Fillable Form 656 - Offer In Compromise - Department Of The Treasury (Page 3 of 4) in pdf

Page 3 of 4

If I/we don't file a protest within 30 days of the date the IRS

(m) The IRS generally files a Notice of Federal Tax Lien to

notifies me/us of the right to protest the decision, I/we waive the

protect the Government's interest on offers with deferred

right to a hearing before the Appeals Office about the Offer in

payments. Also, the IRS may file a Notice of Federal Tax Lien

Compromise.

during the offer investigation. This tax lien will be released

when the payment terms of the offer agreement have been

(l) If I/we fail to meet any of the terms and conditions of the

satisfied.

offer and the offer defaults, the IRS may:

(n) I/We understand that IRS employees may contact third

immediately file suit to collect the entire unpaid balance of

parties in order to respond to this request and I/we authorize

the offer;

the IRS to make such contacts. Further, by authorizing the IRS

to contact third parties, I/we understand that I/we will not

immediately file suit to collect an amount equal to the

receive notice, pursuant to section 7602(c) of the Internal

original amount of the liability, minus any payment already

Revenue Code, of third parties contacted in connection with

received under the terms of this offer;

this request.

disregard the amount of the offer and apply all amounts

(o) I/We are offering to compromise all the liabilities assessed

against me/us as of the date of this offer and under the

already paid under the offer against the original amount of

the liability; and/or

taxpayer identification numbers listed in Section II above. I/We

authorize the IRS to amend Section II, above, to include any

file suit or levy to collect the original amount of the liability,

assessed liabilities we failed to list on Form 656.

without further notice of any kind.

The IRS will continue to add interest, as section 6601 of the

Internal Revenue Code requires, on the amount the IRS

determines is due after default. The IRS will add interest from

the date the offer is defaulted until I/we completely satisfy the

amount owed.

Section VI

Explanation of Circumstances

I am requesting an Offer in Compromise for the reason

listed below:

(s)

Note: If you believe you have special circumstances affecting your ability to fully pay the amount due, explain your situation. You may attach additional

sheets if necessary. Please include your name and SSN or EIN on all additional sheets or supporting documentation.

Section VII

Source of Funds

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

656

Catalog Number 16728N

Form

(Rev. 2-2007)

Form 656 - Offer In Compromise - Department Of The Treasury Page 3

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