Fillable Form Ga-9465 - Installment Agreement Request printable pdf download

Installment Agreement Request

PLEASE READ:

•

DO NOT submit this form if you are currently in bankruptcy, have unfiled state tax returns that are past due, have a pending

offer in compromise with the Department, or your state tax liability has been assigned to a private collection agency.

If your liability has been assigned to a private collection agency, contact that agency.

•

https://gtc.dor.ga.gov.

DO try and submit this form electronically by visiting the Department’s Georgia Tax Center at

Please note that you will not be able to submit an installment payment agreement request via the Georgia Tax Center if you

have an active protest or appeal, are subject to a Department enforcement action, are in bankruptcy, have an accepted offer

in compromise, or already have an active payment plan with the Department.

•

DO enter the Letter ID in Line 1 if you received a notice from the Department showing an amount due.

Instructions for Form GA- 9465, Installment Agreement Request

General Instructions

Purpose of Form

Use Form GA-9465 to request a monthly installment plan if

By approving your request, we agree to let you pay the tax you

you cannot pay the full amount you owe shown on your tax

owe in monthly installments instead of immediately paying the

return (or on a notice we sent you). Generally, you can have

amount in full. In return, you agree to make your monthly

up to 36 months to pay. Before requesting an installment

payments on time. You also agree to meet all your future tax

agreement, you should consider other less costly alternatives,

liabilities. For example, this means that you must have

such as getting a bank loan or using available credit on a

enough withholding or estimated tax payments so that your

credit card.

income tax liability for future years is paid in full when you

timely file your return. Your request for an installment agree-

Do not file this form if you are in bankruptcy or have a pending

ment will be denied if all required tax returns have not been

offer-in-compromise. If your tax liability has been assigned to

filed.

a private collection agency, contact that particular agency for

payment plan options.

If a tax execution has already been recorded prior to the

approval of the agreement, the Department will not initiate

How the Installment Agreement Works

enforcement action against you to collect the outstanding tax

We will usually let you know within 30 days after we receive

debt. Upon default of the installment agreement, the Depart-

your request whether it is approved or denied. If we approve

ment may initiate all appropriate enforced collection activity.

your request, you will receive a notice detailing the terms

The issuance of a tax execution will result in the imposi-

of the agreement. Please note that an additional $50

tion of an additional 20% collection fee that will be added

administration fee will be added to the first payment due.

to the tax liability.

You may qualify to pay a reduced fee of $25 if your income is

less than $22,050.

Payment Method

You will also be charged interest and may be charged a late

payment penalty on any tax not paid by its due date, even if

The Department of Revenue accepts payment by electronic

your request to pay in installments is granted. Interest and

funds withdrawal from your checking or savings account at a

any applicable penalties will be charged until the balance is

bank or other financial institution.

paid in full. To limit interest and penalty charges, file your

Modification of an Installment Agreement

return on time and pay as much of the tax as possible with

After an installment agreement is approved, you may submit a

your return (or notice). All payments received will be applied

request to modify the original agreement. If the modification

to your account in the best interests of the State of Georgia.

is approved, the Department will charge you a $50

Also, any refund due you in a future tax period may be applied

administration fee.

You may qualify to pay a reduced

against the amount you owe. If there remains a balance after

administrative fee of $25 if your income is less than $22,050.

the refund is applied, you are still required to make your

You must comply with the existing agreement while the

regular monthly payments until the liability is paid in full. If the

Department considers your request to modify the agreement.

offset of your refund pays the assessment in full, we will

Termination of an Installment Agreement

cancel the automatic debit from your account. Any

If you do not make your payments on time or do not pay any

overpayment of your account will be refunded to you.

balance due on a return you file later, you will be in default on

your agreement and we may take enforcement actions, such

as the filing of a state tax execution or a levy or garnishment

action, to collect the entire amount you owe.

Form Ga-9465 - Installment Agreement Request

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