Form 14431, 2013, Response To Proposed Adjustment(S) - Page 2
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Step C - Check the applicable payment option
Tip! Pay as much as you can now, as penalties and interest will continue to accrue on the unpaid balance. Make your check or money
order payable to "United States Treasury". Write the tax year, the tax return form number, your Taxpayer Identification Number (SSN/
EIN) and your phone number on your check or money order.
Option 1
• I/We are paying the proposed balance due of $
.
• Balance may not include all applicable penalties - refer to the Penalties Section on the attached letter.
Option 2
• I/We are making a partial payment of $
at this time.
Option 3
• I/We would like to request a payment plan to pay the tax owed.
• For additional information, please refer to the enclosed Publication 3498-A "Payment Options" section or at by
searching the key words, "Payment Options".
14431
Catalog Number 60746H
Form
(Rev. 2-2013)
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Parent category: Financial