Form Cm-1 - Offer In Compromise
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STATE OF HAWAII — DEPARTMENT OF TAXATION
FORM CM-1
OFFER IN COMPROMISE
(REV. 2014)
Attach your check or money order payable to the "Hawaii State Tax Collector" here.
Section 1
Your Contact Information
Your first name, middle initial, last name
Your social security number
If this is a joint offer, spouse’s first name, middle initial, last name
Your spouse’s social security number
Your mailing address (number and street)
City or town, state, and postal/ZIP code
Your telephone number
Business name
Federal employer identification number
Your business mailing address (number and street)
City or town, state, and postal/ZIP code
Business telephone number
Name of your representative (attach Form N-848)
Your representative's telephone number
Section 2
Proposed or Assessed Tax Amounts
To: Director of Taxation
In the following agreement, the pronoun “we” may be assumed in place of “I” when there are joint liabilities and
both parties have signed this agreement.
I submit this offer to compromise the tax liabilities including interest, penalties, additions to tax, and additional
amounts required by law for the tax type(s) and period(s) listed below:
Type of Tax
Period
Amount of Tax
Amount of Penalty
Amount of Interest
Total Amount
If you need more space, attach another sheet of paper titled “Attachment to Form CM-1 dated_____.”
Section 3
Reason for Offer (Select one reason)
Doubt as to Collectibility - I have insufficient assets and income to pay the full amount.
Doubt as to Liability - I have a legitimate reason that I do not owe part or all of the tax debt. I am submitting a
written narrative with this offer to explain my circumstances.
Exceptional Circumstances (Effective Tax Administration) - I owe this amount and have sufficient assets to pay
the full amount, but due to my exceptional circumstances, requiring full payment would cause an economic
hardship or would be unfair and inequitable. I am submitting a written narrative with this offer to explain my
circumstances.
FORM CM-1
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