US Internal Revenue Service: f656

8/14/2019 US Internal Revenue Service: f656

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Form 656

Offer inCompromiseIMPORTANT! THIS BOOKLET CONTAINS INFORMATION THAT YOUNEED IN ORDER TO PREPARE A COMPLETE AND ACCURATE OFFERIN COMPROMISE. PLEASE READ THESE INSTRUCTIONS CAREFULLYBEFORE ATTEMPTING TO COMPLETE THE ENCLOSED FORMS.

CONTENTS

What is an Oer in Compromise? ...............................................................1 Step One: Is Your Offer in Compromise Processable? .................................2

Step Two: What We Need to Fully Evaluate Your Offer ....................................... 3

Step Three: Determining the Amount o Your Oer ..................................5

Step Four: Completing Form 656, Oer in Compromise ........................10

Step Five: Oer in Compromise Application Fee and Payments ............12

Step Six: Where you need to Send Your Oer ........................................14

Step Seven: What to Expect Ater the IRS Receives Your Oer .............15

Step Eight: Oer in Compromise Summary Checklist ............................17

Important Inormation You Need To Know Regarding the

Oer in Compromise ...............................................................................18

Terms and Defnitions ..............................................................................19

Removable Forms Form 656, Oer in Compromise Application Feeand Payment Worksheet, Form 656-A, Form 656 - PPV, Form 433-A,and Form 433-B, .....................................................................................21

Note: If you have any questions, please call our toll-free number at 1-800-829-1040. You can getforms and publications by calling toll free at 1-800-829-3676 (1-800-TAX-FORM), or by visitingyour local Internal Revenue Service (IRS) ofce or our web site at www.irs.gov.

www.irs.govForm 656 (Rev. 02-2007)

Catalog Number 16728N

IRSDepartment o the Treasury

Internal Revenue Service


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What is anOer in Compromise?

the taxpayer owes part or all o theassessed tax liability. To submit aDoubt as to Liability OIC, the taxpayermust use Form 656-L, which canbe obtained by calling the toll reenumber 1-800-829-1040, or by visitingtheir local IRS oice, or our web siteat www.irs.gov.

nEective Tax Administration (ETA).This means that the taxpayer does

not have any doubt that the tax iscorrect and there is potential to collect

the ull amount o the tax owed, but anexceptional circumstance exists thatwould allow us to consider an oer.To be eligible or compromise on thisbasis, a taxpayer must demonstratethat the collection o the tax wouldcreate an economic hardship or wouldbe unair and inequitable. For an ETAoer, a taxpayer must submit:

1. A collection inormation statementwith all appropriate attachments,and

2. A written narrative explaining the

taxpayers special circumstancesand why paying the tax liabilityin ull would create an economichardship or would be unair andinequitable.

The taxpayermust also attach appro-priate documentation that will supporttheir request or an ETA oer such asproo o unusual expenses that wouldcause an economic hardship i thetaxes were collected in ull.

Note: An important actor in determining

the type o oer to submit is the potentialability to pay the liability in ull. I thetaxpayer cannot pay their liability in ull,then they should submit a Doubt as toCollectibility oer. However, i potentialexists to pay their liability in ull, but thecollection o the tax would create aneconomic hardship or would be unair orinequitable, then they should submit anEective Tax Administration (ETA) oer.

An Oer in Compromise (OIC) is anagreement between the taxpayer andthe government that settles a taxliability or payment o less than theull amount owed.

The IRS will generally accept an Oerin Compromise when it is unlikely thatthe tax liability can be collected in ulland the amount oered reasonablyrefects collection potential. An OIC isa legitimate alternative to declaring acase currently not collectible or to a

protracted installment agreement. Thegoal is to achieve collection o whatis potentially collectible at the earliestpossible time and at the least cost to thegovernment.

The success o the Oer in Compromiseprogram will be assured only i taxpayersmake adequate compromise proposalsconsistent with their ability to pay andthe Service makes prompt and reason-able decisions. Taxpayers are expectedto provide reasonable documentationto veriy their ability to pay. The ultimate

goal is a compromise which is in thebest interest o both the taxpayer andthe Service. Acceptance o an adequateoer will also result in creating or thetaxpayer an expectation o, and a reshstart toward, compliance with all utureling and payment requirements.

nDoubt as to Collectibility. Thismeans that doubt exists that thetaxpayer could ever pay the ullamount o tax liability owed withinthe remainder o the statutory periodor collection. The IRS will consider a

doubt as to collectibility oer (absentspecial circumstances) when thetaxpayer is unable to pay the taxesin ull either by liquidating assets orthrough current installment agree-ment guidelines. The taxpayermustsubmit the appropriate collectioninormation statement along withall required supporting documents.

nDoubt as to Liability. This meansthat a legitimate doubt exists that


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Is Your Oer in CompromiseProcessable?

PLEASE DO NOT GO ANY FURTHER WITHOUT FIRST DETERMINING WHETHER OR NOT YOU

ARE ELIGIBLE TO HAVE YOUR OFFER IN COMPROMISE PROCESSED AT THIS TIME.

Step One:

In order to determine whether or not you are eligible to have your Oer in Compromise processed, pleaseanswer the three questions below:

YES NO

1. Do you currently have an open bankruptcy proceeding? You should contact your BankruptcyAttorney i you are not certain. I you are involved in an open bankruptcy proceeding, contactyour local IRS Insolvency oce. I you do not know the location o your local IRS Insolvencyoce, then you may call 1-800-829-1040. They will be able to provide you with the local number.

Any resolution o your outstanding tax liabilities generally must take place within the context oyour bankruptcy proceeding. I you answeredYES to this question, then stop here. You are noteligible to have your oer considered or processed at this time.

2. Oer in Compromise Application Fee Your oer must include the $150 application ee ora completed Form 656-A, Income Certifcation or Oer in Compromise Application Fee andPayment, i you are requesting an exception o the ee because o your income. Oers receivedwithout the $150 ee or a completed Form 656-A will not be accepted or processing. Please seeStep Five on Page 12 o this package or more inormation on the application ee and to deter-mine i you qualiy or the exception.

Have you attached the $150 application ee or the Form 656-A, which ever is applicable, to the

Form 656? I you answered NO to this question, Stop Here. You are not eligible to have youroer considered or processed at this time.

3. Cash payment and Periodic Payment Oers Your oer must include your 20% paymentor Lump Sum Cash payment oers, or your rst installment payment o your Periodic Paymentoer (Short Term or Deerred). I you are requesting an exception to the 20% down payment oryour initial periodic payment because o your income level, then you must complete Form 656-A,Certifcation o Oer in Compromise Application Fee and Payment. Oers received without oneo these will not be accepted or processing. Please see Step Five on Page 12 o this package ormore inormation on the Cash Payment and Periodic Payment Oer.

Have you attached either the 20% payment or Lump Sum Cash payment oers or your rstinstallment payment or a Periodic Payment Oer, or, the Form 656-A? I you answered NO tothis question, Stop Here. You are not eligible to have your oer considered or processed at thistime.

NOTE: I you currently have an approved installment agreement with IRS and are currently makinginstallment payments to IRS, then you may stop making those installment agreement paymentswhen you submit a Periodic Payment oer. This will allow you to make your payments requiredunder the Periodic Payment guidelines. You do not have to make both installment agreementpayments and periodic payments at the same time.

However this procedure does not apply to Lump Sum Cash Oers. I you submit a LumpSum Cash oer and you are currently making installment agreement payments, then you mustcontinue to make your installment agreement payments until your oer is accepted. I it is notaccepted, then installment agreement payments must continue.

STOP


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What We Need to Fully EvaluateYour Oer

. You must le all tax returns that youwere legally required to le prior tosubmitting an Oer in Compromise.I you have not led all required taxreturns, you will be asked to do sobeore we begin to evaluate youroer.This includes but is not limited to:

n All Income Tax, Employment Tax,and Excise Tax returns, along withall returns required to be led byPartnerships, Limited Liability

Companies, or closely held Sub-Chapter S Corporations.

I you did not le a return or aspecic year prior to submitting yourOIC because you were not legallyrequired to le the return, then youmust include a detailed explanationo your circumstances with your OIC.

I you used an employee leasingcompany or all or part o the timeduring the past three years, thenplease provide a detailed explanationo your circumstances with your oer

by providing the exact dates youused the employee leasing company,the name and address o the leasingcompany, and EIN o the leasingcompany, and whether or not you arestill using them.

. I you are a business with employees,then you must have made all requiredederal tax deposits or the currentquarter. I you have not made allthe required deposits, you will beasked to do so beore we begin toevaluate your oer. In addition, you

must remain current on all ling anddeposit requirements while your oeris being investigated.

. ESTIMATED TAX PAYMENTSMUST BE UP TO DATE FOR THECURRENT YEAR We will notprocess your oer to completion iwe determine that your estimatedtax payments or the current yearsincome tax liability are not paid up to

date. I we determine this to be thecase, you will have one opportunity tomake the required payments beorewe return your oer.

NOTE: I you ail to comply withitems , , and , then your oerwill be returned to you and we willeep your $50 application ee aswell as any payments you madewith your oer, such as the 0%payment or your frst installment.

4. COMPLETE AN ACCURATEFORM 656 Complete all applicableitems on Form 656, which is theofcial compromise agreement.Youmust sign Form 656. I someoneelse prepared the oer package, thenplease see the instructions in StepFour, Section IX and X, ound onPage 11 o this package. I your Form656 was prepared by an authorizedrepresentative, youmust includea completed Form 2848, Powero Attorney and Declaration oRepresentative, with your oer, unless

a copy is already on le with the IRSDetailed instructions or the comple-tion o Form 656 are ound on Pages10 and 11 o this package.

Common errors to avoid incompleting Form 656:

n The taxpayers name is missing.

n The street address is missing orincomplete.

n The social security number (SSN)or employer identication number(EIN) is missing, incomplete, orincorrect.

n The preprinted terms and condi-tions listed on the Form 656 havebeen altered or deleted.

n An oer amount or payment termis missing.

n A required signature is missing.

Step Two:


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5. COMPLETE AN ACCURATECOLLECTION INFORMATIONSTATEMENT (Form 4-A and/orForm 4-B) Youmust providenancial inormation when you submitoers based on doubt as to collect-ibility and eective tax administration.Youmust send us current inormationthat refects your nancial situation orthe three months immediately priorto the date you submitted your Oerin Compromise. Collection inorma-tion statementsmust show all assetsand income. The oer investigatorneeds this inormation to evaluateyour oer and may ask you to updateit or veriy certain nancial inorma-tion. These ormsmust be lled incompletely. We may return oer pack-ages that are incomplete. Annotateitems that do not apply to you withN/A. Provide all the inormationrequired to support your fnancialcondition. Required items o docu-mentation are clearly indicated on thecollection inormation statements

with attachment symbols. Photocopies o these support documentsare acceptable.

When only one spouse has a taxliability but both have incomes, onlythe spouse responsible or the taxdebt is required to sign the necessarycollection inormation statements.The responsible spouse shouldinclude onlyhis/her assets andliabilities on his/her collectioninormation statements. However,the income and expenses o the

entire household is required onthe responsible spouses collec-tion inormation statements. Theentire household includes spouse,domestic partner, signicant other,children, and others that contribute

to the household. This is necessaryor the IRS to evaluate the incomeand expenses allocable to the liabletaxpayer.

In states with community propertylaws, we require collection inorma-tion statements rom both spouses.We may also require nancial inor-mation on the non-liable spouse, orcohabitant(s), or oer vericationpurposes, even when communityproperty laws do not apply.

6. RESPOND PROMPTLY TOREQUESTS FOR ADDITIONALINFORMATION While we areevaluating your oer, we maycontact you or any inormation thatis missing or requires clarication.You must respond within the timerame given to you by IRS or, we willnot give your oer any urther consid-eration.Your oer will be returnedto you and we will eep your $50application ee as well as anypayments you made with your oer

such as the 0% payment or yourfrst installment.

7. WE WILL NOT CONSIDER OFFERSWHERE LIABILITIES HAVE NOTBEEN ASSESSED You can notsubmit an oer that is solely or a taxyear or tax period that has not beenassessed. Your oer will be returnedi you submit an oer that is solely oran unassessed tax year or tax periodand you will oreit your applicationee and payment.

8. MAkE COPIES OF REMOVABLE

FORMS AND DOCUMENTS Thisis a reminder that you should makecopies o all the removable orms anddocuments that you send to the IRS.You should keep these copies withyour records.


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Determining the Amount oYour Oer

Doubt as to Collectibility

Your oer amount must equal orexceed your reasonable collectionpotential amount. The inormationprovided on the collection inormationstatements (Form 433-A and Form 433-B) assists us in determining the reason-able collection potential (RCP). TheRCP equals the net equity o your assetsplus the amount we could collect romyour uture income. I our fnancialanalysis indicates that you have the

ability to ully pay the tax liability,either immediately or through aninstallment agreement, your oerwill be rejected.Exception: specialcircumstances. Please see belowor more inormation on specialcircumstances.You must oer anamount greater than or equal to theRCP amount. All oer amounts mustexceed zero.

I special circumstances cause you tooer an amount less than the RCP, you

must complete Section VI, Explana-

tion o Circumstances, on Form 656,explaining your situation. Youmustalso attach to Form 656 any supportingdocuments to help support your specialcircumstances. Special circumstances

may include actors such as advancedage, serious illness rom which recoveryis unlikely, or any other actors that havean impact upon your ability to pay thetotal RCP and continue to provide or thenecessary living expenses or you andyour amily.

I you are a wage earner or sel-employed individual, completion o theworksheet on Pages 8 and 9 will giveyou a good estimate o what an accept-able oer amount may be. You will use

the inormation on your Form 433-A tocomplete the worksheet.

Eective Tax Administration (ETA)

Complete Form 433-A or Form 433-B,as appropriate, and attach to Form 656.Youmust complete Section VI, Expla-nation o Circumstances, on Form 656,explaining your exceptional circum-stances and why requiring payment othe tax liability in ull would either createan economic hardship or would be unairand inequitable. Youmust also attach

to Form 656 any documents to helpsupport your exceptional circumstances.

Step Three:


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Determine YourPayment Terms

There are three payment plans you andthe IRS may agree to:

n Lump Sum Cash Oer This optionrequires the oer amount to be paidin fve or ewer installments, uponwritten notice o acceptance. Twentypercent o the total amount o theoer must be paid when you submitthe Form 656.

I these installments will be paid in vemonths or less, you should oer therealizable value o your assets plus thetotal amount we could collect over 48months o payments (or the remaindero the statutory period or collection,whichever is less).

I these installments will be paid inmore than ve months, you shouldoer the realizable value o yourassets plus the total amount wecould collect over 60 months opayments ( or the remainder o thestatutory period or collection, which-ever is less.)

We may fle a Notice o Federal TaxLien on tax liabilities to be compro-mised under Lump Sum Cash Oer.

n Short Term Periodic PaymentOer This option requires the oeramount to be paid within 24 monthsrom the date IRS received the oer.The rst payment must be submittedwith your Form 656. You mustcontinue to make regular paymentsduring your oer investigation. Failureto make regular payments during youroer investigation will cause your oer

to be withdrawn.The oer must include the realizablevalue o your assets plus any amountwe could collect over 60 months opayments (or the remainder o thestatutory period o collection, which-ever is less.) I you do not have thisinormation you may call our toll reenumber at 1-800-829-1040.

We may fle a Notice o Federal TaxLien on tax liabilities to be compro-mised under Short Term PeriodicPayment Oer.

n Deerred Periodic Payment Oer This option requires you to pay theoer amount over the remaining statu-tory period or collecting the tax. Thisoer option must include the realizablevalue o your assets plus the amountwe could collect through monthlypayments during the remaining lie o

the collection statute. As with the ShortTerm Periodic Payment above, therst payment must be submitted withyour Form 656. You must make regularpayments during your oer investiga-tion. Failure to make regular paymentsduring your oer investigation willcause your oer to be withdrawn.

NOTE: Generally the collectionstatute is 10 years rom thedate that your liability was

assessed. You can call the tollree number 1-800-829-1040

or assistance in calculatingthe remaining time on yourcollection statute.

Use the worksheet on pages 8 and 9,multipy the amount rom item 12, Box0, by the number o months remainingon the collection statute. Add thatamount to item 11, Box N, and use thetotal as the basis or your oer amountin Section IV o Form 656.

As with Short Term PeriodicPayment Oers, we may fle aNotice o Federal Tax Lien on tax

liabilities to be compromised underDeerred Periodic Payment Oer.

Note: The worksheet on Pages 8and 9 instructs wage earnersand sel-employed individualshow to fgure the appropriateamount or Lump Sum Cash,Short Term Periodic Payment

and Deerred PeriodicPayment Oers.


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Oer in Compromise Worsheet

Please see Pages 8 and 9.

Funding Your Oer

I you do not have the cash to pay youroer amount immediately, you shouldbegin the process o exploring optionsto nance your oer amount. Optionsyou may want to consider includeliquidating assets, obtaining a loan roma lending institution, borrowing on yourhome equity through a second mortgageor reverse mortgage, or borrowing undsrom amily members or riends.


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Kee

pthisfor

yourrec

ords

Worksheet to Calculate an Offer AmountFor use by Wage Earners and Self-Employed Individuals.

Keep this worksheet for your recordsDo not send to IRS.

Use this Worksheet tocalculate an offer amount

using information fromForm 433-A.

1. Enter total checking account balances from Item 11c

2. Enter total other account balances from Item 12c

If less than 0 , enter 0

3. Enter total investments from Item 13d

4. Enter total cash on hand from Item 14a

5. Enter life insurance cash value from Item 16f

6. Enter total accounts/notes receivable from Item 23m

Subtotal: Add boxes A through F =

A

B

C

E

D

F

G

From line 18a $ x .8 = $ $ =

From line 18b $ x .8 = $ $ =

From line 18c $ x .8 = $ $ =

Subtotal =

Enter current valuefor each asset

Enter loan balancefor each asset

Individualasset value(if less than 0 ,enter 0 )

7. Purchased Automobiles, Trucks, and Other Licensed Assets

H

From line 20a $ x .8 = $ $ =

From line 20b $ x .8 = $ $ =

Subtotal =



8. Real Estate

I

Individualasset value(if less than 0enter 0 )

From line 21b $ x .8 = $ $ =

From line 21c $ x .8 = $ $ =

From line 21d $ x .8 = $ $ =

From line 21e $ x .8 = $ $ =

Subtotal =

From line 21a $ x .8 = $ $ =

Subtract $ 7720.00

Subtotal =

Enter current value

for each assetEnter loan balancefor each asset

9. Personal Assets

J

K

From line 22b $ x .8 = $ $ =

From line 22c $ x .8 = $ $ =

From line 22d $ x .8 = $ $ =

From line 22e $ x .8 = $ $ =

Subtotal =

From line 22a $ x .8 = $ $ =

Subtract $ 3860.00

Subtotal =



10. Business Assets

L

M

Individualasset value

(if less than 0enter 0 )

Individual

asset value(if less than 0 ,enter 0 )

Keep this worksheet or your recordDo not send to IRS.


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Keepthis

for

you

rrecords

13b.

If you will pay the offer amount in morethan 5 months but less than 2 years:

x 60

Enter amountfrom Box N

Add amountsin Box S andBox T

11. Add amounts in Boxes G through M to obtain your total equity and assets =

12. Enter amount from Item 34 $

Enter amount from Item 45 and subtract $

Net Difference =

This amount would be available

to pay monthly on your tax liability.

N

O

13a.

If you will pay the offer amountin 5 months or less:

Enter amountfrom Box O

Multiply by x 48

=

+

P

Q

=R

Use the amount

from Box R to base

your offer amount

in Section IV of Form

656.

Note: Your offer

amount must equal

or exceed (*) the

amount shown in

Box R.

Enter amountfrom Box N

Enter amountfrom Box O

Multiply by

=

+

S

T

= U

$$

Use the amount

from Box U to base

your offer amount

in Section IV of Form

656.

Note: Your offer

amount must equal

or exceed (*) the

amount shown in

Box U.

Add amountsin Box P andBox Q

If Box O is 0 or less, STOP. Usethe amount from Box N to baseyour offer amount in Section IV of F656. Your offer amount must eq

or exceed (*) the amount shownBox N.

Note: Do not compute your offer amount using 13a or 13b if yourstatute expiration date(s) is less than five years from the date of youroffer. Instead, refer to Page 6 under Deferred Payment Offer.

* Unless you are submitting an offer under effective tax administration or doubt as to collectibilitywith special circumstances considerations, as described on Page 1.

(or the number of monthsremaining on the ten-yearstatutory period for collection,

whichever is less)

(or the number of monthsremaining on the ten-yearstatutory period for collection,

whichever is less)

By law, the IRS has the authority to collect outstanding ederal taxes or ten years rom the dateyour liability is assessed. There may be circumstances that extend the ten year collection statutesuch as when a taxpayer les bankruptcy or an Oer in Compromise.

The IRS may adjust the RCP during the investigation to a higher or lower amount, dependingupon the acts and circumstances o your individual case.

5 months or less:


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Completing Form 656, Offer in CompromiseStep Four:

Note: I you have any questions about completing this orm, you may call toll ree at18008291040 or visit your local IRS ofce or our website at www.irs.gov.We may return your oer i you ail to ollow these instructions.

Section I: Enter your name and home or businessstreet address. Show both names ona joint oer or joint liabilities. You alsoshould include a mailing address i it isdierent rom your street address.

I you owe a liability

Jointly with another person andboth oyou agree to submit an oer, send onlyone Form 656, Oer in Compromise,

and one $150 application ee (or Form656-A, i applicable) and one payment(20% o the amount oered or frst initial

payment).

By yoursel (such as employment taxes),and other liabilities with another person(such as income taxes), but only youare submitting an oer, then listalltaxliabilities on one Form 656 and submitone $150 application ee (or Form 656-A,

i applicable) and one payment (20% oamount oered or frst initial payment).

By yoursel and another one jointly,andboth o you submit an oer, thenyou must showalltax liabilities on

your Form 656 and submit one $150application ee (or Form 656-A, i

applicable) and payment (20% o oeramount or frst initial payment).The otherperson should show onlythe joint taxliability on their Form 656 and submit one$150 application ee (or Form 656-A, i

applicable) and payment (20% o amountoered or frst initial payment)

Please see the matrix in Step 5, Page 12,or urther instructions and examples.

Enter the social security number(s)or the person(s) submitting the oer. Forexample, enter the social security numbero both spouses when submitting a jointoer or a joint tax liability. However,when only one spouse submits an oer,enter only that spouses social securitynumber

Enter the employer identication numberor oers rom businesses.

Show the employer identicationnumbers or all other businesses that youown or in which you have an ownershipinterest, even i they are not included inthe oer.

Section II: Identiy the type o tax liability you oweand enter the tax year or period. Lettersand notices rom us and Notices o

Federal Tax Lien show the tax periods ortrust und recovery penalties.

Section III: Check the appropriate box(es)describing the basis or your oer.

Doubt as to Collectibility oers requireyou to complete a Form 433-A, CollectionInormation Statement or Wage Earners

and Sel-Employed Individuals, i you arean individual taxpayer, or a Form 433-B, Collection Inormation Statement orBusinesses, i you are a corporation or otherbusiness taxpayer.

Eective Tax Administration oersrequire you to complete a Form 433-A,Collection Inormation Statement orWage Earners and Sel-EmployedIndividuals, i you are an individualtaxpayer, or a Form 433-B, CollectionInormation Statement or Businesses,i you are a corporation or otherbusiness taxpayer. Complete Section VI,Explanation o Circumstances.

Note: Attach to the upper let corner o Form 656 the six (6) pages o the collectioninormation statement(s) and all related documents beore you send it to us.


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Section IV: Enter the total amount o your oer(see Page 5, Step Three, Determiningthe Amount o Your Oer).Your oeramount cannot include a reund weowe you or amounts you have alreadypaid.

Check the appropriate payment box (LumpSum Cash Oer, Short Term PeriodicPayment Oer, or Deerred PeriodicPayment Oer see Page 6, DetermineYour Payment Terms) and describe yourpayment plan in the spaces provided.

Section V: It is important that you understandthe requirements listed in this section.Pay particular attention to Items (d), ()

and (g), as they address the uturecompliance provision and reunds.

Section VI: Explain your reason(s) or submittingyour oer in the Explanation o

Circumstances. You may attach

additional sheets i necessary.Include your name and SSN or EIN

on all attachments.

Section VII: Explain where you will get the unds topay the amount you are oering.

Section VIII: AllpersonssubmittingtheoermustsignanddateForm656.Includetitlesoauthorizedcorporateofcers,

executors,trustees,PowersoAttorney,etc.,whereapplicable.

Section IX: IsomeoneotherthanthetaxpayerpreparedthisOerinCompromise,the

taxpayershouldinsertthenameandaddressothepreparer(i known) inSectionIX.

Section X: PaidPreparerUseOnly. PleaseseethePrivacyActNoticeinForm656.

Section XI: IyouwanttoallowtheIRStodiscussyourOerinCompromisewithariend,amilymember,oranyotherperson,includinganindividualyoupaidtopreparethisorm,checktheYesboxinSectionXI,ThirdPartyDesignee,onyourForm656.Alsoenterthedesigneesnameandphonenumber.CheckingtheYesboxallowstheIRStocontactanotherpersonanddiscusswiththatpersonanyadditionalinormation

theIRSneedstoprocessyouroer.

ThisadditionalinormationmayincludeinormationabouttaxliabilitiesyouailedtolistinSectionIIonyourForm656orreturnsyouhaveailedtofle.Iyourcontactpersonisanattorney,CPA,orenrolledagentandyouwishtohavethemrepresentyouregardingthisoer,aForm2848,Power o Attorney andDeclaration o Representative,shouldbecompletedandsubmittedwithyouroer.

Note: Staple in the upper let corner the our (4) pages o Form 656 beore yousend it to us.


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Oer in Compromise Application Fee andPayments

Step Five:

One personis liable

Two peopleare liableor one jointliability

Two peoplehave jointliabilities butwant to leseparateoers

Two peoplehave jointliabilities andone has jointand separateliabilities

Corporationis proposingan oer

Partnershipis proposingan oer

Individualand Corpo-rate orPartnershipliabilities

Number oForms 656

required

1 1 2

Each willshow thejoint liabilities

2

One withthe joint andthe 2nd withthe joint andseparateliabilities

1 1 2

Number oees to be

sent with theForm 656*

1 - $150 ee 1 - $150 2 - $150 2 - $150 1 - $150 1 - $150 2 - $150

Lump SumCash Oer

amount to besent with the

Form 656

20% o theamountoered


20% oreach oeredamount





Amount

to be sentwith the

Short Termor Deerred

PeriodicPayment

Oer

First

paymentamountshown inSection IV othe Form 656

First


First

payment oreach oerthat is shownin Section IVo the Form656

First

payment oreach oerthat is shownin Section IVo the Form656

First


First


First

paymentor eachoer that isshown inSection IV othe Form 656

A. The application ee and payment are due on all oers at the time you submit your oer. Please stapleboth the application ee and payment to the ront o your Form 656. Any oer submitted without theapplication and payment will be returned to you without urther consideration.

* EXCEPTION: I you certiy that your total monthly household income is at or below levels based

on the IRS OIC Low Income Guidelines, then you may be exempt rom the application ee and thepayment (20% o the amount oered or the initial payment) as described above. The exceptionor taxpayers with incomes below these levels only apply to individuals. It does not apply to otherentities such as corporations, partnerships, and LLC.s.

To determine i you qualiy or the exemption, please complete the attached Oer in CompromiseApplication Fee and Payment Worksheet. I you do qualiy, then you must complete and sign orm656A.

B. Do not send cash. Please make all checks or money orders payable to the United States Treasury.

C. The application ee can only be returned to you i the IRS determines that your oer is not process-able. I your oer is determined to be not processable (see Page 2 or the 3 processable require-ments), then IRS will return your application ee.


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However i your oer is determined to be not processable and you have made either the 20%initial payment or Lump Sum Cash oer, or the rst initial installment or the Short Term PeriodicPayment Oer or Deerred Periodic Payment Oer, these payments will not be reunded to you.They will be applied to your outstanding tax liability and your oer will be returned to you as notprocessable.

D. I your oer is determined to be processable and later in the investigation, the oer is returned,rejected, or withdrawn, the application ee and payments will be applied to your outstandingtax liability.

E. I you have any additional questions about your Oer in Compromise, application ee orpayments, please call toll ree at 1-800-829-1040, visit our web site at www.irs.gov or visit yournearest IRS oce. You will nd the exact address in your local phone book under U.S. Govern-ment.


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Where to File IF YOU RESIDE IN

AND

You are a wage earner, retiree, or asel-employed individual withoutemployees,

THEN MAIL

Form 656 and attachments to:

Memphis Internal Revenue ServiceCenter COIC UnitPO Box 080, AMCMemphis, TN 38130-0803

IF YOU RESIDE IN

Arkansas, Connecticut, Delaware, District o Columbia, Florida, Georgia, Illinois,Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota,Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, NorthDakota, Ohio, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, South Carolina,South Dakota, Vermont, Virginia, West Virginia or have a oreign address,

Alaska, Alabama, Arizona, Caliornia, Colorado, Hawaii, Idaho, Kentucky, Louisiana,Mississippi, Montana, Nevada, New Mexico, Oregon, Tennessee, Texas, Utah,Washington, Wisconsin or Wyoming,

AND

You are OTHER than a wage earner,retiree, or a sel-employed individualwithout employees,

THEN MAIL


Memphis Internal Revenue ServiceCenter COIC UnitPO Box 0804, AMCMemphis, TN 38130-0804

AND

You are a wage earner, retiree, or asel-employed individual withoutemployees,

THEN MAIL


Brookhaven Internal Revenue ServiceCenter COIC UnitPO Box 007Holtsville, NY 11742-9007

AND

You are OTHER than a wage earner,retiree, or a sel-employed individualwithout employees,

THEN MAIL


Brookhaven Internal Revenue ServiceCenter COIC UnitPO Box 008Holtsville, NY 11742-9008

Where You Need to Send Your OerStep Six:


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What to Expect Ater the IRS ReceivesYour Oer

Step Seven:

How We ConsiderYour Oer

An oer examiner will evaluate your oerand may request additional documentationrom you to veriy nancial or otherinormation you provide. The examiner willthen make a recommendation to accept orreject the oer. The examiner may also

return your oer i you do not providethe requested inormation. The examinermay decide that a larger oer amount isnecessary to justiy acceptance. You willhave the opportunity to amend your oer.

AdditionalAgreements

When you submit certain oers, we mayalso request that you sign an additionalagreement requiring you to:

Pay a percentage o your utureearnings.

Waive certain present or uture taxbenets.

Withholding

CollectionActivities

There are certain circumstances wherewe will withhold collection activities whilewe consider your oer. We will not act tocollect the tax liability:

While we investigate and evaluate youroer.

For 30 days ater we reject an oer.

While you appeal an oer rejection.

The above do not apply i we nd anyindication that you submitted your oer todelay collection or cause a delay which will

jeopardize our ability to collect the tax.

However, a Notice o Federal TaxLien may be fled at any time while

your oer is being considered

Periodic PaymentsRequirements

I you choose one o the Periodic Paymentoptions, then you are required to continueto make payments while your oer is beinginvestigated. The removable Form 656-PPV is to be used to make these periodic

payments. The instructions to completeForm 656-PPV are contained on the ormas well as the proper address to mail yourpayments to. It is important to note that

the address where you send your periodicpayments is dierent rom the addresswhere you submit your oer orm. Besure you send your periodic payment andForm 656-PPV to the address listed on the

Form 656-PPV, as it applies to where youoriginally led your oer.

NOTE: Step Seven continues on Page 16.


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I We AcceptYour Oer

I we accept your oer, we will notiy youby mail. When you receive your acceptanceletter, you must:

Promptly pay any unpaid amountsthat become due under the terms othe oer agreement. You must complywith the payment terms specied in theagreement in a timely manner or youroer and agreement will be in deault.

Comply with all the terms and conditionso the oer, along with those o anyadditional agreement.

Promptly notiy us o any change oaddress until you meet the conditionso your oer. Your acceptance letterwill indicate the IRS oce to contact iyour address changes. Your noticationallows us to contact you immediatelyregarding the status o your oer.

We will release all Notices o Federal TaxLien when you satisy the payment termso the oered amount. For an immediaterelease o a lien, you can submit certiedunds with a request letter to the addresson the acceptance letter.

Once your oer is accepted, not flingreturns or paying taxes when due couldresult in the deault o an accepted oer(see Section V (d) o Form 656 or the

uture compliance provision). I you deaultyour agreement, we will reinstate theunpaid amount o the original tax liability,le a Notice o Federal Tax Lien on any taxliability without a led notice, and resumecollection activities. The uture complianceprovision applies to all oers based onDoubt as to Collectibility and EectiveTax Administration oers.

We will not deault your oer agreementwhen you have led a joint oer with yourspouse or ex-spouse as long as you havekept or are keeping all the terms o the

agreement, even i your spouse or ex-spouse violates the uture complianceprovision.

The oer agreement requires you toorego certain reunds, and to return thosereunds to us i they are issued to you bymistake. These conditions are also listedon Form 656, Sections V () and (g). Forexample, i your oer was accepted by theIRS in the tax year 2006, the IRS wouldkeep the reund due to you with respectto the tax year 2006, which you wouldnormally receive in calendar year 2007(because the due date or fling the tax year

2006 is April 15, 2007).

If We Reject YourOffer

We will notiy you by mail i we rejectyour oer. In our letter, we will explain ourreason or the rejection. We will also keepyour $150 application ee and payments.I your oer is rejected, you have theright to:

Appeal our decision to the Oce oAppeals within thirty days rom thedate o our letter. The letter will include

detailed instructions on howto appeal the rejection.


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Oer in Compromise Summary ChecklistStep Eight:

Below is a checklist o items that you should review and complete prior to submittingyour Form 656, Oer in Compromise. This checklist is solely or your benet, so do notsubmit with your oer.

Did you answer YES to question oneon Page 2? I you did, then pleasedo not submit Form 656 because youare not eligible to have your oerconsidered at this time.

Did you answer NO to questionstwo or three on Page 2? I you did,then please do not submit Form 656

because you are not eligible to haveyour oer considered at this time.

Have you properly completedForm 656, Oer in Compromise,by ollowing the instructions onPages 10 and 11?

The preprinted terms and conditionslisted on Form 656 have not beenaltered or deleted.

Are you using the most currentversions o Form 656, Form 433-A,and Form 433-B as instructed onPage 4?

You included your name (or names,i joint).

You included your social securitynumber (SSN) (both SSNs are

required i fling a joint oer) and/oremployer identication number (EIN)and it is accurate.

You included an oer amount(the amount must be greater than

zero) or payment term.

You signed the Form 656. I this isa joint Form 656, both spouses mustsign Form 656.

You included complete nancialinormation (Form 433-A or Form

433-B, or both) and all attachmentsas instructed on Page 4.

You either attached theapplication ee in the designatedarea on the Form 656 or attachedthe Form 656-A certifcation,whichever is applicable. Iyou attached Form 656-A, thenyoumust complete the Oer inCompromise (OIC)Application Feeand Payment Worksheet and attach

it to your oer.

You have attached to Form 656either the 20% payment or theLump Sum Cash oer, or the rstinstallment payment or either theShort Term Periodic Payment orDeerred Periodic Payment, ORattached Form 656-A certication,which ever is applicable. I youattached Form 656-A, then you mustcomplete the OIC Application Feeand Payment Worksheet.

You signed or initialed in all requiredplaces on Form 433-A and/orForm 433-B.

Your oer amount is greater thanor equal to the reasonable collectionpotential (RCP) as described onPage 5 and calculated on Page9, unless your oer is based onEective Tax Administration.

I applicable, are Sections IX and XI,on Form 656 completed?

I applicable, is Section X on Form

656 completed and signed?

Have you properly identied whereto mail your Form 656 rom theinstructions on Page 14?

I you have any questions, please call our toll-ree number at 8008040. Youcan get orms and publications by calling toll ree at 8008676(800TAXFORM), or by visiting your local Internal Revenue Service (IRS)ofce or our website at www.irs.gov.


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Important Inormation Regarding theOer in Compromise

Statute o Limitations or Assessmentand Collection is Suspended Thestatute o limitations or assessment andcollection o a tax debt is suspendedwhile an OIC is pending, or beingreviewed. The Oer in Compromise ispending starting with the date an au-thorized IRS employee determines theForm 656 Oer in Compromise, can beprocessed and signs the Form 656. TheOIC remains pending until an authorizedIRS employee accepts, rejects, returns,or acknowledges withdrawal o the oer

in writing. I a taxpayer appeals an OICthat was rejected, the IRS will continue totreat the OIC as pending until the Ap-peals Oce accepts or rejects the OIC inwriting.

Taxpayers Must File and Pay Taxes In order to avoid deaulting an OIC onceit is accepted by the IRS, taxpayers mustremain in compliance in the ling andpayment o all required taxes or a periodo ve years, or until the oered amountis paid in ull, whichever is longer. Failureto comply with these conditions will resultin the deault o the OIC and the rein-

statement o the tax liability.Federal Tax Liens Are Not Released I there is a Notice o Federal Tax Lien onrecord prior to the OIC being submitted,the lien is not released until the terms o theoer in compromise are satised, or untilthe liability is paid, whichever comes rst.

The IRS generally les a Notice o FederalTax Lien to protect the Governments inter-est on all payment oers. This tax lien willbe released when the payment terms o theoer agreement have been satised.

Eect o the Oer on the TaxpayersReund The IRS will keep any reund,including interest due to the taxpayer be-cause o overpayment o any tax or otherliability, or tax periods extending throughthe calendar year that the IRS acceptsthe oer. The taxpayer may not desig-nate an overpayment ordinarily subject toreund, to which the IRS is entitled, to beapplied to estimated tax payments or theollowing year.

Eect o the Oer on Levies The IRSwill keep all payments and credits made,received or applied to the total original

tax liability beore submission o this oer.The IRS may keep any proceeds roma levy served prior to submission o theoer, but not received at the time the oeris submitted. I a levy has been servedprior to submission o the oer, or i a levywas served ater the oer was led, thenimmediately contact the IRS person orunction whose name and phone numberappear on the levy as the contact person.

Public Inspection Files or AcceptedOer in Compromise Files The lawrequires IRS to make certain inormationrom accepted Oers in Compromiseavailable or public inspection and review.These public inspection les are locatedin designated IRS Area Oces. It is im-portant to know that certain inormationregarding your accepted Oer in Compro-mise will be publicly known.

Taxpayer Advocate Services TheTaxpayer Advocate Service (TAS) is anindependent organization within the IRSwhose employees assist taxpayers whoare experiencing harm, who are seekinghelp in resolving tax problems that have

not been resolved through normal chan-nels, or who believe that an IRS systemor procedure is not working as it should.I you believe you are eligible or TASassistance, you can reach TAS by callingtoll ree 1-877-777-4778, orTTY/TTD 1-800-829-4059.

Low Income Taxpayer Clinic (LITC) Low Income Taxpayer Clinics areindependent organizations that provide lowincome taxpayers with representation inFederal tax controversies with the IRS orree or or a nominal charge. The clinicsalso provide tax education and outreach or

taxpayers with limited English prociency orwho speak English as a second language.IRS Publication 4134, Low Income Taxpay-er Clinic List, provides inormation on clinicsin your area and is available through theIRS website at HYPERLINK http://www.irs.gov www.irs.gov, by phone at1-800-TAX-FORM (1-800-829-3676),or at your local IRS oce.

Penalties and Interest Penalites andinterest will continue to accrue on yourunpaid balance o assessment(s) whileyour oer is being considered.


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Necessary Expenses Necessaryexpenses are the allowable paymentsyou make to support you and youramilys health and welare and/or theproduction o income. This expensedoes not apply to businesses. Seeour web site at www.irs.gov or anexplanation o National StandardExpenses and the amounts that areallowed. We derive these amountsrom the Bureau o Labor StatisticsConsumer Expenditure Survey. We alsouse inormation rom the Bureau o the

Census to determine local expenses orhousing, utilities, and transportation.

NOTE:IftheIRSdeterminesthatthefactsandcircumstancesofyoursituationindicatethatusingthescheduledallowanceofnecessaryexpensesisinadequate,wewillallowyouanadequatemeansforprovidingbasiclivingexpenses.Howeveryoumustprovidedocumentationthatusing

nationalandlocalexpensestandardsleavesyouaninadequatemeansofprovidingforbasiclivingexpenses.

Quic Sale Value (QSV) The amountyou could reasonably expect rom thesale o an asset i you sold it quickly,typically in ninety days or less. Thisamount generally is less than currentvalue, but may be equal to current value,based on local circumstances.

Realizable Value The quick sale

value amount minus what you owe to asecured creditor. The creditor must havepriority over a led Notice o Federal TaxLien beore we allow a subtraction romthe assets value.

Reasonable Collection Potential (RCP) The total realizable value o yourassets plus your uture income. The totalis generally your minimum oer amount.

Terms and Defnitions

An understanding o the ollowingterms and conditions will help you toprepare oers based upon doubt asto collectibility or eective taxadministration.

Current Value The amount youcould reasonably expect rom the saleo an asset today. Provide an accuratevaluation o each asset. Determinevalue rom realtors, used car dealers,publications, urniture dealers, or otherexperts on specic types o assets.

Please include a copy o any writtenestimate with your Collection InormationStatement.

Expenses Not Generally Allowed We typically do not allow you to claimtuition or private schools, public orprivate college expenses, charitablecontributions, voluntary retirementcontributions, payments on unsecureddebts such as credit card bills, cabletelevision charges and other similarexpenses as necessary living expenses.However, we may allow these expenses

when you can prove that they arenecessary or the health and welare oyou or your amily or or the productiono income.

Future Income We generallydetermine the amount we could collectrom your uture income by subtractingnecessary living expenses rom yourmonthly income over a set number omonths. For a lump sum cash oerpaid in ve months or less, you mustoer what you could pay in monthlypayments over orty-eight months (or

the remainder o the ten-year statutoryperiod or collection, whichever is less).For a Lump Sum Cash Oer paid inmore than ve months or a Short TermPeriodic Payment Oer, you must oerwhat you could pay in monthly paymentsover 60 months (or the remainder o the

statutory period or collection, whicheveris less). For a deerred periodic paymentoer, you must oer what you couldpay in monthly payments during theremaining time we could legally receivepayments.


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Attach Application Fee and Payment (check or money order)here.

Department of the Treasury Internal Revenue Service

Offer in Compromise

Catalog Number 16728N Form 656 (Rev. 2-2007)www.irs.gov

Form 656(February 2007)

Social Security Number (SSN)

- -

(Primary)

- -

(Secondary)Employer Identification Number (EIN)(EIN included in offer)

-

(EINnotincluded in offer)

-

Taxpayer's First Name and Middle Initial Last Name

Taxpayer's Address (Home or Business)(number, street, and room or suite no., city, state, ZIP code)

Mailing Address (if different from above)(number, street, and room or suite no., city, state, ZIP code)

Section I Taxpayer Contact Information

To: Commissioner of Internal Revenue ServiceSection III/We(includes all types of taxpayers)submit this offer to compromise the tax liabilities plus any interest, penalties, additions to tax, and additional amountsrequired by law (tax liability) for the tax type and period marked below: (Please mark an X in the box for the correct description and fill-in the correct tax period(s),adding additional periods if needed).

1040/1120 Income Tax Year(s)

941 Employers Quarterly Federal Tax Return Quarterly period(s)

940 Employers Annual Federal Unemployment (FUTA) Tax Return Year(s)

Trust Fund Recovery Penalty as a responsible person of (enter corporation name)

for failure to pay withholding and Federal Insurance Contributions Act taxes (Social Security taxes), for period(s) ending

Other Federal Tax(es) [specify type(s) and period(s)]

Note: If you need more space, use a separate sheet of paper and title it Attachment to Form 656 Dated _________________ . Sign and date theattachment following the listing of the tax periods.

Reason for Offer in CompromiseSection III

I/We submit this offer for the reason(s) checked below:

Doubt as to Collectibility I have insufficient assets and income to pay the full amount. You must include a complete Collection InformationStatement, Form 433-A and/or Form 433-B.

Effective Tax Administration I owe this amount and have sufficient assets to pay the full amount, but due to my exceptional circumstances,requiring full payment would cause an economic hardship or would be unfair and inequitable. You must include a complete Collection InformationStatement, Form 433-A and/or Form 433-B and complete Section VI.

Offer in Compromise TermsSection IV

I/We offer to pay $ (must be more than zero). Complete Section VII to explain where you will obtain the funds to make this offer.

Check only one of the following:

Lump sum cash offer 20% of the amount of the offer $ must be sent with Form 656. Upon written acceptance of the offer, thebalance must be paid in 5 or fewer installments.

IRS RECEIVED DATE

DATE RETURNED

$ payable within months after acceptance$ payable within months after acceptance$ payable within months after acceptance$ payable within months after acceptance$ payable within months after acceptance

Short Term Periodic Payment Offer Offer amount is paid within 24 months from the date IRS received your offer. The first payment must besubmitted with your Form 656. You must make regular payments during your offer investigation. Complete the following:

$ will be submitted with the Form 656. Beginning in the month after the offer is submitted (insert month ), on the

day of each month, $ will be sent in for a total of months. (Cannot extend more than 24 months from the date

the offer was submitted.)

If a joint offer, spouses First Name and Middle Initial Last Name

Business Name


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Page 2 of 4


Optional - Designation of Required Payment under IRC 7122(c)

$ paid under IRC 7122 (c) is to be applied to my Tax Year/Quarter(s)(whichever is applicable) for my/our taxform .

Section IV Cont.

You have the option to designate the required payment you made under Section IV above. If you chose not to designate your required payment, thenthe IRS will apply your payment in the best interest of the government. Please complete the following if you choose to designate your payment:

(a) I/We voluntarily submit all tax payments made on thisoffer, including the mandatory payments of tax required undersection 7122(c). These tax payments are not refundable evenif I/we withdraw the offer prior to acceptance or the IRSreturns or rejects the offer. If the offer is accepted, the IRS willapply payments made after acceptance in the best interest ofthe government.

(b) Any payments made in connection with this offer will beapplied to the tax liability unless I have specified that they betreated as a deposit. Only amounts that exceed themandatory payments can be treated as a deposit. Such adeposit will be refundable if the offer is rejected or returned bythe IRS or is withdrawn. I/we understand that the IRS will notpay interest on any deposit.

(c) The application fee for this offer will be kept by the IRSunless the offer was not accepted for processing.

(d) I/We will comply with all provisions of the Internal RevenueCode relating to filing my/our returns and paying my/ourrequired taxes for 5 years or until the offered amount is paid infull, whichever is longer. In the case of a jointly submittedOffer in Compromise joint liabilities, I/we understand thatdefault with respect to the compliance provisions described inthis paragraph by one party to this agreement will not result inthe default of the entire agreement. The default provisionsdescribed in Section V(i) of this agreement will be applied onlyto the party failing to comply with the requirements of thisparagraph.

(e) I/We waive and agree to the suspension of any statutoryperiods of limitation (time limits provided by law) for the IRSassessment of the liability for the periods identified in Section

II. I/We understand that I/we have the right not to waivethese statutory periods or to limit the waiver to a certain lengthor to certain periods. I/We understand, however, that the IRSmay not consider this offer if I/we refuse to waive the statutoryperiods for assessment or if we provide only a limited waiver.The amount of any Federal tax due for the periods describedin Section II may be assessed at any time prior to theacceptance of this offer or within one year of the rejection ofthis offer. I/We understand that the statute of limitations forcollection will be suspended during the period an offer isconsidered pending by the IRS (paragraph (k) of this sectiondefines pending).

(f) The IRS will keep all payments and credits made, receivedor applied to the total original liability before submission of thisoffer and all payments required under section 7122(c). TheIRS will also keep all payments in excess of those required bysection 7122(c) that are received in connection with the offerand that are not designated as deposits in Section IV. TheIRS may keep any proceeds from a levy served prior tosubmission of the offer, but not received at the time the offeris submitted. As additional consideration beyond the amountof my/our offer, the IRS will keep any refund, includinginterest, due to me/us because of overpayment of any tax orother liability, for tax periods extending through the calendaryear in which the IRS accepts the offer. The date ofacceptance is the date on the written notice of acceptanceissued by the IRS to me/us or to my/our representative. I/Wemay not designate an overpayment ordinarily subject torefund, to which the IRS is entitled, to be applied to estimatedtax payments for the following year.

(g) I/We will return to the IRS any refund identified inparagraph (f) received after submission of this offer.

(h) The IRS cannot collect more than the full amount of theliability under this offer.

(i) I/We understand that I/we remain responsible for the fullamount of the liabilities, unless and until the IRS accepts theoffer in writing and I/we have met all the terms and conditionsof the offer. The IRS will not remove the original amount ofthe liabilities from its records until I/we have met all the termsand conditions of the offer. I/We understand that the liabilitiesI/we offer to compromise are and will remain liabilities untilI/we meet all the terms and conditions of this offer. If I/we filefor bankruptcy before the terms and conditions of this offer

are completed, any claim the IRS files in the bankruptcyproceedings will be a tax claim

(j) Once the IRS accepts the offer in writing, I/we have noright to contest, in court or otherwise, the amount of theliability.

(k) The offer is pending starting with the date an authorizedIRS official signs the form. The offer remains pending until anauthorized IRS official accepts, rejects, returns oracknowledges withdrawal of the offer in writing. If I/we appealan IRS rejection decision on the offer, IRS will continue totreat the offer as pending until the Appeals Office accepts orrejects the offer in writing.

By submitting this offer, I/we have read, understand and agree to the following conditions:Section V

Deferred Periodic Payment Offer Offer amount will be paid over the remaining life of the collection statute. The first payment must besubmitted with your Form 656. You must make regular payments during your offer investigation. Complete the following:

$ will be submitted with the Form 656. Beginning in the month after the offer is submitted (insert month ), on the

day of each month, $ will be sent in for a total of months.

If you pay more than the required payment when you submit your offer and want any part of that additional payment treated as a deposit, check thebox below and insert the amount. It is not required that you designate any portion of your payment as a deposit. Note: If the required payment is notpaid, the offer will be returned even if you make a payment you designate as a deposit.

I am making a deposit of $ with this offer.


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Page 3 of 4


If I/we don't file a protest within 30 days of the date the IRSnotifies me/us of the right to protest the decision, I/we waive theright to a hearing before the Appeals Office about the Offer inCompromise.

(l) If I/we fail to meet any of the terms and conditions of theoffer and the offer defaults, the IRS may:

n immediately file suit to collect the entire unpaid balance ofthe offer;

n immediately file suit to collect an amount equal to theoriginal amount of the liability, minus any payment alreadyreceived under the terms of this offer;

n disregard the amount of the offer and apply all amountsalready paid under the offer against the original amount ofthe liability; and/or

n file suit or levy to collect the original amount of the liability,without further notice of any kind.

The IRS will continue to add interest, as section 6601 of theInternal Revenue Code requires, on the amount the IRSdetermines is due after default. The IRS will add interest from

the date the offer is defaulted until I/we completely satisfy theamount owed.

(m) The IRS generally files a Notice of Federal Tax Lien toprotect the Government's interest on offers with deferredpayments. Also, the IRS may file a Notice of Federal Tax Lienduring the offer investigation. This tax lien will be releasedwhen the payment terms of the offer agreement have beensatisfied.

(n) I/We understand that IRS employees may contact thirdparties in order to respond to this request and I/we authorizethe IRS to make such contacts. Further, by authorizing the IRSto contact third parties, I/we understand that I/we will notreceive notice, pursuant to section 7602(c) of the InternalRevenue Code, of third parties contacted in connection withthis request.

(o) I/We are offering to compromise all the liabilities assessedagainst me/us as of the date of this offer and under thetaxpayer identification numbers listed in Section II above. I/Weauthorize the IRS to amend Section II, above, to include anyassessed liabilities we failed to list on Form 656.

Explanation of CircumstancesSection VI

I am requesting an Offer in Compromise for the reason(s) listed below:

Source of FundsSection VII

I / We shall obtain the funds to make this offer from the following source(s):

Note:If you believe you have special circumstances affecting your ability to fully pay the amount due, explain your situation. You may attach additionalsheets if necessary. Please include your name and SSN or EIN on all additional sheets or supporting documentation.


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Page 4 of 4


Mandatory SignaturesSection VIII

I accept the waiver of the statutory period of limitations on assessment for the Internal Revenue Service, as described in Section V(e).

If I / We submit this offer on a substitute form, I / we affirm that this form is a verbatim duplicate of the official Form 656,

and I/we agree to be bound by all the terms and conditions set forth in the official Form 656.

TaxpayerAttestation

Signature of Taxpayer Date

Signature of Taxpayer Date

Signature of Authorized Internal Revenue Service Official DateTitle

Application Prepared by Someone Other than the TaxpayerSection IX

If this application was prepared by someone other than the taxpayer, please fill in that persons name and address below.

Address (if known)(Street, City, State, ZIP code)

Privacy Act Statement

We ask for the information on this form to carry out the internal revenue laws of the United States. Our authority to request this information is Section 7801 of the InternalRevenue Code.

Our purpose for requesting the information is to determine if it is in the best interests of the IRS to accept an Offer in Compromise. You are not required to make an Offer inCompromise; however, if you choose to do so, you must provide all of the taxpayer information requested. Failure to provide all of the information may prevent us fromprocessing your request.

If you are a paid preparer and you prepared the Form 656 for the taxpayer submitting an offer, we request that you complete and sign Section X on Form 656, and provideidentifying information. Providing this information is voluntary. This information will be used to administer and enforce the internal revenue laws of the United States and maybe used to regulate practice before the Internal Revenue Service for those persons subject to Treasury Department Circular No. 230, Regulations Governing the Practice ofAttorneys, Certified Public Accountants, Enrolled Agents, Enrolled Actuaries, and Appraisers before the Internal Revenue Service. Information on this form may be disclosedto the Department of Justice for civil and criminal litigation.

We may also disclose this information to cities, states and the District of Columbia for use in administering their tax laws and to combat terrorism. Providing false orfraudulent information on this form may subject you to criminal prosecution and penalties.

Name

Paid Preparer Use OnlySection X

Signature of Preparer Date Check ifself-employed

Preparer's CAF no. or PTIN

Firm's name (or yours if self-employed), address, and ZIP code EIN

Telephone number( )

Telephone number

( )

Third Party DesigneeSection XI

Official Use Only

Under penalties of perjury, I declare that I have examined this offer, including accompanying schedules and statements,and to the best of my knowledge and belief, it is true, correct and complete.

Do you want to allow another person to discuss this offer with the IRS? Yes. Complete the information below. No

Designee's name

Name of Preparer


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Oer in Compromise Application Fee and Payment Worsheet

IyouansweredYEStoquestiononeonPage2,then do not proceed any urther.Youarenoteligibletohaveyouroerconsideredatthistime.

IyouansweredNOtoquestiononeonPage2othisbooklet,thenyoumaybeeligibletohaveyouroer

consideredandyoumayproceedcompletingtheworksheet.However,itisimportantthatyouusethe

currentversionForm656(Rev.02-2007),Oer in Compromise,andthe(Rev.5-2001)versionsoForms433-A,Collection Information Statement for Wage Earners and Self-Employed Individuals,and/or433-B,Collection

Inormation Statement or Businesses that are included in this package.

TheapplicationeeandpaymentdoesnotapplytoindividualswhoseincomeallsatorbelowlevelsbasedonIRSOersinCompromiseMonthlyLowIncomeGuidelines.Theexceptionortaxpayerswithincomesbelowtheselevelsonlyappliestoindividuals;itdoesnotapplytootherentitiessuchascorporationsorpartnerships.Iyouareselemployed,thenyoumustfrstlookatSection9,Line27otheForm433A.Iyouenteredanetincomeromyourbusiness,thenyoumayneedtomakeanadjustmentorthisitem.Forthepurposesodeterminingitem2,TotalHouseholdMonthlyIncome,youmustdeductanydepreciationoassetsthatyouitemizedonyourTaxForm1040ScheduleC,thatwasusedtodetermineyournetincomeromyourbusiness,line27.Adjustingline27willaecttheamountonline34otheForm433A.Thereoreline34mustbeadjustedandcarriedovertothisworksheetitem2orTotalHouseholdMonthlyIncome.Iyouhadnodepre-ciationoassetsonScheduleC,thenthereisnoadjustmenttobemade.

I you are an individual, ollow the steps below to determine i you must remit the application ee along with yourForm 656, Oer in Compromise.

1. Family Unit Size_____. Enter the total number o dependants (including yoursel and your spouse) listed in Section 1o Form 433-A, Collection Inormation Statement or Wage Earners and Sel-Employed individuals.

2. Total Household Monthly Income_____________. Enter the amount o your total household monthly income romSection 9, Line 34 o the Form 433-A, Collection Inormation Statement or Wage Earners and Sel-EmployedIndividuals. Please see Page 4 under Step Two, item 5, or a denition o total household income.

3. Compare the inormation you entered in items 1 and 2, above, to the monthly IRS OIC Monthly Low Income Guide-lines table below. Find the "Family Unit Size" equal to the number you entered in item 1. Next, nd the column whichrepresents where you reside (48 Contiguous states, DC , Hawaii or Alaska). Compare the Total Household MonthlyIncome you entered in item 2 to the number in the row and column that corresponds to your amily unit size andresidence. For example, i you reside in one o the 48 contiguous states, and your amily unit size rom item 1 above is

4, and your total household monthly income rom item 2 above is $3000, then you are exempt rom the ee andpayment because your income is less than the $4,167 guideline amount.

IRS OIC Monthly Low Income GuidelinesSize of Family Unit 48 Contiguous States and D.C. Hawaii Alaska

1 $2,042 $2,348 $2,552

2 $2,750 $3,163 $3,438

3 $3,458 $3,977 $4,323

4 $4,167 $4,792 $5,208

5 $4,875 $5,606 $6,094

6 $5,583 $6,421 $6,979

7 $6,292 $7,235 $7,865

8 $7,000 $8,050 $8,750

For each additional person, add $708 $815 $885

4. I the total household monthly income you entered in item 2 is more than the amount shown or your amily unit sizeand residence in the monthly IRS OIC Monthly Low Income Guidelines table above,you must send the $50 appli-cation ee and any 0% payment or frst initial installment with each OIC you submit.

Your check or money order should be made payable to the "United States Treasury" and attached to the ront o yourForm 656, Oer In Compromise. Do Not Send Cash. Send a separate application ee with each OIC; do not combine itwith any other tax payments as this may delay processing o your OIC. Your OIC will be returned to you without urtherconsideration i the application ee and the required payments are not properly remitted, or i your check is returned orinsucient unds.

5. I the total income you entered in item 2 is equal to or less than the amount shown or your amily unit size and residence inthe table above, do not send the application ee or the required payments. Sign and date Form 656-A, Income Certifcationor Oer in Compromise Application Fee and Payment.Attach the certifcation and this worsheet to the ront o your

Form 656.


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Income Certification for Offer in CompromiseApplication Fee and Payment

(For Individual Taxpayers Only)

Catalog Number 28300X Form 656-A (Rev. 2-2007)www.irs.gov

Form 656-A(February 2007)

Social Security Number (SSN) orTaxpayer Identification Number (TIN)

If you are not required to submit the fee or payments based on your income level, you must complete this formand attach both it and the worksheet to the front of your Form 656.

Your Name (Last, First, Middle initial) (Please Print)

Social Security Number (SSN) orTaxpayer Identification Number (TIN)

Spouse's Name (Last, First, Middle initial) (Please Print)

DateYour Signature

DateSpouse's Signature(if submitting a joint Offer in Compromise)

Certification: I/We certify under penalty of perjury that I am not required to submit an Offer in Compromise applicationfee and payment, based on my family unit size and income.

Note: If the Internal Revenue Service determines that you were required to pay a fee or payment, your Offer inCompromise will be returned without further consideration.


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Offer in Compromise - Periodic Payment Voucher

Catalog Number 31131Y Form 656-PPV (2-2007)www.irs.gov

Form 656-PPV(February 2007)

Your Social Security Number (SSN) orEmployer Identification Number (EIN)

Taxpayer's First Name and Initial Taxpayer's Last Name

Amount of Your Payment

(Cents)(Dollars)

Apply Payment to: (optional)

Taxpayer's Address (number, street, and room or suite no., city, state, ZIP code)

Form

Period

Offer Number

$

If you filed an offer in compromise and the offered amount is to be paid in 24 months or fewer (Short Term Periodic Payment Offer) or monthlyinstallments paid within the statutory period (Deferred Periodic Payment Offer) in accordance with the Tax Increase Prevention and ReconciliationAct of 2005, you must continue to make the payments during the investigation of the offer until you receive a decision letter (accepted, rejected,returned, or withdrawn). Mail this voucher with your check or money order payable to the "United States Treasury." Write your social security number oremployer identification number on the check or money order. Do not send cash. You may designate a specific tax liability to apply the payments. If youchose to do this, please write it in the "Apply to" section of the 656-PPV.

Enclose your payment with this voucher and mail to:

For those offers originally sent to Holtsville, NY, please send payments to: P.O. Box 9011, Holtsville, NY 11742For those offers originally sent to Memphis, TN, please send payments to: AMC-Stop 880, PO Box 30834, Memphis, TN 38130-0834

(Please Print or Type)


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7

7. Are you or your spouse self-employed or operate a business? (Check Yes if either applies)

No Yes If yes, provide the following information:

7a. Name of Business

7b. Street Address

City State Zip

Section 1PersonalInformation

Section 2YourBusinessInformation

Section 4OtherIncomeInformation

Collection Information Statement for Wage Earnersand Self-Employed Individuals

Section 3EmploymentInformation

Section 5 begins on page 2

Complete all entry spaces with the most current data available.

Important! Write N/A (not applicable) in spaces that do not apply. We may require additional informationto support N/A entries.Failure to complete all entry spaces may result in rejection or significant delay in the resolution of your account.

Check this boxwhen all spaces inSect. 1 are filled in.

Check this boxwhen all spaces inSect. 2 are filled inand attachmentsprovided.

Check this box

when all spaces inSect. 3 are filled inand attachmentsprovided.

Page 1 of 6


10. Do you receive income from sources other than your own business or your employer? (Check all that apply.)

Pension Social Security Other (specify, i.e. child support, alimony, rental)

7c. Employer Identification No., if available :

7d. Do you have employees? No Yes

7e. Do you have accounts/notes receivable? No Yes

If yes, please complete Section 8 on page 5.

ATTACHMENTS REQUIRED: Please provide proof of pension/social security/other income for thepast 3 months from each payor, including any statements showing deductions. If year-to-dateinformation is available, send only 1 such statement as long as a minimum of 3 months isrepresented.

Attachments

ATTACHMENTS REQUIRED: Please include proof of self-employment income for the prior 3months (e.g., invoices, commissions, sales records, income statement).

Attachments

1a. HomeTelephone ( )

Street Address

City State Zip

County of Residence

How long at this address?

3. Your Social Security No.(SSN) 3a. Your Date of Birth (mm/dd/yyyy)

4. Spouses Social Security No. 4a. Spouses Date of Birth (mm/dd/yyyy)

5. Own Home Rent Other (specify, i.e. share rent, live with relative)

6. List the dependents you can claim on your tax return: (Attach sheet if more space is needed.)

First Name Relationship Age Does this personlive with you?

No Yes

No Yes

2. Marital Status:

1. Full Name(s)

First Name Relationship Age Does this personlive with you?

No Yes

No Yes

Married Separated

Unmarried (single, divorced, widowed)

Best Time To Call:am pm

(Enter Hour)

www.irs.gov

Form 433-A (Rev. 5-2001)Catalog Number 20312N

8. Your Employer 9. Spouses Employer

Street Address Street Address

City State Zip City State Zip

Work telephone no. ( ) Work telephone no. ( )

May we contact you at work? No Yes May we contact you at work? No Yes

8a. How long with this employer? 9a. How long with this employer?

8b. Occupation 9b. Occupation

ATTACHMENTS REQUIRED: Please provide proof of gross earnings and deductions for the past3 months from each employer (e.g., pay stubs, earnings statements). If year-to-date informationis available, send only 1 such statement as long as a minimum of 3 months is represented.

Attachments

(Rev. 5-2


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16

CurrentValue:Indicate theamount youcould sell theasset fortoday.

Name SSN

Collection Information Statement for Wage Earners and Self-Employed Individuals Form 433-A

Section 5Banking,Investment,Cash, Credit,and LifeInsuranceInformation

Complete all

entry spaces

with the most

currentdata

available.

Section 5 continued on page 3Page 2 of 6

13d. Total Investments $

13. INVESTMENTS. List all investment assets below. Include stocks, bonds, mutual funds, stock options, certificates of deposits, andretirement assets such as IRAs, Keogh, and 401(k) plans. (If you need additional space, attach a separate sheet.)

13a.

13b.

Number ofShares / Units

CurrentValue

Used as collateralon loan?Name of Company

$ No Yes

No Yes

LoanAmount

$

13c. No Yes

15. AVAILABLE CREDIT. List all lines of credit, including credit cards.

Full Name ofCredit Institution Credit Limit Amount Owed Available Credit

Name

Street Address

City/State/Zip

Name

Street Address

City/State/Zip 15c. Total Credit Available

15a.

15b.

$

$

$

14. CASH ON HAND. Include any money that you have that is not in the bank.

14a. Total Cash on Hand $

12. OTHER ACCOUNTS. List all acounts, including brokerage, savings, and money market, not listed on line 11.

Type of Full Name of Bank, Savings & Loan, Bank Bank CurrentAccount Credit Union or Financial Institution Routing No. Account No. Account Balance

$Name

Street Address

City/State/Zip

$Name

Street Address

City/State/Zip 12c. Total Other Account Balances

12a.

12b.

$

ATTACHMENTS REQUIRED: Please include your current bank statements (checking, savings,money market, and brokerage accounts) for the past three months for all accounts.

Attachments

11. CHECKING ACCOUNTS. List all checking accounts. (If you need additional space, attach a separate sheet.)

$Checking Name

Street Address

City/State/Zip

$Checking NameStreet Address

City/State/Zip

11a.

11b.

Type of Full Name of Bank, Savings & Loan, Bank Bank CurrentAccount Credit Union or Financial Institution Routing No. Account No. Account Balance

11c. Total Checking Account Balances $

(Rev. 5-20


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9

Section 6OtherInformation

Section 7Assets andLiabilities

CurrentValue:Indicate theamount youcould sell theasset fortoday.

Section 7 continued on page 4Page 3 of 6


18. PURCHASED AUTOMOBILES, TRUCKS AND OTHER LICENSED ASSETS. Include boats, RVs, motorcycles, trailers, etc.(If you need additional space, attach a separate sheet.)

Description(Year, Make, Model, Mileage)

CurrentLoanBalance

Name ofLender

Amount ofMonthlyPayment

$ $ $

18a.

18b.

18c.

PurchaseDate

CurrentValue

Year

Make/Model

Mileage

Year

Make/Model

Mileage

Year

Make/Model

Mileage

$ $ $

$ $ $


Section 5continued

17. OTHER INFORMATION. Respond to the following questions related to your financial condition: (Attach sheet if you needmore space.)

Name SSN


17a. Are there any garnishments against your wages? No Yes

If yes, who is the creditor? Date creditor obtained judgement Amount of debt $

17b. Are there any judgments against you? No Yes

If yes, who is the creditor? Date creditor obtained judgement Amount of debt $

17c. Are you a party in a lawsuit? No YesIf yes, amount of suit $ Possible completion date Subject matter of suit

17d. Did you ever file bankruptcy? No Yes

If yes, date filed Date discharged

17e. In the past 10 years did you transfer anyassets out of your name for less than

their actual value? No Yes

If yes, what asset? Value of asset at time of transfer $

When was it transferred? To whom was it transferred?

17f. Do you anticipate any increase in householdincome in the next two years? No Yes

If yes, why will the income increase? (Attach sheet if you need more space.)

How much will it increase? $

17g. Are you a beneficiary of a trust or an estate? No Yes

If yes, name of the trust or estate Anticipated amount to be received $

When will the amount be received?

17h. Are you a par ticipant in a profit sharing plan? No Yes

If yes, name of plan Value in plan $

16. LIFE INSURANCE. Do you have life insurance with a cash value? No Yes

(Term Life insurance does not have a cash value.)

If yes:

16a. Name of Insurance Company

16b. Policy Number(s)

16c. Owner of Policy

16d. Current Cash Value $ 16e. Outstanding Loan Balance $

Subtract Outstanding Loan Balance line 16e from Current Cash Value line 16d = 16f $

ATTACHMENTS REQUIRED: Please include a statement from the life insurance companies thatincludes type and cash/loan value amounts. If currently borrowed against, include loan amountand date of loan.

Attachments

(Rev. 5-20


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18

Section 7continued

19. LEASED AUTOMOBILES, TRUCKS AND OTHER LICENSED ASSETS. Include boats, RVs, motorcycles, trailers, etc.(If you need additional space, attach a separate sheet.)

Description(Year, Make, Model)

LeaseBalance

Name andAddress ofLessor


$ $

19a.

19b.

LeaseDate

Year

Make/Model

YearMake/Model $ $

^ Date ofFinal Pay-ment:Enter the datethe loan orlease will befully paid.

20. REAL ESTATE. List all real estate you own. (If you need additional space, attach a separate sheet.)

DatePurchased

Street Address, City,State, Zip, and County

CurrentValue

Name of Lenderor Lien Holder


Dateof FinaPayme

LoanBalance

$ $ $

20a.

20b.

PurchasePrice

$

^

$ $$ $

CurrentValue:Indicate the

amount youcould sell theasset fortoday.

Section 8 begins on page 5Page 4 of 6


Description

Furniture/Personal Effects $ $

Other: (List below)

Artwork

Jewelry

21. PERSONAL ASSETS. List all Personal assets below. (If you need additional space, attach separate sheet.)Furniture/Personal Effectsincludes the total current market value of your household such as furniture and appliances.Other Personal Assetsincludes all artwork, jewelry, collections (coin/gun, etc.), antiques or other assets.

CurrentValue

LoanBalance Name of Lender


^Date ofFinalPayme

21a.

21b.

21c.

21d.

21e.

$

$ $ $

22. BUSINESS ASSETS. List all business assets and encumbrances below, include Uniform Commercial Code (UCC) filings. (If

you need additional space, attach a separate sheet.) Tools used in Trade or Business includes the basic tools or books used toconduct your business, excluding automobiles. Other Business Assetsincludes any other machinery, equipment, inventory orother assets.

CurrentValue

LoanBalance Name of Lender


^Date oFinalPaymeDescription

Tools used in Trade/Business $ $

Other: (List below)

Machinery

Equipment

22a.

22b.

22c.

22d.

22e.

$ $

$

$

ATTACHMENTS REQUIRED: Please include your current statement from lender with monthly carpayment amount and current balance of the loan for each vehicle purchased or leased.

Attachments

ATTACHMENTS REQUIRED: Please include your current statement from lender with monthlypayment amount and current balance for each piece of real estate owned.

Attachments

Name SSN


(Rev. 5-2


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11

Page 5 of 6

Section 8Accounts/NotesReceivable

Use only if

needed.

Check thisbox if Section

8 not needed.

23. ACCOUNTS/NOTES RECEIVABLE. List all accounts separately, including contracts awarded, but not

started. (If you need additional space, attach a separate sheet.)


Section 9 begins on page 6

Description Amount Due Date Due Age of Account

0 - 30 days

60 - 90 days

30 - 60 days

90+ days

$

$

$

23a. Name

Street Address

City/State/Zip

23b. Name

Street Address

City/State/Zip

23c. Name

Street Address

City/State/Zip

0 - 30 days

60 - 90 days

30 - 60 days

90+ days

0 - 30 days

60 - 90 days

30 - 60 days

90+ days

0 - 30 days

60 - 90 da

Documents

US Internal Revenue Service: f656