Fillable Form Mo-656 - Offer In Compromise Application (Page 5 of 13) in pdf

purchase price, and the date. Attach

Subtract

total

living

expenses

Other Valuable Items:

supporting documentation of the

from total monthly income to obtain

Include cash, accounts receivable,

loan balance and your most recent

total disposable income.

artwork, collectibles, and any other

real personal property tax receipt

valuable items not previously listed.

STOP HERE! Complete sections

for each property.

Enter item, description, and current

6-8 only if you own a business or

market value.

you are self employed. Otherwise

Other Valuable Items:

skip to Section 9.

Include artwork, guns, collectibles,

Securities:

jewelry, and any other valuable

Include stocks, bonds, mutual funds,

SECTION 6: BUSINESS

items not previously listed. Enter

money market funds and 401(k),

INFORMATION

item, description, and current mar-

not previously listed. Enter the type

ket value.

Enter business name, Missouri tax

of security, location, record owner,

identification number, business ad-

quantity

denomination,

and

Credit Cards and Unsecured Lines

dress, telephone number, and web

current value. Attach supporting

of Credit:

site. Select the type of business and

documentation and additional pag-

Enter type of credit, name of creditor,

give a description of the business.

es as needed.

record owner, balance owed, and

Enter the average gross monthly

available credit. Attach supporting

Business Credit Cards and other

income and average number of

documentation of balances owed.

Lines of Credit:

employees for the past 12 months.

Life Insurance:

If you or your spouse own additional

Enter the type of credit, name of the

Enter name of insurance company,

businesses, complete an additional

creditor, record owner, balance

agent name and telephone number,

attachment with the information for

owed, and available credit. Attach

policy number, type of insurance,

each business.

supporting

documentation

face amount, and loan or cash

balances owed.

surrender value. Include copies of

SECTION 7: BUSINESS

Other Financial Information:

life insurance policies.

FINANCIAL INFORMATION

Indicate no or yes for the options in

Bank Accounts:

Securities:

this section. If “yes” is checked

Include certificates of deposit, etc.

Include stocks, bonds, mutual funds,

provide dates, explanation, and

Attach all pages of the most recent

money market funds and 401(k),

documentation. Transferred assets

three months bank statements for

not previously listed. Enter type of

include vehicles, equipment, and

each account. If you owe more than

security, location, record owner,

property sold, given away, donated,

$50,000, attach the most recent six

quantity or denomination, and cur-

or repossessed in the last 12

months of bank statements. Attach

rent value. Attach supporting docu-

months.

additional pages as needed.

mentation showing current value of

each.

Personal Property:

SECTION 8: BUSINESS

Include automobiles, boats, ATV’s,

Other Financial Information:

INCOME AND EXPENSE

motorcycles, recreational vehicles,

Indicate no or yes for the options

ANALYSIS

airplanes, machinery, and equipment

in this section. If “yes” is checked

Choose the accounting method

owned by or used in your business.

provide dates, explanation, and

Enter year, make, model/style, license

used and enter the dates for income

documentation. Transferred assets

number, lender/lien holder, current

and expenses. Enter gross monthly

may include any vehicles, equip-

market value, current payoff, and

income

and

monthly

business

ment, and property sold, given away,

available equity. Enter zero if equity

expenses for each category that

donated, or repossessed in the last

is less than zero. Attach copies of loan

applies. Attach proof of monthly

12 months.

statement including current payoff.

business

expenses

and

total

monthly income.

Real Property:

SECTION 5: PERSONAL

Before submitting your offer

For each property, enter description,

INCOME AND EXPENSE

county, parcel number, mortgage

read the terms and conditions in

ANALYSIS

lender’s name and address, current

Section 9.

Enter gross monthly income. Under

market value, loan balance, and

other, include income contributed

available equity. Include name of

SECTION 9: SIGNATURES

by others in the household. Enter

owner as it appears on the deed,

Signatures and dates are required

monthly expenses for each category

purchase price, and date. Attach

for your offer to be considered. If the

that applies. Attach proof of monthly

supporting documentation of loan

MO-656 is sent without signatures

living expenses such as receipts,

balance and most recent property

and dates the offer will be deemed

utility bills, tax payments, etc.

tax receipt for each property.

invalid.

Form Mo-656 - Offer In Compromise Application Page 5

Related Articles

Related forms

Related Categories