Form 656-L - Offer In Compromise (Doubt As To Liability) Page 8
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Third Party Designee
Section 9
Do you want to allow another person to discuss this offer with the IRS?
Yes. Complete the information below.
No
Designee’s Name
Telephone Number
(
)
Include a valid, signed Form 2848 or 8821 with this application or a copy of a previously filed form.
IRS Use Only
I accept the waiver of the statutory period of limitations on assessment for the Internal Revenue Service, as described in Section 5 (d).
Signature of Authorized IRS Official
Title
Date (mm/dd/yyyy)
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 contained
in Section 7801 of the Internal Revenue Code.
Our purpose for requesting the information is to determine if it is in the best interests of the IRS to accept an offer. You are not required to make an
offer; however, if you choose to do so, you must provide all of the information requested. Failure to provide all of the information may prevent us from
processing your request.
If you are a paid preparer and you prepared the Form 656-L for the taxpayer submitting an offer, we request that you complete and sign Section 8 on
the Form 656-L, and provide identifying information. Providing this information is voluntary. This information will be used to administer and enforce the
internal revenue laws of the United States and may be used to regulate practice before the Internal Revenue Service for those persons subject to
Treasury Department Circular No. 230, Regulations Governing the Practice of Attorneys, Certified Public Accountants, Enrolled Agents, Enrolled
Actuaries, and Appraisers before the Internal Revenue Service. Information on this form may be disclosed to 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 or fraudulent information on this form may subject you to criminal prosecution and penalties.
Application Checklist
Did you complete all fields and sign the Form 656-L?
Did you make an offer amount that is greater than zero ($0)?
If you want to allow the IRS to discuss your offer with another person did you complete the “Third-Party Designee”
section on the Form 656-L?
If someone other than you completed the Form 656-L, did that person sign it?
Did you sign and include the Form 656-L?
If you want a third party to represent you during the offer process, did you include a Form 2848 or Form 8821
unless one is already on file?
Did you include supporting documentation and an explanation as to why you doubt you owe the tax?
Note: There is no application fee or deposit required for a Doubt as to Liability offer.
Mail your package to:
Brookhaven Internal Revenue Service
COIC Unit
P.O. Box 9008
Holtsville, NY 11742-9008
Catalog Number 47516R
656-L
Form
(Rev. 2-2012)
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