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Federal Free Printable Form 656-B (Rev. 4-2023) for 2024 Federal Offer in Compromise Booklet

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Offer in Compromise Booklet
Form 656-B (Rev. 4-2023)

Form 656 Booklet Offer in Compromise CONTENTS ■ What you need to know................................................................................. 1 ■ Paying for your offer ..................................................................................... 3 ■ How to apply ................................................................................................ 4 ■ Completing the application package ............................................................ 5 ■ Important information ................................................................................... 6 ■ Removable Forms - Form 433-A (OIC), Collection Information Statement for Wage Earners and Self-Employed Individuals; Form 433-B (OIC), Collection Information Statement for Businesses; Form 656, Offer in Compromise ................................................................................................. 7 ■ Application Checklist .................................................................................... 29 IRS contact information If you want to see if you qualify for an offer in compromise before filling out the paperwork, you may use the Offer in Compromise (OIC) Pre-Qualifier tool. The questionnaire format assists in gathering the information needed and provides instant feedback as to your eligibility based on the information you provided. The tool will also assist you in determining a preliminary offer amount for consideration of an acceptable offer but is not a guarantee of acceptance. Access the tool at IRS.gov/OICtool or by scanning the QR code with your smart device. If you have questions regarding qualifications for an offer in compromise, please call our toll-free number at 800-829-1040. A video on how to complete an offer in compromise is available for viewing on our website at https://www.irsvideos.gov/Individual/PayingTaxes/CompletingForm656-OfferInCompromiseApplication. Forms and publications are available by calling 800-TAX-FORM (800-829-3676), by visiting your local IRS office, or at www.IRS.gov. For answers to frequently asked questions about the offer process from submission to closure see Offer in Compromise FAQs. Taxpayer resources The Taxpayer Advocate Service (TAS) is an independent organization within the Internal Revenue Service (IRS) that helps taxpayers and protects taxpayers' rights. TAS can offer you help if your tax problem is causing a financial difficulty, you’ve tried and been unable to resolve your issue with the IRS, or you believe an IRS system, process, or procedure just isn't working as it should. If you qualify for TAS assistance, which is always free, TAS will do everything possible to help you. Visit www.taxpayeradvocate.irs.gov or call 877-777-4778. Low Income Taxpayer Clinics (LITCs) are independent from the IRS and TAS. LITCs represent individuals whose income is below a certain level and who need to resolve tax problems with the IRS. LITCs can represent taxpayers in audits, appeals, and tax collection disputes before the IRS and in court. In addition, LITCs can provide information about taxpayer rights and responsibilities in different languages for individuals who speak English as a second language. Services are offered for free or a small fee. For more information or to find an LITC near you, see the LITC page at www.taxpayeradvocate.irs.gov/litc or IRS Publication 4134, Low Income Taxpayer Clinic List. This publication is also available online at www.irs.gov/forms-pubs or by calling the IRS toll-free at 800-TAX-FORM (800-829-3676). WHAT YOU NEED TO KNOW What is an Offer? An Offer in Compromise (offer) is an agreement between you (the taxpayer) and the IRS that settles a tax debt for less than the full amount owed. The offer program provides eligible taxpayers with a path toward paying off their tax debt. The ultimate goal is a compromise that suits the best interest of both the taxpayer and the IRS. Generally, you must make an appropriate offer based on what the IRS considers your true ability to pay. Submitting an application does not ensure that the IRS will accept your offer. It begins a process of evaluation and verification by the IRS, taking into consideration any special circumstances that may affect your ability to pay. This booklet will lead you through a series of steps to help you calculate an appropriate offer based on your assets, income, expenses, and future earning potential. The application requires you to describe your financial situation in detail, so before you begin, make sure you have the necessary information and documentation. Are You Eligible? Before your offer can be considered, you must (1) file all tax returns you are legally required to file, (2) have received a bill for at least one tax debt included on your offer, (3) make all required estimated tax payments for the current year, and (4) if you are a business owner with employees, make all required federal tax deposits for the current quarter and the two preceding quarters. Note: If it is determined you have not filed all tax returns you are legally required to file, the IRS will apply any initial payment you sent with your offer to your tax debt and return both your offer and application fee to you. You cannot appeal this decision. Bankruptcy, Open Audit or Innocent Spouse Claim If you or your business is currently in an open bankruptcy proceeding, you are not eligible to apply for an offer. Any resolution of your outstanding tax debts generally must take place within the context of your bankruptcy proceeding. If you are not sure of your bankruptcy status, contact the Centralized Insolvency Operation at 800-973-0424. Be prepared to provide your bankruptcy case number and/or Taxpayer Identification Number. Resolve any open audit or outstanding innocent spouse claim issues before you submit an offer. Can You Pay in Full? Generally, the IRS will not accept an offer if you can pay your tax debt in full through an installment agreement or equity in assets. Note: Adjustments or exclusions, which may be considered during the offer investigation, such as allowance of $1,000 to a bank balance or $3,450 against the value of a car, are only applied if you are an individual and after it is determined that you cannot pay your tax debt in full. Your Tax Refunds The IRS may keep any tax period refund, including interest, processed through the date the IRS accepts your offer by offsetting it against your tax debt, as applicable. Since your tax refund may be offset to the tax liability while the offer is pending, assistance from Taxpayer Advocate or the IRS at 800-829-1040 could be available for taxpayers (other than businesses) facing economic hardship. For example, the IRS accepts your offer on July 1, 2022, and you file your 2021 Form 1040 on April 15, 2022, showing a refund; the IRS will apply that refund to your outstanding tax debt. The refund is not considered as a payment toward your offer. Doubt as to Liability If you have a legitimate doubt that you owe part or all of the tax debt, complete and submit a Form 656-L, Offer in Compromise (Doubt as to Liability). To request a Form 656-L, visit www.IRS.gov or a local IRS office or call toll-free 800-TAXFORM (800-829-3676). Note: Do not submit both an offer under Doubt as to Liability and an offer under Doubt as to Collectibility or Effective Tax Administration at the same time. You must resolve any doubt you owe part or all of the tax debt before submitting an offer based on your ability to pay. 1 Notice of Federal Tax Lien A lien is a legal claim against all your current and future property. When you don’t pay your first bill for taxes due, a lien is created by law and attaches to your property. A Notice of Federal Tax Lien (NFTL) provides public notice to creditors. The IRS files the NFTL to establish priority of the IRS claim versus the claims of certain other creditors. The IRS may file a NFTL at any time. You may be entitled to file an appeal under the Collection Appeals Program (CAP) before this occurs or request a Collection Due Process hearing after this occurs. The IRS may be entitled to any proceeds from the sale of property subject to the lien(s). If you sell the property prior to the release of the lien, property sale proceeds over and above the offer amount may be applied to your tax liability, even if your offer has been accepted and not yet paid. Note: A Notice of Federal Tax Lien (NFTL) will not be filed on any individual shared responsibility payment under the Affordable Care Act. Trust Fund Taxes If your business owes liabilities that include trust fund taxes, the IRS may hold responsible individuals liable for the trust fund portion of the tax pursuant to applicable law. Trust fund taxes are the money withheld from an employee's wages, such as income tax, Social Security, and Medicare taxes. If the IRS accepts an offer from an employer for a portion of the trust fund tax liability, the remainder of the trust fund taxes may be collected from the responsible parties. You are not eligible for consideration of an offer unless the trust fund portion of the tax is paid, or the IRS has made the Trust Fund Recovery Penalty determination(s) on all potentially responsible individual(s). However, if you are submitting the offer as a victim of payroll service provider fraud or failure, the Trust Fund Recovery Penalty assessment discussed above is not required prior to submitting the offer. Other Important Facts Each and every taxpayer has a set of fundamental rights they should be aware of when interacting with the IRS. Explore your rights and our obligations to protect them. For more information on your rights as a taxpayer, go to http://www.irs.gov/ Taxpayer-Bill-of-Rights. Note: You have the right to appeal an offer rejection, but not the return of an offer. Penalties and interest will continue to accrue while your offer is considered by the IRS. After you submit your offer, you must continue to timely file and pay all required tax returns, estimated tax payments, and federal tax payments for yourself and any business in which you have an interest. Failure to meet your filing and payment responsibilities during consideration of your offer will result in the IRS returning your offer. If the IRS accepts your offer, you must continue to stay current with all tax filing and payment obligations through the fifth year after your offer is accepted. Note: If you have filed your tax returns but you have not received a bill for at least one tax debt included on your offer, your offer and application fee may be returned and any initial payment sent with your offer will be applied to your tax debt. To prevent the return of your offer, wait until you have received a bill for at least one tax debt and then include a copy of any tax return filed within 12 weeks of this offer submission. The IRS can't process your offer if the IRS referred your case, or cases, involving all of the liabilities identified in the offer to the Department of Justice. In addition, the IRS cannot compromise any tax liability arising from a restitution amount ordered by a court or a tax debt reduced to judgment. Furthermore, the IRS will not compromise any IRC § 965 tax liability for which an election was made under IRC § 965(i). You cannot appeal this decision. Note: Any offer containing a liability for which payment is being deferred under IRC § 965(h)(1) can only be processed for investigation if an acceleration of payment under section 965(h)(3) and the regulations thereunder has occurred and no portion of the liability to be compromised resulted from entering into a transfer agreement under section 965(h)(3). 2 The law requires the IRS to make certain information from accepted offers available for public inspection and review. Find instructions to request a public inspection file at www.IRS.gov keyword "OIC". The IRS may levy your assets up to the time the IRS official signs and acknowledges your offer as pending. In addition, the IRS may keep any proceeds received from the levy. If your assets are levied after your offer is submitted and pending evaluation, immediately contact the IRS employee whose name and phone number are listed on the levy. If you currently have an approved installment agreement, you will not be required to make your installment agreement payments while your offer is being considered. If your offer is not accepted and you have not incurred any additional tax debt, the IRS will reinstate your installment agreement. PAYING FOR YOUR OFFER Application Fee Offers require a $205 application fee. Exception: If you are an individual and meet the Low-Income Certification guidelines, there is no requirement to send any money with your offer. You are considered an individual if you are seeking compromise of a liability for which you are personally responsible, including any liability you incurred as a sole proprietor. Payment Options You must select a payment option and include the initial payment with your offer. The amount of the initial payment and subsequent payments will depend on the total amount of your offer and which of the following payment options you choose: Lump Sum Cash: This option requires 20% of the total offer amount to be paid with the offer and the remaining balance paid in 5 or fewer payments within 5 or fewer months of the date your offer is accepted. Periodic Payment: This option requires you to make the first payment with the offer and the remaining balance paid in monthly payments within 6 to 24 months, in accordance with your proposed offer terms. Note: Under the periodic payment option, you must continue to make monthly payments while the IRS is evaluating your offer. If you fail to make these payments at any time prior to receiving a final decision letter, the IRS may return your offer. You cannot appeal this decision. Total payments must equal the total offer amount. Generally, payments made on an offer will not be returned. The initial payment and monthly payments are not required if you meet the LowIncome Certification guidelines. If you qualified under the Low-Income Certification and are not required to submit payments while the offer is under consideration, your first payment will be due 30 calendar days after acceptance of the offer, unless another date is agreed to in an amended offer or addendum. If you do not have sufficient cash to pay for your offer, you may need to consider borrowing money from a bank, friends, and/or family. Other options may include borrowing against or selling other assets. If you are an individual, use the OIC Pre-Qualifier tool at IRS.gov/OICtool to assist in determining a starting point for your offer amount. Note: You may not pay your offer amount with an expected or current tax refund, money already paid, funds attached by any collection action, or anticipated benefits from a capital or net operating loss. If you are planning to use your retirement savings from an IRA or 401k plan, you may have future tax debt as a result. Contact the IRS or your tax advisor before taking this action. 3 HOW TO APPLY Application Process The application must include: • Form 656, Offer in Compromise • Completed and signed Form 433-A (OIC), Collection Information Statement for Wage Earners and Self-Employed Individuals, if applicable • Completed and signed Form 433-B (OIC), Collection Information Statement for Businesses, if applicable • $205 application fee, unless you meet Low-Income Certification Guidelines • Initial offer payment based on the payment option you choose, unless you meet Low-Income Certification Guidelines Note: Your offer(s) cannot be considered without the completed and signed Form(s) 656, 433-A (OIC), 433-B (OIC) (if applicable), and supporting documentation. If You and Your Spouse Owe Joint and Separate Tax Debts If you and your spouse have joint tax debt(s) and you or your spouse are also responsible for separate tax debt(s) (including Trust Fund Recovery Penalty), you will each need to send in a separate Form 656. You will complete one Form 656 for yourself listing all your joint and any separate tax debts and your spouse will complete one Form 656 listing all their joint tax debt(s) plus any separate tax debt (s), for a total of two Forms 656. If you and your spouse or ex-spouse have a joint tax debt and your spouse or exspouse does not want to be part of the offer, you may submit a Form 656 to compromise your responsibility for the joint tax debt. Each Form 656 will require the $205 application fee and initial payment unless you are an individual and meet the Low-Income Certification guidelines. If You Owe Individual and Business Tax Debt If you have individual and business tax debt that you wish to compromise, you will need to send in two Forms 656. Complete one Form 656 for your individual tax debts and one Form 656 for your business tax debts. Each Form 656 will require the $205 application fee and initial payment. Note: A business is defined as a corporation, partnership, or any business that is operated as other than a sole-proprietorship. You may not compromise an individual's share of a partnership debt. The partnership must submit its own offer based on the partnership's and partners' ability to pay. 4 COMPLETING THE APPLICATION PACKAGE Step 1 – Gather Your Information To calculate an offer amount, you will need to gather information about your financial situation, including cash, investments, available credit, assets, income, and debt. You will also need to gather information about your household's average gross monthly income and expenses. The household includes all those in addition to yourself who contribute money to pay expenses relating to the household such as: rent, utilities, insurance, groceries, etc. This is necessary for the IRS to accurately evaluate your offer. The IRS may also use this to determine your share of the total household income and expenses. In general, the IRS will not consider expenses for tuition for private schools, college expenses, charitable contributions, and other unsecured debt payments as part of the expense calculation. Step 2 – Fill out Form 433-A (OIC), Collection Information Statement for Wage Earners and Self-Employed Individuals Fill out Form 433-A (OIC) if you are an individual wage earner, operate or operated as a sole proprietor, or are authorized to submit an offer on behalf of the estate of a deceased individual. If you are married but living separately from your spouse then you each must submit a Form 433-A (OIC). This will assist in the calculation of an appropriate offer amount based on your assets, income, expenses, and future earning potential. You will have the opportunity to provide a written explanation of any special circumstances that affect your financial situation. Step 3 – Fill out Form 433-B (OIC), Collection Information Statement for Businesses Fill out Form 433-B (OIC) if the business is a Corporation, Partnership, or LLC. This will assist in the calculation of an appropriate offer amount based on the business assets, income, expenses, and future earning potential. If the business has assets used to produce income (for example, a tow truck used in the business for towing vehicles), the business may be allowed to exclude equity in these assets. Step 4 – Attach Required Documentation You will need to attach supporting documentation with Form(s) 433-A (OIC) and 433-B (OIC). See a list of the documents required at the end of each form. Include copies of all required attachments. Do not send original documents. Step 5 – Fill out Form 656, Offer in Compromise Fill out Form 656. The Form 656 identifies the tax years and type of tax you would like to compromise. It also identifies your offer amount and the payment terms. Your offer amount must be equal to or greater than the amount calculated in Form 433-A(OIC) or 433-B(OIC). Step 6 – Include Initial Payment and $205 Application Fee Include a personal check, cashier's check, or money order for your initial payment based on the payment option you selected (20% of the offer amount for a lump sum cash offer or the first month's payment for a periodic payment offer). Generally, initial payments will not be returned but will be applied to your tax debt if your offer is not accepted. If you choose to pay the user fee and offer payment by personal check, cashier’s check, or money order, provide a separate personal check, cashier’s check, or money order for each user fee and offer payment. Make checks or money orders in U.S. dollars and payable to the "United States Treasury." As an alternative to checks or money orders, you may pay the user fee and offer payment through the Electronic Federal Tax Payment System (EFTPS), which allows you to pay by direct debit from your bank account or by credit/debit cards. Reminder: If you meet the Low-Income Certification guidelines DO NOT send any money. Step 7 – Mail the Application Package Make a copy of your application package and keep it for your records. Mail the completed application package to the appropriate IRS facility. See page 29, Application Checklist, for details. Note: If you are working with an IRS employee, let them know you are sending or have sent an offer to compromise your tax debt(s). 5 IMPORTANT INFORMATION After You Mail Your Application: We will contact you after we receive and review your offer application. Promptly reply to any requests for additional information within the time frame specified. Failure to reply timely will result in the return of your offer without appeal rights. If the IRS accepts your offer, you must continue to timely file all required tax returns and timely pay all estimated tax payments and federal tax payments that become due in the future. If you fail to timely file and timely pay any tax obligations that become due within the five years after your offer acceptance your offer may be defaulted. If the IRS defaults your offer, you will be liable for the original tax debt, less payments made, and all accrued interest and penalties. An offer does not stop the accrual of interest and penalties. Please note that if your final payment is more than the agreed amount, the IRS will not return the money but will apply it to your tax debt. In addition, the IRS may default your offer if you fail to promptly pay any tax debts assessed after acceptance of your offer for any tax years prior to acceptance that were not included in your original offer. 6 Form 433-A (OIC) (April 2023) Department of the Treasury — Internal Revenue Service Collection Information Statement for Wage Earners and Self-Employed Individuals Use this form if you are ● An individual who owes income tax on a Form 1040, U.S. Individual Income Tax Return ● An individual who is personally responsible for a partnership liability (only if the partnership is submitting an offer) ● An individual who is submitting an offer on behalf of the estate of a deceased person ● An individual with a personal liability for Excise Tax ● An individual responsible for a Trust Fund Recovery Penalty ● An individual who is self-employed or has self-employment income. You are considered to be self-employed if you are in business for yourself, or carry on a trade or business. Note: Include attachments if additional space is needed to respond completely to any question. This form should only be used with the Form 656, Offer in Compromise. Section 1 Personal and Household Information Last name First name Social Security Number Date of birth (mm/dd/yyyy) Marital status Home physical address (street, city, state, ZIP code) Unmarried Married Own your home If married, date of marriage (mm/dd/yyyy) - Do you Rent Other (specify e.g., share rent, live with relative, etc.) If you were married and lived in AZ, CA, ID, LA, NM, NV, TX, WA or WI within the last ten years check here County of residence Primary phone ( Secondary phone ( ) ) Home mailing address (if different from above or post office box number) - FAX number - ( ) - Provide information about your spouse. Spouse's last name Spouse's first name Date of birth (mm/dd/yyyy) Social Security Number - - Provide information for all other persons in the household or claimed as a dependent. Name Section 2 Age Relationship Claimed as a dependent on your Form 1040 Contributes to household income Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Employment Information for Wage Earners Complete this section if you or your spouse are wage earners and receive a Form W-2. If you or your spouse have self-employment income (that is you file a Schedule C, E, F, etc.) instead of, or in addition to wage income, you must also complete Business Information in Sections 4, 5, and 6. Your employer’s name Pay period Weekly Bi-weekly Monthly Other Employer’s address (street, city, state, ZIP code) Do you have an ownership interest in this business Yes (also complete and submit Form 433-B) No Your occupation How long with this employer Spouse’s employer's name Pay period (years) (months) Weekly Bi-weekly Monthly Other Employer’s address (street, city, state, ZIP code) Does your spouse have an ownership interest in this business Yes (also complete and submit Form 433-B) Spouse's occupation No How long with this employer (years) Catalog Number 55896Q (months) www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Page 2 Section 3 Personal Asset Information (Domestic and Foreign) Use the most current statement for each type of account, such as checking, savings, money market and online accounts, stored value cards (such as a payroll card from an employer), investment, retirement accounts (IRAs, Keogh, 401(k) plans, stocks, bonds, mutual funds, certificates of deposit) and digital assets such as virtual currency (cryptocurrency), non-fungible token (NFT), and smart contracts you own or in which you have a financial interest (e.g., Bitcoin, Ethereum, Litecoin, Ripple, etc.), life insurance policies that have a cash value, and safe deposit boxes including those located in foreign countries or jurisdictions. Asset value is subject to adjustment by IRS based on individual circumstances. Enter the total amount available for each of the following (if additional space is needed include attachments). Ensure you also include assets located in foreign countries or jurisdictions and add attachment(s) if additional space is needed to respond. Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0". Cash and Investments (domestic and foreign) Cash Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (1a) $ Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (1b) $ Investment account Stocks Bonds Total of bank accounts from attachment (1c) $ Add lines (1a) through (1c) minus ($1,000) = (1) $ Other Name of Financial Institution and country location Account number Current market value Minus loan balance $ X .8 = $ Investment account Stocks – $ Bonds = (2a) $ Other Name of Financial Institution and country location Account number Current market value Minus loan balance $ X .8 = $ – $ Name of digital asset such as virtual currency wallet, exchange or digital currency exchange (DCE) Digital asset Type of digital asset Name of individual who has access to the private key(s) and/or digital wallets = Email address used to set-up the digital asset such as virtual currency exchange or DCE (2b) $ Location(s) of digital asset (mobile wallet, online, and/or external hardware storage) Digital asset amount and value in US dollars as of today $ = (2c) $ Total investment accounts from attachment. [current market value minus loan balance(s)] (2d) $ Add lines (2a) through (2d) = (2) $ Retirement account 401K IRA Other Name of Financial Institution and country location Account number Current market value $ Minus loan balance X .8 = $ – $ = (3a) $ Total of retirement accounts from attachment. [current market value X .8 minus loan balance(s)] (3b) $ Add lines (3a) through (3b) = (3) $ Note: Your reduction from current market value may be greater than 20% due to potential tax consequences/withdrawal penalties. Cash value of Life Insurance Policies Name of Insurance Company Current cash value $ Total cash value of life insurance policies from attachment $ Catalog Number 55896Q Policy number Minus loan balance – $ = (4a) $ = (4b) $ Add lines (4a) through (4b) = (4) $ Minus loan balance(s) – $ www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Page 3 Section 3 (Continued) Personal Asset Information (Domestic and Foreign) Real property (enter information about any house, condo, co-op, time share, etc. that you own or are buying including any assets owned by your spouse if you live in a community property state) Is your real property currently for sale or do you anticipate selling your real property to fund the offer amount Yes No (listing price) Property description (indicate if personal residence, rental property, vacant, etc.) Purchase date (mm/dd/yyyy) Amount of mortgage payment How title is held (joint tenancy, etc.) Date of final payment Location (street, city, state, ZIP code, county, and country) Lender/Contract holder name, address (street, city, state, ZIP code) and phone Minus loan balance (mortgages, etc.) Current market value $ X .8 = $ – $ (total value of real estate) = Property description (indicate if personal residence, rental property, vacant, etc.) Purchase date (mm/dd/yyyy) Amount of mortgage payment How title is held (joint tenancy, etc.) Date of final payment Location (street, city, state, ZIP code, county, and country) (5a) $ Lender/Contract holder name, address (street, city, state, ZIP code) and phone Minus loan balance (mortgages, etc.) Current market value $ X .8 = $ – $ (total value of real estate) = (5b) $ Total value of property(s) from attachment [current market value X .8 minus any loan balance(s)] (5c) $ Add lines (5a) through (5c) = (5) $ Vehicles (enter information about any cars, boats, motorcycles, etc. that you own or lease). Include those located in foreign countries or jurisdictions. If additional space is needed, list on an attachment. Vehicle make & model Lease Year Date purchased Name of creditor Mileage Date of final payment Monthly lease/loan amount Own $ Current market value $ Minus loan balance X .8 = $ Vehicle make & model Lease Total value of vehicle (if the vehicle is leased, enter 0 as the total value) = (6a) $ Subtract $3,450 from line (6a) (If line (6a) minus $3,450 is a negative number, enter "0") (6b) $ – $ Year Date purchased Name of creditor Mileage Date of final payment License/Tag number Monthly lease/loan amount Own $ Current market value $ License/Tag number Minus loan balance Total value of vehicle (if the vehicle is leased, enter 0 as the total value) = (6c) $ If you are filing a joint offer, subtract $3,450 from line (6c) (If line (6c) minus $3,450 is a negative number, enter "0") If you are not filing a joint offer, enter the amount from line (6c) (6d) $ Total value of vehicles listed from attachment [current market value X .8 minus any loan balance(s)] (6e) $ X .8 = $ – $ Total lines (6b), (6d), and (6e) = Catalog Number 55896Q www.irs.gov (6) $ Form 433-A (OIC) (Rev. 4-2023) Page 4 Section 3 (Continued) Personal Asset Information (Domestic and Foreign) Other valuable items (artwork, collections, jewelry, items of value in safe deposit boxes, interest in a company or business that is not publicly traded, etc.) Description of asset(s) Current market value Minus loan balance $ X .8 = $ – $ = (7a) $ = (7b) $ Total value of valuable items listed from attachment [current market value X .8 minus any loan balance(s)] (7c) $ Value of remaining furniture and personal effects (not listed above) Description of asset Minus loan balance Current market value $ X .8 = $ – $ Add lines (7a) through (7c) minus IRS deduction of $10,810 = Do not include amount on the lines with a letter beside the number. Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative, enter "0" on that line. Add lines (1) through (7) and enter the amount in Box A = (7) $ Box A Available Individual Equity in Assets $ NOTE: If you or your spouse are self-employed, Sections 4, 5, and 6 must be completed before continuing with Sections 7 and 8. Section 4 Self-Employed Information If you or your spouse are self-employed (e.g., files Schedule(s) C, E, F, etc.), complete this section. Is your business a sole proprietorship Yes Address of business (if other than personal residence) No Name of business Business telephone number ( ) Employer Identification Number Business website address Total number of employees Frequency of tax deposits Description of business Do you or your spouse have any other business interests? Include any interest in an LLC, LLP, corporation, partnership, etc. Yes Trade name or DBA - (percentage of ownership: Average gross monthly payroll $ Business address (street, city, state, ZIP code) ) Title No Business name Employer Identification Number Business telephone number ( ) - Type of business (select one) Partnership LLC Section 5 Corporation Other Business Asset Information (for Self-Employed) (Domestic and Foreign) List business assets such as bank accounts, digital assets (cryptocurrency), tools, books, machinery, equipment, business vehicles and real property that is owned/leased/rented. If additional space is needed, attach a list of items. Do not include personal assets listed in Section 3. Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative number, enter "0". Cash Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (8a) $ Cash Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (8b) $ Digital asset Type of digital asset Name of digital asset such as virtual currency wallet, exchange or digital currency exchange (DCE) Name of individual who has access to the private key(s) and/or digital wallets Email address used to set-up the digital asset such as virtual currency exchange or DCE Digital asset amount and value in US dollars as of today $ Catalog Number 55896Q Location(s) of digital asset (mobile wallet, online, and/or external hardware storage) = (8c) $ Total bank accounts from attachment (8d) $ Add lines (8a) through (8d) = (8) $ www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Page 5 Section 5 (Continued) Business Asset Information (for Self-Employed) (Domestic and Foreign) Description of asset Total value (if leased or used in the production of income, enter 0 as the total value) = (9a) $ Total value (if leased or used in the production of income, enter 0 as the total value) = (9b) $ Total value of assets listed from attachment [current market value X .8 minus any loan balance(s)] (9c) $ Current market value $ Minus loan balance X .8 = $ – $ Description of asset: Current market value $ Minus Loan Balance X .8 = $ – $ Add lines (9a) through (9c) = IRS allowed deduction for professional books and tools of trade for individuals and sole-proprietors – Enter the value of line (9) minus line (10). If less than zero enter zero. = (9) $ (10) $ (11) $ Notes Receivable Do you have notes receivable Yes No If yes, attach current listing that includes name(s) and amount of note(s) receivable Accounts Receivable Do you have accounts receivable, including e-payment, factoring companies, and any bartering or online auction accounts Yes No If yes, provide a list of your current accounts receivable (include the age and amount) Do not include amounts from the lines with a letter beside the number [for example: (9c)]. Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative, enter "0" on that line. Box B Available Business Equity in Assets Add lines (8) and (11) and enter the amount in Box B = $ Section 6 Business Income and Expense Information (for Self-Employed) If you provide a current profit and loss (P&L) statement for the information below, enter the total gross monthly income on line 17 and your monthly expenses on line 29 below. Do not complete lines (12) - (16) and (18) - (28). You may use the amounts claimed for income and expenses on your most recent Schedule C; however, if the amount has changed significantly within the past year, a current P&L should be submitted to substantiate the claim. Period provided beginning through Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative number, enter "0". Business income (you may average 6-12 months income/receipts to determine your gross monthly income/receipts) Gross receipts (12) $ Gross rental income (13) $ Interest income (14) $ Dividends (15) $ Other income (16) $ Add lines (12) through (16) = (17) $ Business expenses (you may average 6-12 months expenses to determine your average expenses) Materials purchased (e.g., items directly related to the production of a product or service) (18) $ Inventory purchased (e.g., goods bought for resale) (19) $ Gross wages and salaries (20) $ Rent (21) $ Supplies (items used to conduct business and used up within one year, e.g., books, office supplies, professional equipment, etc.) (22) $ Utilities/telephones (23) $ Vehicle costs (gas, oil, repairs, maintenance) (24) $ Business insurance (25) $ Current business taxes (e.g., real estate, excise, franchise, occupational, personal property, sales and employer's portion of employment taxes) (26) $ Secured debts (not credit cards) (27) $ Other business expenses (include a list) (28) $ Add lines (18) through (28) = (29) $ Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative, enter "0" on that line. Box C Net Business Income Subtract line (29) from line (17) and enter the amount in Box C = $ Catalog Number 55896Q www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Page 6 Section 7 Monthly Household Income and Expense Information Enter your household's average gross monthly income. Gross monthly income includes wages, social security, pension, unemployment, and other income. Examples of other income include but are not limited to: agricultural subsidies, gambling income, oil credits, rent subsidies, sharing economy income from providing on-demand work, services or goods (e.g., Uber, Lyft, AirBnB, VRBO), income through digital platforms like an app or website, etc., and recurring capital gains from the sale of securities including cryptocurrency, non-fungible tokens, etc. The information below is for yourself, your spouse, and anyone else who contributes to your household's income. The entire household includes spouse, non-liable spouse, significant other, children, and others who contribute to the household. This is necessary for the IRS to accurately evaluate your offer. Monthly Household Income Note: Entire household income should also include income that is considered not taxable and may not be included on your tax return. Round to the nearest whole dollar. Primary taxpayer Gross wages Social Security Pension(s) Other income (e.g. unemployment) Total primary $ + $ + $ + $ taxpayer income = (30) $ Spouse Gross wages Social Security Pension(s) Other Income (e.g. unemployment) Total spouse $ + $ + $ + $ income = (31) $ Additional sources of income used to support the household, e.g., non-liable spouse, or anyone else who may contribute to the household income, etc. List source(s) (32) $ Interest, dividends, and royalties (33) $ Distributions (e.g., income from partnerships, sub-S Corporations, etc.) (34) $ Net rental income (35) $ Net business income from Box C [Deductions for non-cash expenses on Schedule C (e.g., depreciation, depletion, etc.) are not permitted as an expense for offer purposes and must be added back in to the net income figure] (36) $ Child support received (37) $ Alimony received (38) $ Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative, enter "0" on that line. Box D Total Household Income Add lines (30) through (38) and enter the amount in Box D = $ Monthly Household Expenses Enter your average monthly expenses. Note: For expenses claimed in boxes (39) and (45) only, you should list the full amount of the allowable standard even if the actual amount you pay is less. For the other boxes input your actual expenses. You may find the allowable standards at http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Collection-Financial-Standards. Round to the nearest whole dollar. Food, clothing, and miscellaneous (e.g., housekeeping supplies, personal care products, minimum payment on credit card). A reasonable estimate of these expenses may be used (39) $ Housing and utilities (e.g., rent or mortgage payment and average monthly cost of property taxes, home insurance, maintenance, dues, fees and utilities including electricity, gas, other fuels, trash collection, water, cable television and internet, monthly rent payment telephone, and cell phone) (40) $ Vehicle loan and/or lease payment(s) (41) $ Vehicle operating costs (e.g., average monthly cost of maintenance, repairs, insurance, fuel, registrations, licenses, inspections, parking, tolls, etc.). A reasonable estimate of these expenses may be used Public transportation costs (e.g., average monthly cost of fares for mass transit such as bus, train, ferry, etc.). A reasonable estimate of these expenses may be used Health insurance premiums (42) $ (43) $ (44) $ Out-of-pocket health care costs (e.g. average monthly cost of prescription drugs, medical services, and medical supplies like eyeglasses, hearing aids, etc.) (45) $ Court-ordered payments (e.g., monthly cost of any alimony, child support, etc.) (46) $ Child/dependent care payments (e.g., daycare, etc.) (47) $ Life insurance premiums (48) $ Life insurance policy amount Current monthly taxes (e.g., monthly cost of federal, state, and local tax, personal property tax, etc.) (49) $ Secured debts/Other (e.g., any loan where you pledged an asset as collateral not previously listed, government guaranteed student loan, employer required retirement or dues) List debt(s)/expense(s) (50) $ Enter the amount of your monthly delinquent state and/or local tax payment(s) . Total tax owed (51) $ Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative, enter "0" on that line. Box E Total Household Expenses Add lines (39) through (51) and enter the amount in Box E = $ Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative, enter "0" on that line. Box F Remaining Monthly Income Subtract Box E from Box D and enter the amount in Box F = $ Catalog Number 55896Q www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Page 7 Section 8 Calculate Your Minimum Offer Amount The next steps calculate your minimum offer amount. The amount of time you take to pay your offer in full will affect your minimum offer amount. Paying over a shorter period of time will result in a smaller minimum offer amount. Note: The multipliers below (12 and 24) and the calculated offer amount (which included the amount(s) allowed for vehicles and bank accounts) do not apply if the IRS determines you have the ability to pay your tax debt in full within the legal period to collect. Round to the nearest whole dollar. If you will pay your offer in 5 or fewer payments within 5 months or less, multiply "Remaining Monthly Income" (Box F) by 12 to get "Future Remaining Income" (Box G). Do not enter a number less than $0. Enter the total from Box F Box G Future Remaining Income $ X 12 = $ If you will pay your offer in 6 to 24 months, multiply "Remaining Monthly Income" (Box F) by 24 to get "Future Remaining Income" (Box H). Do not enter a number less than $0. Enter the total from Box F Box H Future Remaining Income $ X 24 = $ Determine your minimum offer amount by adding the total available assets from Box A and Box B (if applicable) to the amount in either Box G or Box H. Enter the amount from Box A plus Box B (if applicable) Enter the amount from either Box G or Box H + $ Offer Amount Your offer must be more than zero ($0). Do not leave blank. Use whole dollars only. = $ $ Place the offer amount shown above on the Form 656, Section 4, Payment Terms, unless you cannot pay that amount due to special circumstances. If you cannot pay that amount due to special circumstances, place the amount you can pay on the Form 656, Section 4, Payment Terms, and explain your special circumstances on the Form 656, Offer in Compromise, Section 3, Reason for Offer. Section 9 Other Information Additional information IRS needs to consider settlement of your tax debt. If you or your business are currently in a bankruptcy proceeding, you are not eligible to apply for an offer. Are you a party to or involved in litigation (if yes, answer the following) Plaintiff Yes Location of filing Represented by Possible completion date (mmddyyyy) Subject of litigation No Docket/Case number Defendant Amount of dispute $ Have you filed bankruptcy in the past 7 years (if yes, answer the following) Date filed (mmddyyyy) Date dismissed (mmddyyyy) Date discharged (mmddyyyy) Petition no. In the past 10 years, have you lived outside of the U.S. for 6 months or longer (if yes, answer the following) Dates lived abroad: From (mmddyyyy) Yes No Yes No Location filed To (mmddyyyy) Are you or have you ever been party to any litigation involving the IRS/United States (including any tax litigation) Yes No If yes and the litigation included tax debt, provide the types of tax and periods involved Yes Are you the beneficiary of a trust, estate, or life insurance policy, including those located in foreign countries or jurisdictions No (if yes, answer the following) Place where recorded Name of the trust, estate, or policy EIN Anticipated amount to be received When will the amount be received $ Are you a trustee, fiduciary, or contributor of a trust Name of the trust Yes No Yes No EIN Do you have a safe deposit box (business or personal) including those located in foreign countries or jurisdictions (if yes, answer the following) Location (name, address and box number(s)) Value Contents $ Catalog Number 55896Q www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Page 8 Section 9 (Continued) Other Information In the past 10 years, have you transferred any asset with a fair market value of more than $10,000 including real property, for less than their full value (if yes, answer the following) Value at time of transfer List asset(s) Date transferred (mmddyyyy) Yes No To whom or where was it transferred $ Do you have any assets or own any real property outside the U.S. Yes No Yes No If yes, provide description, location, and value Do you have any funds being held in trust by a third party If yes, how much $ Section 10 Where Signatures Under penalties of perjury, I declare that I have examined this offer, including accompanying documents, and to the best of my knowledge it is true, correct, and complete. Signature of Taxpayer Date (mm/dd/yyyy) Signature of Spouse Date (mm/dd/yyyy) Remember to include all applicable attachments listed below. Copies of the most recent pay stub, earnings statement, etc., from each employer. Copies of the most recent statement for each investment and retirement account. Copies of the most recent statement, etc., from all other sources of income such as pensions, Social Security, rental income, interest and dividends (including any received from a related partnership, corporation, LLC, LLP, etc.), court order for child support, alimony, royalties, agricultural subsidies, gambling income, oil credits, rent subsidies, sharing economy income from providing on-demand work, services or goods (e.g., Uber, Lyft, AirBnB, VRBO), income through digital platforms like an app or website, etc., and recurring capital gains from the sale of securities including cryptocurrency, non-fungible tokens. Copies of individual complete bank statements for the three most recent months. If you operate a business, copies of the six most recent complete statements for each business bank account. Completed Form 433-B (Collection Information Statement for Businesses) if you or your spouse have an interest in a business entity other than a sole-proprietorship. Copies of the most recent statement from lender(s) on loans such as mortgages, second mortgages, vehicles, etc., showing monthly payments, loan payoffs, and balances. List of Accounts Receivable or Notes Receivable, if applicable. Verification of delinquent State/Local Tax Liability showing total delinquent state/local taxes and amount of monthly payments, if applicable. Copies of court orders for child support/alimony payments claimed in monthly expense section. Copies of Trust documents if applicable per Section 9. Documentation to support any special circumstances described in the “Explanation of Circumstances” on Form 656, if applicable. Attach a Form 2848, Power of Attorney, if you would like your attorney, CPA, or enrolled agent to represent you and you do not have a current form on file with the IRS. Ensure all years and forms involved in your offer are listed on Form 2848 and include the current tax year. Check the appropriate box to ensure copies of communications are sent to your representative. Completed and signed current Form 656. Catalog Number 55896Q www.irs.gov Form 433-A (OIC) (Rev. 4-2023) Form Department of the Treasury — Internal Revenue Service 433-B (OIC) Collection Information Statement for Businesses (April 2023) Complete this form if your business is a ● Corporation ● Limited Liability Company (LLC) classified as a corporation ● Partnership ● Other LLC Note: If your business is a sole proprietorship do not use this form. Instead, complete Form 433-A (OIC) Collection Information Statement for Wage Earners and Self-Employed Individuals. This form should only be used with the Form 656, Offer in Compromise. Include attachments if additional space is needed to respond completely to any question. Section 1 Business Information (Domestic and Foreign) Business name Employer Identification Number Business physical address (street, city, state, ZIP code) County of business location Description of business and DBA or "Trade Name" Primary phone ( Secondary phone ) - ( ) Business mailing address (if different from above or post office box number) - Business website address FAX number ( ) Yes Total number of employees Federal contractor Yes Does the business outsource its payroll processing and tax return preparation for a fee - No No If yes, list provider name and address in box below (street, city, state, ZIP code) Check here if you are the only employee Frequency of tax deposits Average gross monthly payroll $ Provide information about all partners, officers, LLC members, major shareholders (domestic and foreign), etc., associated with the business. Include attachments if additional space is needed. Last name First name Title Percent of ownership and annual salary Social Security Number Primary phone ( ) Secondary phone - ( ) - Last name First name Percent of ownership and annual salary Social Security Number Primary phone Secondary phone Title ( ) - ( ) - First name Percent of ownership and annual salary Social Security Number Primary phone Secondary phone Title ) - Catalog Number 55897B ( ) Home address (street, city, state, ZIP code) - Last name ( Home address (street, city, state, ZIP code) - Home address (street, city, state, ZIP code) - www.irs.gov Form 433-B (OIC) (Rev. 4-2023) Page 2 Section 2 Business Asset Information (Domestic and Foreign) Gather the most current statement from banks, lenders on loans, mortgages (including second mortgages), monthly payments, loan balances, and accountant's depreciation schedules, if applicable. Also, include make/model/year/mileage of vehicles and current value of business assets. To estimate the current value, you may consult resources like Kelley Blue Book (www.kbb.com), NADA (www.nada.com), local real estate postings of properties similar to yours, and any other websites or publications that show what the business assets would be worth if you were to sell them. Asset value is subject to adjustment by IRS. Enter the total amount available for each of the following (if additional space is needed, please include attachments). Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0". Cash and investments (domestic and foreign) Cash Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (1a) $ Cash Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (1b) $ Cash Checking Savings Money Market Account/CD Bank name and country location Online Account Stored Value Card Account number (1c) $ Investment account Stocks Bonds Total bank accounts from attachment (1d) $ Add lines (1a) through (1d) = (1) $ Other Name of Financial Institution and country location Account number Current market value Minus loan balance $ X .8 = $ Investment Account: Stocks – $ Bonds = (2a) $ = (2b) $ Other Name of Financial Institution and country location Account number Current market value Minus loan balance $ X .8 = $ – $ Name of digital asset such as virtual currency wallet, exchange or digital currency exchange (DCE) Digital asset Type of digital asset Name of individual who has access to the private key(s) and/or digital wallets Email address used to set-up the digital asset such as virtual currency exchange or DCE Location(s) of digital asset (mobile wallet, online, and/or external hardware storage) Digital asset amount and value in US dollars as of today $ = (2c) $ Total investment accounts from attachment. [current market value minus loan balance(s)] (2d) $ Add lines (2a) through (2d) = (2) $ Notes Receivable Do you have notes receivable Yes No If yes, attach current listing which includes name, age, and amount of note(s) receivable Accounts Receivable Do you have accounts receivable, including e-payment, factoring companies, and any bartering or online auction accounts Yes No If yes, provide a list of name, age, and amount of the current accounts receivable Catalog Number 55897B www.irs.gov Form 433-B (OIC) (Rev. 4-2023) Page 3 Section 2 (Continued) Business Asset Information (Domestic and Foreign) If the business owns more properties, vehicles, or equipment than shown in this form, please list on a separate attachment. Real estate (buildings, lots, commercial property, etc.) Is your real property currently for sale or do you anticipate selling your real property to fund the offer amount Yes No (listing price) Property address (street address, city, Property description (indicate if rental property, vacant, etc.) Date purchased state, ZIP code, county, and country) Monthly mortgage payment Date of final payment Name of lender/contract holder Current market value Minus loan balance (mortgages, etc.) $ X .8 = $ Property address (street address, city, – $ Total value of real estate = (3a) $ Property description (indicate if rental property, vacant, etc.) Date purchased state, ZIP code, county, and country) Monthly mortgage payment Date of final payment Name of lender/contract holder Current market value Minus loan balance (mortgages, etc.) $ X .8 = $ – $ Total value of real estate = (3b) $ Total value of property(s) listed from attachment [current market value X .8 minus any loan balance(s)] (3c) $ Add lines (3a) through (3c) = (3) $ Business vehicles (cars, boats, motorcycles, trailers, etc.). Include those located in foreign countries or jurisdictions. If additional space is needed, list on an attachment Vehicle make & model Year Lease Monthly lease/loan amount Own $ Current market value $ Vehicle make & model Name of creditor License/Tag number Date of final payment Total value of vehicle (if the vehicle is leased, enter 0 as the total value) = – $ Year Lease Monthly lease/loan amount Own $ Current market value Date purchased Mileage or use hours Name of creditor (4a) $ License/Tag number Date of final payment Minus loan balance X .8 = $ Vehicle make & model Total value of vehicle (if the vehicle is leased, enter 0 as the total value) = – $ Year Lease Monthly lease/loan amount Own $ Current market value $ Mileage or use hours Minus loan balance X .8 = $ $ Date purchased Date purchased Mileage or use hours Name of creditor (4b) $ License/Tag number Date of final payment Minus loan balance Total value of vehicle (if the vehicle is leased, enter 0 as the total value) = (4c) $ Total value of vehicles listed from attachment [current market value X .8 minus any loan balance(s)] (4d) $ Add lines (4a) through (4d) = (4) $ X .8 = $ Catalog Number 55897B – $ www.irs.gov Form 433-B (OIC) (Rev. 4-2023) Page 4 Section 2 (Continued) Business Asset Information (Domestic and Foreign) Other business equipment [If you have more than one piece of equipment, please list on a separate attachment and put the total of all equipment in box (5b)] Type of equipment Minus loan balance Current market value Total value of equipment (if leased or used in the production of income enter 0 as the total value) = (5a) $ Total value of equipment listed from attachment [current market value X .8 minus any loan balance(s)] (5b) $ $ X .8 = $ – $ Total value of all business equipment (5) $ Add lines (5a) and (5b) = Do not include amount on the lines with a letter beside the number. Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0" on that line. Box A Available Equity in Assets Add lines (1) through (5) and enter the amount in Box A = $ Section 3 Business Income Information Enter the average gross monthly income of your business. To determine your gross monthly income use the most recent 6-12 months documentation of commissions, invoices, gross receipts from sales/services, etc.; most recent 6-12 months earnings statements, etc., from every other source of income (such as rental income, interest and dividends, or subsidies); or you may use the most recent 6-12 months Profit and Loss (P&L) to provide the information of income and expenses. Note: If you provide a current profit and loss statement for the information below, enter the total gross monthly income in Box B below. Do not complete lines (6) - (10). Period provided beginning through Gross receipts (6) $ Gross rental income (7) $ Interest income (8) $ Dividends (9) $ (10) $ Other income (specify on attachment) Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0" on that line. Box B Total Business Income Add lines (6) through (10) and enter the amount in Box B = $ Section 4 Business Expense Information Enter the average gross monthly expenses for your business using your most recent 6-12 months statements, bills, receipts, or other documents showing monthly recurring expenses. Deductions for non-cash expenses (e.g., depreciation, depletion, etc.) are not permitted as an expense for offer purposes. Note: If you provide a current profit and loss statement for the information below, enter the total monthly expenses in Box C below. Do not complete lines (11) - (20). Period provided beginning through Materials purchased (e.g., items directly related to the production of a product or service) (11) $ Inventory purchased (e.g., goods bought for resale) (12) $ Gross wages and salaries (13) $ Rent (14) $ Supplies (items used to conduct business and used up within one year, e.g., books, office supplies, professional equipment, etc.) (15) $ Utilities/telephones (16) $ Vehicle costs (gas, oil, repairs, maintenance) (17) $ Insurance (other than life) (18) $ Current taxes (e.g., real estate, state, and local income tax, excise franchise, occupational, personal property, sales and employer's portion of employment taxes, etc.) (19) $ Other expenses (e.g., secured debt payments. Specify on attachment. Do not include credit card payments) (20) $ Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0" on that line. Box C Total Business Expenses Add lines (11) through (20) and enter the amount in Box C = $ Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0" on that line. Box D Remaining Monthly Income Subtract Box C from Box B and enter the amount in Box D = $ Catalog Number 55897B www.irs.gov Form 433-B (OIC) (Rev. 4-2023) Page 5 Section 5 Calculate Your Minimum Offer Amount The next steps calculate your minimum offer amount. The amount of time you take to pay your offer in full will affect your minimum offer amount. Paying over a shorter period of time will result in a smaller minimum offer amount. Note: The multipliers below (12 and 24) and the calculated offer amount do not apply if IRS determines you have the ability to pay your tax debt in full within the legal period to collect. If you will pay your offer in 5 or fewer payments within 5 months or less, multiply "Remaining Monthly Income" (Box D) by 12 to get "Future Remaining Income." Do not enter a number less than zero. Round to the nearest whole dollar. Enter the total from Box D Box E Future Remaining Income X 12 = $ $ If you will pay your offer in 6 to 24 months, multiply "Remaining Monthly Income" (Box D) by 24 to get "Future Remaining Income". Do not enter a number less than zero. Enter the total from Box D Box F Future Remaining Income X 24 = $ $ Determine your minimum offer amount by adding the total available assets from Box A to the amount in either Box E or Box F. Your offer amount must be more than zero. Enter the amount from Box A* Enter the amount from either Box E or Box F + $ Offer Amount Your offer must be more than zero ($0). Do not leave blank. Use whole dollars only. Place your offer amount on Form 656 Section 4, Payment Terms. = $ $ *You may exclude any equity in income producing assets (except real estate) shown in Section 2 of this form. Section 6 Other Information Additional information IRS needs to consider settlement of your tax debt. If this business is currently in a bankruptcy proceeding, the business is not eligible to apply for an offer. Is the business currently in bankruptcy Yes No Has the business filed bankruptcy in the past 10 years Yes No If yes, provide Date dismissed or discharged (mm/dd/yyyy) Date filed (mm/dd/yyyy) Petition no. Location filed Does this business have other business affiliations (e.g., subsidiary or parent companies) Yes No If yes, list the name and Employer Identification Number Do any related parties (e.g., partners, officers, employees) owe money to the business Yes No Is the business currently, or in the past, party to litigation Yes No If yes, answer the following Plaintiff Location of filing Represented by Possible completion date (mmddyyyy) Subject of litigation Docket/Case number Defendant Amount in dispute $ Are you or have you been party to litigation involving the IRS/United States (including any tax litigation) Yes No If yes and the litigation included tax debt, provide the types of tax and periods involved. Catalog Number 55897B www.irs.gov Form 433-B (OIC) (Rev. 4-2023) Page 6 Section 6 (Continued) Other Information In the past 10 years, has the business transferred any asset with a fair market value of more than $10,000, including real property, for less than its full value Yes No If yes, provide date, value, and type of asset transferred In the past 3 years have you transferred any real property (land, house, etc.) Yes No If yes, list the type of property, value, and date of the transfer Has the business been located outside the U.S. for 6 months or longer in the past 10 years Yes No Do you have any assets or own any real property outside the U.S. Yes No If yes, please provide description, location, and value Does the business have any funds being held in trust by a third party Yes No If yes, how much $ Where Does the business have any lines of credit Yes No If yes, credit limit $ Amount owed $ What property secu
Extracted from PDF file 2023-federal-form-656-b.pdf, last modified December 2022

More about the Federal Form 656-B Other TY 2023

We last updated the Offer in Compromise Booklet in January 2024, so this is the latest version of Form 656-B, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 656-B directly from TaxFormFinder. You can print other Federal tax forms here.

Other Federal Other Forms:

TaxFormFinder has an additional 774 Federal income tax forms that you may need, plus all federal income tax forms.

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Form W-4V Voluntary Withholding Request
Form 940 Employer's Annual Federal Unemployment (FUTA) Tax Return
Form 8840 Closer Connection Exception Statement for Aliens
Form 1310 Statement of Person Claiming Refund Due a Deceased Taxpayer
Form 5329 Additional Taxes on Qualified Plans (Including IRAs) and Other Tax-Favored Accounts

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Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 656-B from the Internal Revenue Service in January 2024.

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Historical Past-Year Versions of Federal Form 656-B

We have a total of eleven past-year versions of Form 656-B in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form 656-B

Form 656-B (Rev. 4-2023)

2022 Form 656-B

Form 656-B (Rev. 4-2022)

2021 Form 656-B

Form 656-B (Rev. 4-2021)

2020 Form 656-B

Form 656-B (Rev. 4-2020)

2019 Form 656-B

Form 656-B (Rev. 8-2019)

2018 Form 656-B

Form 656-B (Rev. 3-2018)

2017 Form 656-B

Form 656-B (Rev. 3-2017)

2016 Form 656-B

Form 656-B (Rev. 3-2017)

Form 656 Booklet Offer in Compromise 2015 Form 656-B

Form 656-B (Rev. 1-2015)

Form 656 Booklet Offer in Compromise 2012 Form 656-B

Form 656-B (Rev. 5-2012)

Form 656 Booklet Offer in Compromise 2011 Form 656-B

Form 656-B (Rev. 3-2011)


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