Instructions For Form 9465 (Rev. December 2012) (Page 2 of 3) in pdf

of a Notice of Federal Tax Lien or an IRS levy action, to collect the

For taxpayers filing Form 1040 with Schedule(s) C, E, or F for any tax year

entire amount you owe. To ensure that your payments are made

for which this installment agreement is being requested.

timely, you should consider making them by electronic funds transfer

(EFT) (see the instructions for lines 11a and 11b, later).

IF you live in . . .

THEN use this address . . .

Requests to modify or terminate an installment agreement.

Alabama, Arkansas, Georgia, Illinois,

Indiana, Iowa, Kansas, Kentucky,

After an installment agreement is approved, you may submit a

Department of the Treasury

Louisiana, Michigan, Minnesota,

request to modify or terminate an installment agreement. You may

Internal Revenue Service

Mississippi, Missouri, Nebraska, New

modify your payment amount or due date by going to IRS.gov,

P.O. Box 69

Jersey, North Dakota, Ohio, Oklahoma,

clicking on “Tools” and then “Online Payment Agreement.” You may

Stop 811

Pennsylvania, South Dakota,

also call 1-800-829-1040 to modify or terminate your agreement.

Memphis, TN 38101–0069

Tennessee, Texas, West Virginia,

Wisconsin

An installment agreement may be terminated if you provide

materially incomplete or inaccurate information in response

Alaska, Arizona, California, Colorado,

Department of the Treasury

TIP

to an IRS request for a financial update.

Hawaii, Idaho, Montana, Nevada, New

Internal Revenue Service

Mexico, Oregon, Utah, Washington,

P.O. Box 9941

Wyoming

Stop 5500

For additional information on the IRS collection process, see

Ogden, UT 84409

Pub. 594, The IRS Collection Process.

Connecticut, Maine, Massachusetts,

Department of the Treasury

A Notice of Federal Tax Lien (NFTL) may be filed to protect

New Hampshire, New York, Rhode

Internal Revenue Service

the government’s interests until you pay in full. However, an

Island, Vermont

P.O. Box 480

NFTL is generally not filed with a Guaranteed Installment

Stop 660

CAUTION

Agreement.

Holtsville, NY 11742–0480

Delaware, District of Columbia, Florida,

Department of the Treasury

Where To File

Maryland, North Carolina, South

Internal Revenue Service

Carolina, Virginia

Stop 4–N31.142

Attach Form 9465 to the front of your return and send it to the

Philadelphia, PA 19255–0030

address shown in your tax return booklet. If you have already filed

your return or you are filing this form in response to a notice, file

A foreign country, American Samoa, or

Puerto Rico (or are excluding income

Form 9465 by itself with the Internal Revenue Service Center using

under Internal Revenue Code section

Department of the Treasury

the address in the table below that applies to you.

933), or use an APO or FPO address, or

Internal Revenue Service

file Form 2555, 2555-EZ, or 4563, or are

3651 South I-H 35, 5501AUSC

a dual-status alien or nonpermanent

Austin, TX 78741

For all taxpayers except those filing Form 1040 with Schedule(s) C, E, or F

resident of Guam or the U.S. Virgin

for any tax year for which this installment agreement is being requested.

Islands*

IF you live in . . .

THEN use this address . . .

* Permanent residents of Guam or the U.S. Virgin Islands cannot use Form 9465.

Alabama, Florida, Georgia, Kentucky,

Department of the Treasury

Louisiana, Mississippi, North Carolina,

Internal Revenue Service

Specific Instructions

South Carolina, Texas, Virginia

P.O. Box 47421

Stop 74

Doraville, GA 30362

Alaska, Arizona, Colorado, Connecticut,

Line 1

Delaware, District of Columbia, Hawaii,

If you are making this request for a joint tax return, show the names

Idaho, Illinois, Maine, Maryland,

Department of the Treasury

and social security numbers (SSNs) in the same order as they

Massachusetts, Montana, Nevada, New

Internal Revenue Service

appear on your tax return.

Hampshire, New Jersey, New Mexico,

310 Lowell St.

North Dakota, Oregon, Rhode Island,

Stop 830

Line 2

South Dakota, Tennessee, Utah,

Andover, MA 01810

Vermont, Washington, Wisconsin,

If the address you provided on line 1 is new since you filed your last

Wyoming

tax return, check the box on line 2.

Arkansas, California, Indiana, Iowa,

Department of the Treasury

Kansas, Michigan, Minnesota, Missouri,

Internal Revenue Service

Line 7

Nebraska, New York, Ohio, Oklahoma,

Stop P-4 5000

Pennsylvania, West Virginia

Kansas City, MO 64999–0250

Enter the total amount you owe as shown on your tax return(s) (or

notice(s)).

A foreign country, American Samoa, or

Puerto Rico (or are excluding income

If the total amount you owe is greater than $25,000 but not

under Internal Revenue Code section

Department of the Treasury

more than $50,000, you must complete line 11 and agree to

933), or use an APO or FPO address, or

Internal Revenue Service

an Electronic Funds Transfer (EFT) Agreement to qualify

file Form 2555, 2555-EZ, or 4563, or are

3651 South I-H 35, 5501AUSC

CAUTION

for an Installment Agreement (IA) without completing a financial

a dual-status alien or nonpermanent

Austin, TX 78741

statement. If you do not agree to a DDIA, you must complete Form

resident of Guam or the U.S. Virgin

433-F, Collection Information Statement, and mail it with this form.

Islands*

* Permanent residents of Guam or the U.S. Virgin Islands cannot use Form 9465.

If the amount you owe is greater than $50,000, you must complete

Form 433-F and mail it with this form. You can download Form 433-F

at IRS.gov or order it by calling 1-800-TAX-FORM

(1-800-829-3676).

If the total amount you owe is not more than $50,000

(including any amounts you owe from prior years), you do

TIP

not need to file Form 9465; you can request an installment

agreement online. For more information see Applying online for a

payment agreement, earlier.

-2-

Instructions For Form 9465 (Rev. December 2012) Page 2

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