OMB No. 1545-0074 Tip If you owe 50 000 or less you may be able to avoid filing Form 9465 and establish an installment agreement online even if you haven t yet received a tax bill. Go to www.irs.gov/OPA to apply for an Online Payment Agreement. Spouse s signature. If a joint return both must sign. Cat. No. 14842Y Form 9465 Rev. 12-2018 Page Additional information. Complete this part only if all three conditions apply 1. Form Rev. December 2018 Department of the Treasury Internal Revenue Service Installment Agreement Request Go to www.irs.gov/Form9465 for instructions and the latest information. If you are filing this form with your tax return attach it to the front of the return. See separate instructions. You defaulted on an installment agreement in the past 12 months 2. you owe more than 25 000 but not more than 50 000 and 3. the amount on line 11a or 11b if applicable is less than line 10. Note If you owe more than 50 000 complete and attach Form 433-F Collection Information Statement. 11a and penalty charges as these charges will continue to accrue until you pay in full. If you have an existing installment agreement this amount should represent your total proposed monthly payment amount for all your liabilities. If no payment amount is listed on line 11a a payment will be determined for you by dividing the balance due on line 9 by 72 months. See instructions Amount owed. Subtract line 8 from line 7 and enter the result. Divide the amount on line 9 by 72 and enter the result. 11a and penalty charges as these charges will continue to accrue until you pay in full. If you have an existing installment agreement this amount should represent your total proposed monthly payment amount for all your liabilities. Enter the total amount you owe as shown on your tax return s or notice s. If you have any additional balances due that aren t reported on line 5 enter the amount here even if the amounts are included in an existing installment agreement. Add lines 5 and 6 and enter the result. Enter the amount of any payment you re making with this request. Foreign postal code Employer identification number EIN Your home phone number Best time for us to call Your work phone number Ext. Enter the total amount you owe as shown on your tax return s or notice s. If you have any additional balances due that aren t reported on line 5 enter the amount here even if the amounts are included in an existing installment agreement. Part I This request is for Form s for example Form 1040 or Form 941 Enter tax year s or period s involved for example 2016 and 2017 or January 1 2017 to June 30 2017 1a Your first name and initial Last name Your social security number If a joint return spouse s first name and initial Spouse s social security number Current address number and street. If you have a P. O. box and no home delivery enter your box number. Apt. number City town or post office state and ZIP code. If a foreign address also complete the spaces below see instructions. Foreign province/state/county Foreign country name 1b If this address is new since you filed your last tax return check here Name of your business must no longer be operating.
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What Is irs form 9465?
The Form 9465 is used to prepare a request for a monthly installment plan in case a taxpayer can’t pay the full amount shown on their tax return or on a notice that the Internal Revenue Service has sent. Most installment agreements meet the streamlined installment agreement criteria. The maximum term for a streamlined agreement is 72 months.
Form 9465 works for individuals, who owe fees on Form 1040, who are also responsible for a Trust Recovery Penalty and owe unemployment fees related to a sole proprietor business that is no longer in operation.
Complete this sample if you share responsibility payment under the Affordable Care Act. Depending on your financial situation you may send a request to pay longer or you may establish an agreement for an amount that is less than the amount of taxes to pay.
Every blank of 9465 consists of 22 lines. Insert the following information:
- the name and social security number (SSN); if you file a joint tax return, show the same information in the same order as it appears on your tax return; enter the name of the state and the city, if you have a foreign address;
- the name and employer identification number (EIN) of your business;
- the total amount you owe as shown on your tax return or notice;
- any additional balances, adjustments and other charges;
- the amount you can pay each month;
- information regarding the payment method.
After the sample is completed attach it to the front of your return and send to the address shown in your tax booklet.
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