Form 12a200 - Kentucky Individual Income Tax Installment Agreement Request Page 2
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1
2INDIVIDUAL INCOME TAX
INSTALLMENT AGREEMENT REQUEST
GENERAL INFORMATION
A Kentucky taxpayer has the right to consideration of an
Setting up the Agreement
installment agreement for the payment of delinquent
taxes, interest, penalties and fees. The right to an
Taxpayers who believe they qualify for an installment
installment agreement is provided for in KRS 131.081(9)
agreement should complete Form 12A200, Individual
and is primarily dependent on the taxpayer’s inability
Income Tax Installment Agreement Request, and attach
to pay the amount due in full.
the form to the front of the return.
Eligibility for an Installment Agreement
State Tax Lien
An installment agreement should be requested only
Depending on the amount and length of the agreement,
when there is no other way of paying the liability on
a State Tax Lien may be filed. If a lien is filed, it will
time.
remain on the taxpayer’s credit record for up to
seven years after the liability is paid and the lien is
A taxpayer must clearly demonstrate an inability to pay
released.
the liability in full and the agreement must facilitate
collection. Generally this means that taxpayers who
Assistance
have the ability to pay with available funds or borrow
from a financial institution are not eligible.
Questions should be directed to:
Proposed Monthly Payment Amount
Division of Collections
Kentucky Department of Revenue
The monthly payment amount will be based upon the
P .O. Box 491
taxpayer’s ability to pay after considering the taxpayer’s
Frankfort, KY 40602-0491
monthly income and reasonable expenses. Allowable
(502) 564-4921, ext. 5354
expenses generally include reasonable amounts for
food, clothing, housing (and associated expenses),
Form 12A200, Individual Income Tax Installment
installment payments and other necessary living
Agreement Reques t, is available at Kentuck y
expenses. The proposed monthly payment amount
Taxpayer Service Centers located throughout the
should be as much as possible to minimize the length
Commonwealth. Forms may also be obtained from
of the agreement and the accrual of interest, penalties
the Internet at , or by contacting
and fees.
the Division of Collections or by sending a written
request to:
Interest, Penalties, Fees and Refund Offsets
FORMS
The law provides for the assessment of interest,
penalties and fees for tax liabilities paid after the
Operations and Support Services Branches
due date. Interest accrues at the tax interest rate (6
Kentucky Department of Revenue
percent for 2015). In addition, penalties of 2 percent
501 High Street
per month may be assessed on the unpaid tax. A 25
Frankfort, KY 40620
percent Cost of Collection Fee is imposed on tax due
(502) 564-3658
which becomes due and payable (generally 46 days
after the assessment date). Interest, penalties and fees
continue to accumulate while an installment agreement
is in place. Also, any money Kentucky may owe you
(tax refunds, etc.) will be offset to your outstanding
liability. Additionally, any federal income tax refund
that may become due to you may be offset to this
liability pursuant to 26 USC §6402(e). Penalties and
fees may be waived or reduced if the taxpayer files the
return on time, honors the payment agreement and/or
demonstrates reasonable cause.
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