Form 656-B - Offer In Compromise Booklet Page 12
Download a blank fillable Form 656-B - Offer In Compromise Booklet in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 656-B - Offer In Compromise Booklet with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32Page 4 of 8
Section 3
Personal Asset Information
(Continued)
Other valuable items
(artwork, collections, jewelry, items of value in safe deposit boxes, interest in a company or business that is not publicly traded, etc.)
Note: Do not include clothing, furniture and other personal effects.
Description of asset:
Current Market Value
Minus Loan Balance
$
X .8 = $
– $
=
(7a) $
Description of asset:
Current Market Value
Minus Loan Balance
$
X .8 = $
– $
(7b) $
=
Total value of valuable items listed from attachment [current market value X .8 minus any loan balance(s)]
(7c) $
Add lines (7a) through (7c) =
(7) $
Box A
Available Individual Equity in
Do not include amount on the lines with a letter beside the number. Round to the nearest whole dollar.
Assets
Do not enter a negative number. If any line item is a negative, enter "0" on that line.
$
Add lines (1) through (7) and enter the amount in Box A =
NOTE: If you or your spouse are self-employed, Sections 4, 5, and 6 must be completed before continuing with Sections 7 and 8.
Section 4
Self-Employed Information
If you or your spouse are self-employed (e.g., files Schedule(s) C, E, F, etc.), complete this section.
Is your business a sole proprietorship?
Address of Business
(If other than personal residence)
Yes
No
Name of Business
Employer Identification Number
Business Website
Trade Name or DBA
Business Telephone Number
(
)
-
Description of Business
Total Number of Employees
Frequency of Tax Deposits
Average Gross Monthly
Payroll $
Do you or your spouse have any other business interests? Include any
Business Address
(Street, City, State, ZIP code)
interest in an LLC, LLP, corporation, partnership, etc.
Yes
Title:
(Percentage of ownership:
)
No
Business Name
Employer Identification Number
Business Telephone Number
(
)
-
Type of business
(Select one)
Partnership
LLC
Corporation
Other
Section 5
Business Asset Information (for Self-Employed)
List business assets such as bank accounts, tools, books, machinery, equipment, business vehicles and real property that is owned/leased/rented. If
additional space is needed, attach a list of items. Do not include personal assets listed in Section 3.
Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative number, enter "0".
Cash
Checking
Savings
Money Market/CD
Online Account
Stored Value Card
Bank Name
Account Number
(8a) $
Cash
Checking
Savings
Money Market/CD
Online Account
Stored Value Card
Bank Name
Account Number
(8b) $
Total bank accounts from attachment
(8c) $
Add lines (8a) through (8c) =
(8) $
433-A (OIC)
Form
(Rev. 3-2017)
Catalog Number 55896Q
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial