Form 656 Booklet - Offer In Compromise Page 16

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Page 2 of 6
Section 2
Business Asset Information
If any total below results in a negative number, enter "0".
Enter the total amount available for each of the following
. Gather the most current statement from
(if additional space is needed, please include attachments)
banks, lenders on loans, mortgages
, monthly payments, loan balances, and accountant's depreciation schedules, if
(including second mortgages)
applicable. Also, include make/model/year/mileage of vehicles and current value of business assets. To estimate the current value, you may consult
resources like Kelley Blue Book ( ), NADA
, local real estate postings of properties similar to yours, and any other websites
( )
or publications that show what the business assets would be worth if you were to sell them.
Bank Account:
Checking
Savings
Money Market
Online Account
Stored Value Card
Bank Name
Account Number
(1a) $
Bank Account:
Checking
Savings
Money Market
Online Account
Stored Value Card
Bank Name
Account Number
(1b) $
Bank Account:
Checking
Savings
Money Market
Online Account
Stored Value Card
Bank Name
Account Number
(1c) $
Total value of bank accounts from attachment
(1d) $
Add lines (1a) through (1d) = (1)
$
Investment Account:
Stocks
Bonds
Other
Name of Financial Institution
Account Number
Current Market Value
Less Loan Balance
= (2a) $
$
X .8 = $
– $
Investment Account:
Stocks
Bonds
Other
Name of Financial Institution
Account Number
Current Market Value
Less Loan Balance
(2b) $
$
X .8 = $
– $
=
Total of investment accounts from attachment. [current market value X.8 less loan balance(s)]
(2c) $
Add lines (2a) through (2c) = (2)
$
Notes receivable - Do you have notes receivable?
Yes
No
If yes, attach current listing which includes name and amount of note(s) receivable.
Total notes receivable from attached listing = (3)
$
433-B (OIC)
Catalog Number 55897B
Form
(3-2011)

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