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Kentucky Free Printable  for 2021 Kentucky Kentucky Individual Income Tax Installment Agreement Request

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Kentucky Individual Income Tax Installment Agreement Request
Form 12A200

GENERAL INSTRUCTIONS If you are unable to pay the full amount due with your individual income tax return, you may request an installment agreement by completing this form and mailing it to: Division of Collections, P. O. Box 491, Frankfort, Kentucky 406020491. Specify the amount of the monthly payment you propose to make in the block marked “Proposed Monthly Payment Amount.” Payments should be as large as possible to lower penalty and interest charges. Requested Installment Agreements must be created by the Division of Collections after a tax notice has been issued. You can make installment payments in three ways. Credit cards or ACH Debits will save you the time and trouble of mailing monthly payments and may help save you additional penalties, interest or fees. • Pay by ACH Debit—To request that your monthly payments be withdrawn electronically from a bank account, enclose a voided check with the completed form below. You may also call (502) 564-4921, ext. 5354 to request this option. Please indicate date for ACH Debit payment. • Pay by Mail—Make your checks or money orders payable to the Kentucky State Treasurer. Include the taxpayer’s full name(s), Social Security number(s), and the tax period you are paying. Mail the payments to the Division of Collections, P.O. Box 491, Frankfort, KY 40602-0491. You will be advised if your request for an installment agreement is approved or denied. If you do not receive a response to this request within 90 days from the date you file your return, please call the Division of Collections, (502) 564-4921, ext. 5354. CUT HERE  MAIL THIS FORM TO THE DIVISION OF COLLECTIONS 12A200 (11-19) DEPARTMENT OF REVENUE Taxpayer full name(s) as shown on return Taxpayer Social Security number Address City Home telephone number Convenient time to call (   ) Amount paid with return 2 0 _ _ KENTUCKY INDIVIDUAL INCOME TAX INSTALLMENT AGREEMENT REQUEST Amount you owe (Form 740, Form 740-EZ, Form 740-NP) Spouse Social Security number State ZIP Code Pay by ACH   Check if paying by ACH Debit Debit/Electronic (Attach voided check) Check     PROPOSED MONTHLY PAYMENT AMOUNT Amount I am able to pay each month $ Date of first payment Date each month I am able to pay $ $ Page 1 of 2 INDIVIDUAL INCOME TAX INSTALLMENT AGREEMENT REQUEST GENERAL INFORMATION A Kentucky taxpayer has the right to consideration of an installment agreement for the payment of delinquent taxes, interest, penalties and fees. The right to an installment agreement is provided for in KRS 131.081(9) and is primarily dependent on the taxpayer’s inability to pay the amount due in full. Eligibility for an Installment Agreement An installment agreement should be requested only when there is no other way of paying the liability on time and in full. A taxpayer must clearly demonstrate an inability to pay the liability in full and the agreement must facilitate collection. Generally this means that taxpayers who have the ability to pay with available funds or borrow from a financial institution are not eligible. Proposed Monthly Payment Amount The monthly payment amount will be based upon the taxpayer’s ability to pay after considering the taxpayer’s monthly income and reasonable expenses. Allowable expenses generally include reasonable amounts for food, clothing, housing (and associated expenses), installment payments and other necessary living expenses. The proposed monthly payment amount should be as much as possible to minimize the length of the agreement and the accrual of interest, penalties and fees. Interest, Penalties, Fees and Refund Offsets The law provides for the assessment of interest, penalties and fees for tax liabilities paid after the due date. Interest accrues at the tax interest rate (7 percent for 2020). In addition, penalties of 2 percent per month may be assessed on the unpaid tax. A 25 percent Cost of Collection Fee is imposed on tax due which becomes due and payable (generally 61 days after the assessment date). Interest, penalties and fees continue to accumulate while an installment agreement is in place. Also, any money Kentucky may owe you (tax refunds, etc.) will be offset to your outstanding liability. Additionally, any federal income tax refund that may become due to you may be offset to this liability pursuant to 26 USC §6402(e). Page 2 of 2 Setting up the Agreement Taxpayers who believe they qualify for an installment agreement should complete Form 12A200, Individual IncomeTax Installment Agreement Request, and mail it to the Division of Collections, P. O. Box 491, Frankfort, Kentucky 40602-0491. State Tax Lien Depending on the amount and length of the agreement, a State Tax Lien may be filed. If a lien is filed, it will remain on the taxpayer’s credit record for up to seven years after the liability is paid and the lien is released. Assistance Questions should be directed to: Division of Collections Kentucky Department of Revenue P.O. Box 491 Frankfort, KY 40602-0491 (502) 564-4921, ext. 5354 Form 12A200, Individual Income Tax Installment Agreement Reques t, is available at Kentuck y Taxpayer Service Centers located throughout the Commonwealth. Forms may also be obtained from the Internet at www.revenue.ky.gov, or by contacting the Division of Collections or by sending a written request to: FORMS Operations and Support Services Branches Kentucky Department of Revenue P. O. Box 518 Frankfort, KY 40602-0518 (502) 564-3658
Extracted from PDF file 2019-kentucky-form-12a200.pdf, last modified October 2019

More about the Kentucky Form 12A200 Individual Income Tax

If you are unable to pay the full amount due with your individual income tax return, you may request an installment agreement by completing this form.

We last updated the Kentucky Individual Income Tax Installment Agreement Request in March 2020, and the latest form we have available is for tax year 2019. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Kentucky Department of Revenue. You can print other Kentucky tax forms here.


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Other Kentucky Individual Income Tax Forms:

TaxFormFinder has an additional 129 Kentucky income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form 740ES Estimated Income Tax Return
Form 740 Kentucky Individual Income Tax Return
Income Tax Instructions Form 740 Instructions
Schedule KW-2 Kentucky Income Tax Withheld
Schedule M (740) Kentucky Federal Adjusted Gross Income Modifications

Download all KY tax forms View all 130 Kentucky Income Tax Forms


Form Sources:

Kentucky usually releases forms for the current tax year between January and April. We last updated Kentucky Form 12A200 from the Department of Revenue in March 2020.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Kentucky Form 12A200

We have a total of nine past-year versions of Form 12A200 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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