Form 656 - Offer In Compromise Page 3

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Page 3 of 4
Section 6
Designation of Down Payment and Deposit
(Optional)
If you want your payment to be applied to a specific tax year and a specific tax debt, please tell us the tax form
and
Tax Year/Quarter
. If you do not designate a preference, we will apply any money you send in to the governments best interest.
If you are paying more than the required payment when you submit your offer and want any part of that payment treated as a deposit, check the box
below and insert the amount.
I am making a deposit of $
with this offer.
Section 7
Source of Funds and Making Your Payment
Tell us where you will obtain the funds to pay your offer. You may consider borrowing from friends and/or family, taking out a loan, or selling assets.
Include separate checks for the payment and application fee.
Make checks payable to the "United States Treasury" and attach to the front of your Form 656, Offer in Compromise. All payments must be in U.S.
dollars. Do not send cash. Send a separate application fee with each offer; do not combine it with any other tax payments, as this may delay
processing of your offer. Your offer will be returned to you if the application fee and the required payments are not properly remitted, or if your check is
returned for insufficient funds.
Section 8
Offer Terms
By submitting this offer, I/we have read, understand and agree to the following terms and conditions:
Terms, Conditions, and Legal
a) I request that the IRS accept the offer amount listed in this offer application as payment of my outstanding tax
debt (including interest, penalties, and any additional amounts required by law) as of the date listed on this form. I
Agreement
authorize the IRS to amend Section 2 on page 1 in the event I failed to list any of my assessed tax debt. I
understand that my offer will be accepted, by law, unless IRS notifies me otherwise, in writing, within 24 months of
the date my offer was received by IRS.
IRS will keep my payments,
b) I voluntarily submit the payments made on this offer and understand that they are not refundable even if I
fees, and some refunds.
withdraw the offer or the IRS rejects or returns the offer. Unless I designated how to apply the required
payment (page 3 of this application), the IRS will apply my payment in the best interest of the government,
choosing which tax years and tax liabilities to pay off. The IRS will also keep my application fee unless the offer is
not accepted for processing.
c) The IRS will keep any refund, including interest, that I might be due for tax periods extending through the
calendar year in which the IRS accepts my offer. I cannot designate that the refund be applied to estimated tax
payments for the following year or the accepted offer amount. If I receive a refund after I submit this offer for any
tax period extending through the calendar year in which the IRS accepts my offer, I will return the refund as soon
as possible.
d) The IRS will keep any monies it has collected prior to this offer and any payments that I make relating to this
offer that I did not designate as a deposit. Only amounts that exceed the mandatory payments can be treated as a
deposit. Such a deposit will be refundable if the offer is rejected or returned by the IRS or is withdrawn. I
understand that the IRS will not pay interest on any deposit. The IRS may seize ("levy") my assets up to the time
that the IRS official signs and accepts my offer as pending.
Pending status of an offer
e) Once an authorized IRS official signs this form, my offer is considered pending as of that signature date and it
remains pending until the IRS accepts, rejects, returns, or terminates my offer or I withdraw my offer. An offer is
and right to appeal
also considered pending for 30 days after any rejection of my offer by the IRS, and during the time that any
rejection of my offer is being considered by the Appeals Office. An offer will be considered withdrawn when the
IRS receives my written notification of withdrawal by personal delivery or certified mail or when I inform the IRS of
my withdrawal by other means and the IRS acknowledges in writing my intent to withdraw the offer.
f) I waive the right to an Appeals hearing if I do not request a hearing within 30 days of the date the IRS notifies
me of the decision to reject the offer.
I must comply with my future
g) I will file tax returns and pay required taxes for the five year period beginning with the date of acceptance of this
offer. If this is an offer being submitted for joint tax debt, and one of us does not comply with future obligations,
tax obligations and
only the non-compliant taxpayer will be in default of this agreement.
understand I remain liable for
the full amount of my tax
h) The IRS will not remove the original amount of my tax debt from its records until I have met all the terms and
debt until all terms and
conditions of this offer. Penalty and interest will continue to accrue until all payment terms of the offer have been
conditions of this offer have
met. If I file for bankruptcy before the terms are fully met, any claim the IRS files in the bankruptcy proceedings
been met.
will be a tax claim.
i) Once the IRS accepts my offer in writing, I have no right to contest, in court or otherwise, the amount of the tax
debt.
I understand what will
j) If I fail to meet any of the terms of this offer, the IRS may levy or sue me to collect any amount ranging from the
unpaid balance of the offer to the original amount of the tax debt without further notice of any kind. The IRS will
happen if I fail to meet the
continue to add interest, as Section 6601 of the Internal Revenue Code requires, on the amount the IRS
terms of my offer (e.g.,
determines is due after default. The IRS will add interest from the date I default until I completely satisfy the
default).
amount owed.
I agree to waive time limits
k) To have my offer considered, I agree to the extension of the time limit provided by law to assess my tax debt
(statutory period of assessment). I agree that the date by which the IRS must assess my tax debt will now be
provided by law.
the date by which my debt must currently be assessed plus the period of time my offer is pending plus one
additional year if the IRS rejects, returns, or terminates my offer or I withdraw it. (Paragraph (e) of this section
656
Catalog Number 16728N
Form
(Rev. 5-2012)

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