Form 656 Booklet - Offer In Compromise Page 17
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28Page 3 of 6
Section 2
Business Asset Information - (Continued)
If the business owns more properties, vehicles, or equipment than shown in this form, please list on an attachment.
Real Estate
If any total below results in a negative number, enter "0".
(Buildings, Lots, Commercial Property, etc.)
Property Address
Property Description
(Street Address, City, State, ZIP Code)
County and Country
Current Market Value
Less Loan Balance
(Mortgages, etc.)
$
X .8 = $
– $
Total Value of Real Estate = (4a) $
Property Address
(Street Address, City, State, ZIP Code)
Property Description
County and Country
Current Market Value
Less Loan Balance
(Mortgages, etc.)
$
X .8 = $
– $
Total Value of Real Estate = (4b) $
Total value of property(s) listed from attachment [current market value X .8 less any loan balance(s)]
(4c) $
Add lines (4a) through (4c) = (4)
$
Business Vehicles
. If additional space is needed, list on an attachment.
(cars, boats, motorcycles, trailers, etc.)
Vehicle Make
Year
Model
Mileage or Use Hours
Monthly Lease/Loan Amount
Lease
$
Loan
Current Market Value
Less Loan Balance
Total value of vehicle
(if the vehicle
$
X .8 = $
–
$
(5a) $
is leased, enter 0 as the total value) =
Vehicle Make
Year
Model
Mileage or Use Hours
Monthly Lease/Loan Amount
Lease
$
Loan
Current Market Value
Less Loan Balance
Total value of vehicle
(if the vehicle
$
X .8 = $
–
$
(5b) $
is leased, enter 0 as the total value) =
Vehicle Make
Year
Model
Mileage or Use Hours
Monthly Lease/Loan Amount
Lease
$
Loan
Current Market Value
Less Loan Balance
Total value of vehicle
(if the vehicle
$
X .8 = $
– $
(5c) $
is leased, enter 0 as the total value) =
Total value of vehicles listed from attachment [current market value X .8 less any loan balance(s)]
(5d) $
Add lines (5a) through (5d) = (5)
$
Other Business Equipment
Current Market Value
Less Loan Balance
Total value of equipment
(if
$
X .8 = $
– $
= (6a) $
leased, enter 0 as the total value)
Total value of equipment listed from attachment [current market value X .8 less any loan balance(s)]
(6b) $
IRS allowed exemption - (6c) $ 4,120
Total value of all business equipment =
If number is less than zero, enter zero. (6)
$
Box 1 Total Available Assets
Do not include the amount on lines with a letter beside the number.
$
Add lines (1) through (6) and enter the amount in Box 1 =
433-B (OIC)
Catalog Number 55897B
Form
(3-2011)
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