Fillable Form Mo-656 - Offer In Compromise Application (Page 12 of 13) in pdf

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SECTION 9 SIGNATURES

Terms and Conditions

1. I/we will remain in compliance with all tax types for three years after acceptance of the offer.

2. The offer remains pending until an authorized Department official issues notification of acceptance or

rejection, or until the offer is withdrawn by me/us.

3. I/we understand that I/we voluntarily submit any payment made with this offer.

4. If the Department rejects the offer or if the offer is withdrawn, the Department will treat any paid amount

with the offer as payment toward the outstanding tax liability.

5. Collection activity is normally suspended while an offer is pending, but such suspension is not

required by law. I/we further understand that collection activity may continue if it is determined to

be in the state’s best interests, or if it is otherwise determined that the filing of the offer has not been

made in good faith.

6. The Department will retain any payment(s) toward the liability for which the offer is made if such

payment was made prior to receipt of the offer by the Department. The Department will retain and apply

all amounts due to refund offset when such amounts are received prior to full payment of an accepted

offer. An offset does not reduce the accepted Offer in Compromise amount.

7. I/we understand that the tax I/we owe is, and will remain, a tax liability until I/we meet all the terms and

conditions of the offer. If I/we file bankruptcy before the terms and conditions of the offer are completed,

any claim the Department files will be for the full amount less any payments.

8. Once the Department accepts the offer in writing, I/we have no right to contest, in court or otherwise,

the amount of tax liability.

9. I/we the taxpayer shall bear all of my/our own costs, including attorney fees.

10 . If I/we fail to meet the terms and conditions of an accepted offer, the compromise will be considered

null and void. Updated interest and penalties will be added to the total balance due until paid in full.

In addition the Department may:

• Immediately issue and record any tax liens necessary to protect the state’s legal interest;

• Proceed with enforced collection of the total outstanding liability;

• Apply amounts already paid under the offer to the total liability.

I/WE AGREE TO BE BOUND BY ALL THE TERMS AND CONDITIONS SET FORTH IN THIS OFFER. UNDER PENALTIES OF PERJURY, I DECLARE

THAT I HAVE EXAMINED THIS OFFER, INCLUDING ACCOMPANYING SCHEDULES AND STATEMENTS, AND TO THE BEST OF MY KNOWLEDGE

AND BELIEF, IT IS TRUE, CORRECT, AND COMPLETE. I ALSO DECLARE UNDER PENALTIES OF PERJURY THAT I EMPLOY NO ILLEGAL

OR UNAUTHORIZED ALIENS AS DEFINED UNDER FEDERAL LAW AND THAT I AM NOT ELIGIBLE FOR ANY TAX EXEMPTION, CREDIT, OR

ABATEMENT IF I EMPLOY SUCH ALIENS.

SIGNATURE OF TAXPAYER

DATE

SIGNATURE OF TAXPAYER SPOUSE/PARTNER

DATE

DOR USE ONLY

ON BEHALF OF THE MISSOURI DEPARTMENT OF REVENUE, I ACCEPT THE OFFER TO PAY FOR THE REASONS LISTED IN SECTION 2.

SIGNATURE OF AUTHORIZED DEPARTMENT OFFICIAL

TITLE

DATE

MO-656 (5-2012)

Form Mo-656 - Offer In Compromise Application Page 12

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