process when making a determination        Property Valuation – The Department 
                                                                                       amount  proposed  in  settlement,  your 
for an offer:                              will  assess  the  value  of  all  property 
                                                                                       offer may be denied.  
                                           that you own. If the Department deter-
Omitted  Items –  If  you  omit  income, 
                                           mines value of the property is greater      Other –  The  law  gives  the  Secretary 
assets, or other items of significance 
                                           than  shown  on  your  RCP  work-sheet      the option to accept an offer but in no 
from  your  financial  statement,  your 
                                           and  financial  statement,  your  offer     way requires it. In any instance where 
offer may be denied.  
                                           may be denied.                              the  Secretary  determines  that  ac-
History of Non-Compliance – A history                                                  ceptance is not in the best interest of 
                                           Collected  Taxes – If  your  debt  is 
of  regular  or  willful  non-compliance                                               the State, the offer will be denied.  
                                           based  on  taxes  that  were  collected 
with  revenue  statutes  may  constitute 
                                           from others, but not remitted, such as  
grounds for the rejection of your offer. 

                                           Will Offers for My Interest Only in a Joint Income Tax 
                                           Liability Be Considered?  

                                           No. If you have filed a joint income        interest in a jointly filed income tax 
                                           tax  return  for  the  year(s)  in  which   liability,  you  must  qualify  for  Inno-
In order to settle one                     you  are  requesting  relief,  you  must    cent Spouse Relief under N.C.G.S. § 
person’s interest in a joint               submit an offer in compromise from          105-153.8(e).  
                                           both  parties  that  includes  financial 
income tax liability, you                  information  from  and  has  been           If  you  request  and  qualify  for  Inno-
                                           signed by both parties.                     cent Spouse Relief, you will be noti-
must qualify for Innocent                                                              fied by the Department of your per-
                                           Pursuant  to  G.S.  §  105-153.8(e),  a 
Spouse Relief.                             wife  and  husband  filing  jointly  are    centage  of  relief  once  your  request 
                                           treated as one taxpayer for the pur-        has been processed.  
You cannot be relieved                     pose of determining the tax imposed 
                                                                                       If  you  do  not  qualify  for  Innocent 
                                           by  this  Part.  A  husband  and  wife 
of the liability through an                                                            Spouse Relief, you will remain jointly 
                                           filing jointly are jointly and severally 
Offer In Compromise.                       liable  for  the  tax  imposed  by  this    and  severally  liable  for  the  balance 
                                           Part reduced by the sum of all cred-        of tax, penalty and interest due. You 
                                           its allowable including tax payments        cannot  request  an  offer  in  compro-
                                           made  by  or  on  behalf  of  the  hus-     mise  to  settle  your  interest  in  the 
                                           band and wife.                              outstanding liability. 
                                           In  order  to  receive  relief  for  your

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 OIC-101                                                                                                              Offer In Compromise Page 6 
(03/2022)                                                                                                             Instruction Booklet 

                             What Happens After My Offer Is Submitted? 

                             The  Offer  In  Compromise  (OIC)      search.                              The  OIC  Unit  makes  a  recom-
                             Unit  conducts  an  initial  review                                         mendation  to  the  Secretary  of 
                             of  the  offer  to  determine  if  it  During  the  review  of  the  OIC    Revenue and/or their designee, 
                             meets  the  basic  qualifications      packet, the OIC Unit may deter-      who  has  the  final  approval  for 
                             to be processed.                       mine that more documentation         all  offer  in  compromise  deci-
                                                                    is  needed  from  you.  If  this  is sions. 
                             If  the  qualifications  are  met      the case, then the OIC Unit will 
                             and the offer can be processed,        contact you.                         The process can take up to 90 
                             then the completed OIC packet                                               days.  This  timeframe  can  vary 
 A Certificate of            is reviewed and analyzed by the        If the additional documentation      depending  on  the  current  vol-
 Tax Liability may           OIC  Unit  using  the  information     is not submitted as requested,       ume  of  submissions  and  the 
                             provided.  The  OIC  Unit  also        then  your  offer  will  not  be     time of year.  
 be filed at any time        performs  independent  re-             processed. 
 while your offer is 
                             Will Collection Actions Stop? 
 being considered.  
                             Not necessarily.                       processing,  we  will  not  act  to  your  offer. 
                                                                    collect the tax liability while we 
                             There  are  certain  circumstanc-                                           It is important to note that the 
                                                                    consider  and  evaluate  your 
         Offer amounts       es  when  the  Department  will                                             Department  will  not  suspend 
         must be paid in     suspend  collection  activities        offer. 
                                                                                                         collection  if  we  determine  that 
                             while  we  consider  your  offer,                                           you  submitted  your  offer  to 
                                                                    We  will  also  allow  14  days  for 
         full with certified but it is not a requirement.                                                delay  collection  or  cause  a  
                                                                    you to respond after we send a 
         funds or by credit  After  an  offer  is  determined  to   letter  notifying  you  of  the  De- delay  which  will  jeopardize  our 
                             be complete and submitted for          partment’s  decision  to  deny       ability to collect the tax. 
         card when an offer 
         is accepted.        If Your Offer Is Accepted 
         Payment plans       The  Department  will  notify  you     or by credit card by the payment     the total offer amount due.  
                             and  your  designated  repre-          due  date  as  indicated  on  the 
                                                                                                         The  Department  does  not    
         are not accepted    sentative  if  the  offer  is  accept- acceptance  letter  (usually  30 
                                                                                                         accept  payment  plans  on  an 
                      .      ed, and direct you to remit pay-       days  from  date  of  the  ac-
         for offer funds                                                                                 offer in compromise.   
                             ment  to:  NC  Department  of          ceptance letter).  
                             Revenue, Attn.: Offer in Compro-                                            A  recorded  Certificate  of  Tax 
                                                                    The  total  amount  due  will  be 
                             mise  Unit,  at:  1500  Pinecroft                                           Liability  will  be  released  when 
         All Offer In                                               the accepted offer amount less 
                             Rd., Suite 300, Greensboro, NC                                              the  Department  receives  pay-
                                                                    the 20% down payment. 
         Compromise          27407-3724.                                                                 ment  of  the  accepted  offer 
                                                                    Payments  made  toward  the          amount in certified funds or by 
                             Payment  of  the  accepted  offer 
         forms and                                                  account while the offer is being     credit card. 
                             must be made in certified funds 
                                                                    considered  will  not  decrease 
         payments should 
         be remitted to:  
                             If Your Offer Is Denied 
         NC Department       The  Department  will  notify  you     Offering  the  calculated     RCP    vision  for  appeal  of  a  denied 
                             and  your  designated  repre-          does not necessarily guarantee       offer.  
         of Revenue, 
                             sentative if the offer is denied.      the Department will accept the 
                                                                                                         The  Department  may  reconsid-
         Attn: OIC Unit,                                            offer.  
                             As  part  of  the  review  process,                                         er  a  denied  offer  if  there  is  a 
         1500 Pinecroft      the  Department  calculates  the       If  you  are  unable  to  counter    material  change  in  the  taxpay-
                             RCP. If  your  RCP  is  less  than     offer,  you  should  immediately     er’s  circumstances  and  docu-
         Rd., Suite 300,     the  total  liability  due  but  more  contact  the  Department  to  ar-    mentation  is  provided  prior  to 
         Greensboro, NC      than  the  amount  offered,  in        range  payment  of  the  entire      the due date on the denial let-
                             most  cases,  the  Department          liability.                           ter. If it is after the due date on 
         27407-3724          will include the calculated  RCP                                            the  denial  letter,  you  will  be 
                                                                    Appealing  the  Decision:  North 
                             in the denial letter and give you                                           required to submit a new offer. 
                                                                    Carolina statutes make no pro-
                             the option to offer this amount.

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OIC-101 Page 7
(03/2022)

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 the taxpayer claims 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.

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OIC-101       Page 8 
(03/2022) 

Form OIC 100 
02/21

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OIC-101   Page 9 
(03/2022)

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OIC-101                                                                                                                                              Page 10 

Calculating the RCP and Down Payment - Individuals 
Worksheet for Offer in Compromise - Individual                                                                   Form OIC 101-A 
Must complete RO-1062 prior to completion of worksheet                                                                                               Refer to  
                                                                                                                                           
Step 1:  Assessing Liquid Assets - Section 3                                                                                                  RO-1062 
                                                                                                                                              Collection 
Cash on Hand -  Line 12                                                                                                                    
Average Bank Balance- line 13e                                                                                                                Statement for 
Investment account balance (stocks, bonds, retirement, virtual currency) -  Line 14e + Line 15d                                            
Cash value of insurance policy - Line 16c                                                                                                     Individuals when 
                                                                                                                                              completing this 
TOTAL LIQUID ASSETS                                                                                                                         A 
                                                                                                                                                     form  
Step 2:  Real Property - Section 4                                                                                                         
                                                                                                                                           
Fair Market Value                                 x   80%    -   Loan Balance                             =  Asset Value                    B 
                        Section 4 Line 17c            QSV                      Section 4 Line 17d                                          
                                                                                                                                            
Step 3:  Purchased Vehicle/ Other Licensed Asset -Section 5                                                                                
                                                                                                                                              The Department 
Fair Market Value                                 x   80%    -   Loan Balance                             =  Asset Value                    C 
                        Section 5 Line 18c            QSV                      Section 5 Line 18d                                             allows you to 
                                                                                                                                              discount property 
Step 4:  Subtracting Judgments/Liens -Section 7                                                                                            
                                                                                                              Balance due                   D values to 80%. 
                                                                                                                 Section 7 Line 20d           This is referred to 
                                                                                                                                            
Step 5:  Total Equity in Assets Held                                                                                                          as Quick Sale 
                                                                                                                                            E (QSV) value  
                                                                                                                             (A+B+C)-D= E    
                                                                                                                                            
Step 6:  Disposable Income Analysis -Section 10                                                                                            
                                                                                                                                           
Total Monthly Income (line 36)                                                                                                             
Wages, pensions, Social Security, dividends, profit from business, alimony, child support, commissions, other                               F 
                                                                                                                 Section 10 Line 36   
Less                                                                                                                                       
                                                                                                                                           
Total Monthly Expenses (line 48)                                                                                                           
Housing and Utilities, Vehicle ownership & operating costs, food & clothing, health & life insurance,                                      
out-of-pocket medical, alimony, child support, and other court-ordered payments, child care, tax payments                                   G 
                                                                                                                 Section 10 Line 48   
                                                                                                                                           
Disposable Monthly Income:                                                                                                                  H 
                                                                                                                             F-G= H          
                                                                                                                                            
Step 7:  Proposed Offer Amount                                                                                                             
                                                                                                                                           
**Do not enter amounts below $0.00.  If equity in assets or disposable income                                                              
   calculations are less than $0.00, enter $0.00.                                                                                          
                                                                                                                                           
Equity in Assets Held (E)                                                                                                                   I 
                                                                                                                                             
Disposable Monthly Income (H)                     x       60 (months)                                     =                                 J 
                                                                                                                             H X 60          
                                                                                                                                             
Reasonable Collection Potential                                                                                                             K 
                                                                                                                             I + J = K       
Allowance for Accounting/Legal Fees (not to exceed $2,000-must provide receipt)                                                             L 
                                                                                                                                             
Proposed Amount Offered In Compromise (must be greater than 0)                                                                              M 
                                                                                                                             K-L=M           
                                                                                                                                             
20% Deposit (see instructions for exceptions)                                                                                               N 
                                                                                                                             M x 20% = O

- 11 -

 OIC-101                                                                                                                                      Page 11 

Calculating the RCP and Down Payment - Business Entities 
Worksheet for Offer in Compromise - Business                                                                       Form OIC 101-B  
Must complete RO-1063 prior to completion of worksheet                                                                               
                                                                                                                                              Refer to  
Step 1:  Assessing Business Assets- Section 4                                                                                          RO-1063 
                                                                                                                                     
Cash on Hand - Line 15                                                                                                                 Collection 
Total Cash in Banks - Line 16d                                                                                                       
Accounts/Notes Receivable - Line 18f                                                                                                   Statement for 
Total Investments (stocks, bonds, mutual funds, stock options, CDs, virtual currency) - Line 17c + Line 19c                          
Total Credit Available - Line 20c                                                                                                      Businesses when 
                                                                                                                                       completing this 
Total Business Assets                                                                                                                A 
                                                                                                                                              form          
Step 2:  Real Property -Section 4                                                                                                    
                                                                                                                                     
Fair Market Value                               x      80%    -  Loan Balance                        = Asset Value                   B 
                          Section 4 Line 21e           QSV                     Section 4 Line  21f                                   
                                                                                                                                     
Step 3:  Vehicles, Leased and Purchased -Section 4                                                                                   
                                                                                                                                     
Fair Market Value                               x      80%    -   Loan Balance                       = Asset Value                   C The Department 
                          Section 4 Line 22e           QSV                      Section 4 Line 22f                                     allows you to 
                                                                                                                                       discount property 
Step 4:  Business Equipment - Section 4                                                                                              
                                                                                                                                       values to 80%. 
Fair Market Value                               x      80%    -   Loan Balance                       = Asset Value                   D This is referred to 
                          Section 4 Line 23e           QSV                      Section 4 Line 23f                                   
                                                                                                                                       as Quick Sale 
Step 5:  Business Liens, Judgments  and Other Liabilities - Section 4                                                                  (QSV) value          
                                                                                                                                     
                                                                                                       Balance due                   E 
                                                                                                                     Line 24d         
Step 6:  Total Equity in Assets Held                                                                                                 F 
                                                                                                                                     
                                                                                                                     (A+B+C+D)-E= F   
Step 7:  Disposable Income Analysis -Section 5                                                                                       
                                                                                                                                     
Total Monthly Income (Line 35)                                                                                                       G 
                                                                                                                                      
Less                                                                                                                                 
                                                                                                                                     
Total Monthly Expenses (Line 48)                                                                                                     H 
                                                                                                                                      
Disposable Monthly Income:                                                                                                           I 
                                                                                                                     G-H= I           
                                                                                                                                     
Step 8: Proposed Amount Offered In Compromise (must be greater than 0).                                                              
                                                                                                                                     
**Do not enter amounts below 0.  If equity in assets or disposable income                                                            
   calculations are less than 0, enter 0.                                                                                            
Equity in Assets Held (F)                                                                                                            J 
                                                                                                                                      
Disposable Monthly Income (I)                   x          60 (months)                               =                               K 
                                                                                                                     I X 60           
                                                                                                                                      
Reasonable Collection Potential (RCP)                                                                                                L 
                                                                                                                     J+K=L            
Allowance for Accounting/Legal Fees (not to exceed $2,000-must provide receipt)                                                      M 
                                                                                                                                      
Proposed Amount Offered In Compromise (must be greater than $0.00)                                                                   N 
                                                                                                                     L-M =N           
                                                                                                                                      
20% Deposit (see instructions for exceptions)                                                                                        O 
                                                                                                                     N x 20% = O

- 12 -

OIC-101                                                                                                                                                      Page 12 

Calculating the RCP and Down Payment - Self Employed Individuals 
Worksheet for Offer in Compromise - Self Employed Individuals                                                                Form OIC 101-C 
Must complete RO-1062 prior to completion of worksheet                                                                                                       Refer to  
                                                                                                                                                 
Step 1:  Assessing Liquid Assets - Section 3                                                                                                          RO-1062 
                                                                                                                                                 
Cash on Hand -  Line 12 + Line 59                                                                                                                     Collection 
Average Bank Balance - Section 3 Line 13e + Section 11 Line 60c                                                                                       Statement for 
Investment account balance (stocks, bonds, retirement, virtual currency) -  Line 14e + Line 15d                                                  
Cash value of insurance policy - Line 16c                                                                                                             Individuals when 
                                                                                                                                                      completing this 
TOTAL LIQUID ASSETS                                                                                                                                 A 
                                                                                                                                                             form  
Step 2:  Real Property - Section 4                                                                                                               
                                                                                                                                                 
Fair Market Value                                   x   80%   -  Loan Balance                                 =  Asset Value                        B 
                          Section 4 Line 17c            QSV                    Section 4 Line 17d                                                
                                                                                                                                                  
Step 3:  Purchased Vehicle/ Other Licensed Asset -Section 5                                                                                      
                                                                                                                                                      The Department 
Fair Market Value                                   x   80%   -  Loan Balance                                 =  Asset Value                        C 
                          Section 5 Line 18c            QSV                    Section 5 Line 18d                                                     allows you to 
                                                                                                                                                      discount property 
Step 4:  Subtracting Judgments/Liens -Section 7                                                                                                  
                                                                                                               Balance due                          D values to 80%. 
                                                                                                                             Section 7 Line 20d 
                                                                                                                                                      This is referred to 
Step 5:  Total Equity in Assets Held                                                                                                                  as Quick Sale 
                                                                                                                                                    E 
                                                                                                                               (A+B+C)-D= E           (QSV) value  
                                                                                                                                                  
Step 6:  Disposable Income Analysis -Section 10 / 12                                                                                             
                                                                                                                                                 
Total Monthly Income (Line 36 + Line 72)                                                                                                         
Wages, pensions, Social Security, dividends, profit from business, alimony, child support, commissions, other                                       F 
                                                                                                                             Section 10 Line 36 +   
Less                                                                                                                         Section 12 Line 72  
                                                                                                                                                 
Total Monthly Expenses (Line 48 + Line 84)                                                                                                       
Housing and Utilities, Vehicle ownership & operating costs, food & clothing, health & life insurance,                                            
out-of-pocket medical, alimony, child support, and other court-ordered payments, child care, tax payments                                           G 
                                                                                                                             Section 10 Line 48 +   
                                                                                                                             Section 12 Line 84  
Disposable Monthly Income:                                                                                                                          H 
                                                                                                                               F-G= H                
                                                                                                                                                  
Step 7:  Proposed Offer Amount                                                                                                                   
                                                                                                                                                 
**Do not enter amounts below $0.00.  If equity in assets or disposable income                                                                    
   calculations are less than $0.00, enter $0.00.                                                                                                
                                                                                                                                                 
Equity in Assets Held (E)                                                                                                                           I 
                                                                                                                                                     
Disposable Monthly Income (H)                       x       60 (months)                                    =                                        J 
                                                                                                                               H X 60                
                                                                                                                                                     
Reasonable Collection Potential                                                                                                                     K 
                                                                                                                               I + J = K             
Allowance for Accounting/Legal Fees (not to exceed $2,000-must provide receipt)                                                                     L 
                                                                                                                                                     
Proposed Amount Offered In Compromise (must be greater than 0)                                                                                      M 
                                                                                                                               K-L=M                 
                                                                                                                                                     
20% Deposit (see instructions for exceptions)                                                                                                       N 
                                                                                                                               M x 20% = O

- 13 -

OIC-101                                                                                                                    Page 13 
(03/2022) 
Form OIC-102 
(06-12) 
 
                                  NORTH CAROLINA DEPARTMENT OF REVENUE 

                              Third Party Affirmation of Offered Amount 
Taxpayer Name:  ______________________________________ 
 
Taxpayer SSN/FEIN:  __________________________________ 
 
Amount Offered: _____________________________________ 
 
I, ___________________________________________ (third party name), will provide $ ________________  (amount of offer) in certified 

funds for ________________________________________ (taxpayer name) payable to the North Carolina Department of Revenue within 

30 days after acceptance of the offer in compromise. 

Printed Third Party Name: _____________________________________________________________________________________ 
Third Party Address: __________________________________________________________________________________________ 
Third Party Signature: ________________________________________________________________________________________ 
Date: ___________________________ 
 
            _____________________ State 
            _____________________ County 
 
               “I, _________________________________________, a Notary Public for said County and State, do hereby certify  

                that  _______________________________________ personally appeared before me this day and acknowledged the       

                      due execution of the foregoing instrument. 
           
               Witness my hand and official seal, this the ________ day of 

               _____________________________, 20___. 
 
                                                                    ________________________________ 
                                                                    Notary Public 
 
             My commission expires ___________, 20 ___.

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