Offer In Compromise Application (Continued) Form - California Franchise Tax Board (Page 3 of 3) in pdf

State of California — Franchise Tax Board

Offer in Compromise Application (Continued)

5. BASIS FOR THE OFFER

The following facts and reasons are submitted as grounds for acceptance of this offer:

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(If more space is needed, please attach additional pages.)

6. It is understood that this offer will be considered and acted upon in due course and that it does not relieve the entity

from the liability sought to be compromised unless and until the offer is accepted by the Franchise Tax Board and

there has been full compliance with the terms of the agreement including any collateral agreement.

7. It is agreed that, except for any amounts deposited in connection with this offer, the Franchise Tax Board will keep

all payments and other credits made to the account for the periods covered by this offer, and that the Franchise Tax

Board will keep any and all amounts to which the entity may be entitled under the Revenue and Taxation Code, due

through overpayments of any tax, penalty or interest, for any periods ending before the end of the calendar year in

which this offer is accepted.

8. It is further agreed that upon notice to the entity of the acceptance of the offer, the entity shall have no right to contest

in court or otherwise the amount of the liability sought to be compromised. No liability will be compromised until all

obligations of the corporation under the compromise agreement or collateral agreement are completely performed. In

the event of a default by the corporation on the collateral agreement, it is agreed that the Franchise Tax Board may

disregard the amount of the offer and retain all amounts previously deposited under the offer and proceed to collect

the balance of the original liability.

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Under penalties of perjury, I declare that I have examined the information given in this statement and all other documents

included with this offer and to the best of my knowledge and belief, it is (or they are) true, correct and complete.

Date of the Statement

Signature

Title

____________________________

_________________________________________

_______________________

____________________________

_________________________________________

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FTB 4905BE C1 (NEW 05-2007)

Offer In Compromise Application (Continued) Form - California Franchise Tax Board Page 3