Instructions For Form 9465 - Installment Agreement Request (Page 3 of 5) in pdf

For all taxpayers except those filing Form 1040 with

For all taxpayers living outside the 50 states, for any tax year

Schedule(s) C, E, or F for any tax year for which this installment

for which the installment agreement is being requested

agreement is being requested

IF you live in . . .

THEN use this address . . .

IF you live in . . .

THEN use this address . . .

A foreign country, American

Alaska, Arizona, Colorado,

Samoa, Puerto Rico (or are

Department of the Treasury

Connecticut, Delaware, District of

excluding income under section

Internal Revenue Service

Columbia, Hawaii, Idaho, Illinois,

933), Guam, or the U.S. Virgin

Department of the Treasury

3651 South I-H 35

Maine, Maryland, Massachusetts,

Islands, or use an APO or FPO

Internal Revenue Service

5501AUSC

Montana, Nevada, New

address, or file Form 2555,

310 Lowell St.

Austin, TX 78741

Hampshire, New Jersey, New

2555-EZ, or 4563, or are a

Stop 830

Mexico, North Dakota, Oregon,

dual-status alien

Andover, MA 01810

Rhode Island, South Dakota,

Tennessee, Utah, Vermont,

Washington, Wisconsin, Wyoming

For all taxpayers who are bona fide residents of Guam,

Alabama, Florida, Georgia,

Department of the Treasury

the U.S. Virgin Islands, or the Commonwealth of the

Kentucky, Louisiana, Mississippi,

Internal Revenue Service

Northern Mariana Islands, see Pub. 570, Tax Guide for

North Carolina, South Carolina,

P.O. Box 47421

Income From U.S. Possessions.

Texas, Virginia

Stop 74

Doraville, GA 30362

Specific Instructions

Arkansas, California, Indiana,

Department of the Treasury

Iowa, Kansas, Michigan,

Part I

Internal Revenue Service

Minnesota, Missouri, Nebraska,

Stop P-4 5000

New York, Ohio, Oklahoma,

Kansas City, MO 64999–0250

Line 1a

Pennsylvania, West Virginia

If you’re making this request for a joint tax return, show the

names and social security numbers (SSNs) in the same

order as they appear on your tax return.

For taxpayers filing Form 1040 with Schedule(s) C, E, or F for

If you have a foreign address, enter the city name on

any tax year for which this installment agreement is being

the appropriate line. Do not enter any other information on

requested

that line, but also complete the spaces below that line. Do

IF you live in . . .

THEN use this address . . .

not abbreviate the country name. Follow the country's

Connecticut, Maine,

Department of the Treasury

practice for entering the postal code and the name of the

Massachusetts, New Hampshire,

Internal Revenue Service

province, county, or state.

New York, Rhode Island, Vermont

P.O. Box 480

Stop 660

Line 1b

Holtsville, NY 11742-0480

If the address you provided on line 1a is new since you

Alabama, Arkansas, Georgia,

filed your last tax return, check the box on line 1b.

Illinois, Indiana, Iowa, Kansas,

Kentucky, Louisiana, Michigan,

Department of the Treasury

Line 2

Minnesota, Mississippi, Missouri,

Internal Revenue Service

Show the name and employer identification number (EIN)

Nebraska, New Jersey, North

P.O. Box 69

Dakota, Ohio, Oklahoma,

Stop 811

of your business (must no longer be operating).

Pennsylvania, South Dakota,

Memphis, TN 38101-0069

Line 5

Tennessee, Texas, West Virginia,

Wisconsin

Enter the total amount you owe as shown on your tax

Alaska, Arizona, California,

Department of the Treasury

return(s) or notice(s). The amount you owe could include

Colorado, Hawaii, Idaho,

Internal Revenue Service

amounts from more than one tax year.

Montana, Nevada, New Mexico,

P.O. Box 9941

Oregon, Utah, Washington,

Stop 5500

Line 6

Wyoming

Ogden, UT 84409

If you have additional balances due that are not reflected

District of Columbia, Delaware,

Department of the Treasury

on line 5, list the total here (even if they are included in an

Florida, Maryland, North Carolina,

Internal Revenue Service

existing installment agreement). Any adjustments or other

South Carolina, Virginia

Stop 4–N31.142

charges that are not reported on a tax return or notice

Philadelphia, PA 19255–0030

should be listed on this line.

Line 7

Add lines 5 and 6 and enter the result.

-3-

Instructions For Form 9465 - Installment Agreement Request Page 3

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