Fillable Form 656-L - Offer In Compromise (Doubt As To Liability) (Page 8 of 8) in pdf

Page 8

IRS Use Only

I accept the waiver of the statutory period of limitations on assessment for the Internal Revenue Service, as described in Section 4(g).

Signature of Authorized IRS Official

Title

Today's date (mm/dd/yyyy)

Privacy Act Statement

We ask for the information on this form to carry out the internal revenue laws of the United States. Our authority to request this information is contained

in Section 7801 of the Internal Revenue Code.

Our purpose for requesting the information is to determine if it is in the best interests of the IRS to accept an offer. You are not required to make an offer;

however, if you choose to do so, you must provide all of the information requested. Failure to provide all of the information may prevent us from

processing your request.

If you are a paid preparer and you prepared the Form 656-L for the taxpayer submitting an offer, we request that you complete and sign Section 8 on the

Form 656-L, and provide identifying information. Providing this information is voluntary. This information will be used to administer and enforce the

internal revenue laws of the United States and may be used to regulate practice before the Internal Revenue Service for those persons subject to

Treasury Department Circular No. 230, Regulations Governing the Practice of Attorneys, Certified Public Accountants, Enrolled Agents, Enrolled

Actuaries, and Appraisers before the Internal Revenue Service. Information on this form may be disclosed to the Department of Justice for civil and

criminal litigation.

We may also disclose this information to cities, states and the District of Columbia for use in administering their tax laws and to combat terrorism.

Providing false or fraudulent information on this form may subject you to criminal prosecution and penalties.

APPLICATION CHECKLIST

Did you include supporting documentation and an explanation as to why you doubt you owe the tax?

Did you complete all fields on the Form 656-L?

Did you make an offer amount that is $1 or more?

Note: The amount of your offer should be based on what you believe the correct amount of the tax debt

should be. However, you must offer at least $1. If you do not want to offer $1 or more, you should pursue the

alternative solutions provided under "What alternatives do I have to sending in an Offer in Compromise

(Doubt as to Liability)?" found on page 3.

If someone other than you completed the Form 656-L, did that person sign it?

Did you sign and include the Form 656-L?

If you want a third party to represent you during the offer process, did you include a Form 2848 or Form 8821 unless

one is already on file?

Note: There is no application fee or deposit required for a Doubt as to Liability offer. Do not send any

payments with this offer.

Mail your package to:

Brookhaven Internal Revenue Service

COIC Unit

P.O. Box 9008

Stop 681-D

Holtsville, NY 11742-9008

656-L

Catalog Number 47516R

Form

(Rev. 1-2018)

Form 656-L - Offer In Compromise (Doubt As To Liability) Page 8

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