Federal Offer in Compromise Booklet

Offer in Compromise Booklet
Form 656-B (Rev. 4-2023)
Form 656 Booklet

Offer in
Compromise
CONTENTS
■ What you need to know................................................................................. 1
■ Paying for your offer ..................................................................................... 3
■ How to apply ................................................................................................ 4
■ Completing the application package ............................................................ 5
■ Important information ................................................................................... 6
■ Removable Forms - Form 433-A (OIC), Collection Information Statement
for Wage Earners and Self-Employed Individuals; Form 433-B (OIC),
Collection Information Statement for Businesses; Form 656, Offer in
Compromise ................................................................................................. 7
■ Application Checklist .................................................................................... 29
IRS contact information
If you want to see if you qualify for an offer in compromise before filling out the paperwork, you may
use the Offer in Compromise (OIC) Pre-Qualifier tool. The questionnaire format assists in gathering
the information needed and provides instant feedback as to your eligibility based on the information
you provided. The tool will also assist you in determining a preliminary offer amount for consideration
of an acceptable offer but is not a guarantee of acceptance. Access the tool at IRS.gov/OICtool
or by scanning the QR code with your smart device.
If you have questions regarding qualifications for an offer in compromise, please call our toll-free number at
800-829-1040. A video on how to complete an offer in compromise is available for viewing on our website at
https://www.irsvideos.gov/Individual/PayingTaxes/CompletingForm656-OfferInCompromiseApplication. Forms
and publications are available by calling 800-TAX-FORM (800-829-3676), by visiting your local IRS office, or at
www.IRS.gov. For answers to frequently asked questions about the offer process from submission to closure
see Offer in Compromise FAQs.

Taxpayer resources
The Taxpayer Advocate Service (TAS) is an independent organization within the Internal Revenue Service
(IRS) that helps taxpayers and protects taxpayers' rights. TAS can offer you help if your tax problem is causing
a financial difficulty, you’ve tried and been unable to resolve your issue with the IRS, or you believe an IRS
system, process, or procedure just isn't working as it should. If you qualify for TAS assistance, which is always
free, TAS will do everything possible to help you. Visit www.taxpayeradvocate.irs.gov or call 877-777-4778.
Low Income Taxpayer Clinics (LITCs) are independent from the IRS and TAS. LITCs represent individuals
whose income is below a certain level and who need to resolve tax problems with the IRS. LITCs can represent
taxpayers in audits, appeals, and tax collection disputes before the IRS and in court. In addition, LITCs can
provide information about taxpayer rights and responsibilities in different languages for individuals who speak
English as a second language. Services are offered for free or a small fee. For more information or to find an
LITC near you, see the LITC page at www.taxpayeradvocate.irs.gov/litc or IRS Publication 4134, Low Income
Taxpayer Clinic List. This publication is also available online at www.irs.gov/forms-pubs or by calling the IRS
toll-free at 800-TAX-FORM (800-829-3676).

WHAT YOU NEED TO KNOW
What is an Offer?

An Offer in Compromise (offer) is an agreement between you (the taxpayer) and
the IRS that settles a tax debt for less than the full amount owed. The offer
program provides eligible taxpayers with a path toward paying off their tax debt.
The ultimate goal is a compromise that suits the best interest of both the taxpayer
and the IRS. Generally, you must make an appropriate offer based on what the
IRS considers your true ability to pay.
Submitting an application does not ensure that the IRS will accept your offer.
It begins a process of evaluation and verification by the IRS, taking into
consideration any special circumstances that may affect your ability to pay.
This booklet will lead you through a series of steps to help you calculate an
appropriate offer based on your assets, income, expenses, and future earning
potential. The application requires you to describe your financial situation in detail,
so before you begin, make sure you have the necessary information and
documentation.

Are You Eligible?

Before your offer can be considered, you must (1) file all tax returns you are legally
required to file, (2) have received a bill for at least one tax debt included on your
offer, (3) make all required estimated tax payments for the current year, and (4) if
you are a business owner with employees, make all required federal tax deposits
for the current quarter and the two preceding quarters.
Note: If it is determined you have not filed all tax returns you are legally
required to file, the IRS will apply any initial payment you sent with your offer
to your tax debt and return both your offer and application fee to you. You
cannot appeal this decision.

Bankruptcy, Open Audit or
Innocent Spouse Claim

If you or your business is currently in an open bankruptcy proceeding, you are not
eligible to apply for an offer. Any resolution of your outstanding tax debts generally
must take place within the context of your bankruptcy proceeding.
If you are not sure of your bankruptcy status, contact the Centralized Insolvency
Operation at 800-973-0424. Be prepared to provide your bankruptcy case number
and/or Taxpayer Identification Number.
Resolve any open audit or outstanding innocent spouse claim issues before
you submit an offer.

Can You Pay in Full?

Generally, the IRS will not accept an offer if you can pay your tax debt in full
through an installment agreement or equity in assets.
Note: Adjustments or exclusions, which may be considered during the offer
investigation, such as allowance of $1,000 to a bank balance or $3,450 against the
value of a car, are only applied if you are an individual and after it is determined
that you cannot pay your tax debt in full.

Your Tax Refunds

The IRS may keep any tax period refund, including interest, processed through the
date the IRS accepts your offer by offsetting it against your tax debt, as applicable.
Since your tax refund may be offset to the tax liability while the offer is pending,
assistance from Taxpayer Advocate or the IRS at 800-829-1040 could be available
for taxpayers (other than businesses) facing economic hardship. For example, the
IRS accepts your offer on July 1, 2022, and you file your 2021 Form 1040 on April
15, 2022, showing a refund; the IRS will apply that refund to your outstanding tax
debt. The refund is not considered as a payment toward your offer.

Doubt as to Liability

If you have a legitimate doubt that you owe part or all of the tax debt, complete and
submit a Form 656-L, Offer in Compromise (Doubt as to Liability). To request a
Form 656-L, visit www.IRS.gov or a local IRS office or call toll-free 800-TAXFORM (800-829-3676).
Note: Do not submit both an offer under Doubt as to Liability and an offer
under Doubt as to Collectibility or Effective Tax Administration at the same
time. You must resolve any doubt you owe part or all of the tax debt before
submitting an offer based on your ability to pay.
1

Notice of Federal Tax Lien

A lien is a legal claim against all your current and future property. When you don’t
pay your first bill for taxes due, a lien is created by law and attaches to your
property. A Notice of Federal Tax Lien (NFTL) provides public notice to creditors.
The IRS files the NFTL to establish priority of the IRS claim versus the claims of
certain other creditors. The IRS may file a NFTL at any time. You may be entitled
to file an appeal under the Collection Appeals Program (CAP) before this occurs or
request a Collection Due Process hearing after this occurs. The IRS may be
entitled to any proceeds from the sale of property subject to the lien(s). If you sell
the property prior to the release of the lien, property sale proceeds over and above
the offer amount may be applied to your tax liability, even if your offer has been
accepted and not yet paid.
Note: A Notice of Federal Tax Lien (NFTL) will not be filed on any individual shared
responsibility payment under the Affordable Care Act.

Trust Fund Taxes

If your business owes liabilities that include trust fund taxes, the IRS may hold
responsible individuals liable for the trust fund portion of the tax pursuant to
applicable law. Trust fund taxes are the money withheld from an employee's
wages, such as income tax, Social Security, and Medicare taxes. If the IRS
accepts an offer from an employer for a portion of the trust fund tax liability, the
remainder of the trust fund taxes may be collected from the responsible parties.
You are not eligible for consideration of an offer unless the trust fund portion of the
tax is paid, or the IRS has made the Trust Fund Recovery Penalty determination(s)
on all potentially responsible individual(s). However, if you are submitting the offer
as a victim of payroll service provider fraud or failure, the Trust Fund Recovery
Penalty assessment discussed above is not required prior to submitting the offer.

Other Important Facts

Each and every taxpayer has a set of fundamental rights they should be aware of
when interacting with the IRS. Explore your rights and our obligations to protect
them. For more information on your rights as a taxpayer, go to http://www.irs.gov/
Taxpayer-Bill-of-Rights.
Note: You have the right to appeal an offer rejection, but not the return of an offer.
Penalties and interest will continue to accrue while your offer is considered by the
IRS.
After you submit your offer, you must continue to timely file and pay all required tax
returns, estimated tax payments, and federal tax payments for yourself and any
business in which you have an interest. Failure to meet your filing and payment
responsibilities during consideration of your offer will result in the IRS
returning your offer. If the IRS accepts your offer, you must continue to stay
current with all tax filing and payment obligations through the fifth year after your
offer is accepted.
Note: If you have filed your tax returns but you have not received a bill for at
least one tax debt included on your offer, your offer and application fee may
be returned and any initial payment sent with your offer will be applied to
your tax debt. To prevent the return of your offer, wait until you have
received a bill for at least one tax debt and then include a copy of any tax
return filed within 12 weeks of this offer submission.
The IRS can't process your offer if the IRS referred your case, or cases, involving
all of the liabilities identified in the offer to the Department of Justice. In addition,
the IRS cannot compromise any tax liability arising from a restitution amount
ordered by a court or a tax debt reduced to judgment. Furthermore, the IRS
will not compromise any IRC § 965 tax liability for which an election was
made under IRC § 965(i). You cannot appeal this decision.
Note: Any offer containing a liability for which payment is being deferred under IRC
§ 965(h)(1) can only be processed for investigation if an acceleration of payment
under section 965(h)(3) and the regulations thereunder has occurred and no
portion of the liability to be compromised resulted from entering into a transfer
agreement under section 965(h)(3).

2

The law requires the IRS to make certain information from accepted offers
available for public inspection and review. Find instructions to request a public
inspection file at www.IRS.gov keyword "OIC".
The IRS may levy your assets up to the time the IRS official signs and
acknowledges your offer as pending. In addition, the IRS may keep any proceeds
received from the levy. If your assets are levied after your offer is submitted and
pending evaluation, immediately contact the IRS employee whose name and
phone number are listed on the levy.
If you currently have an approved installment agreement, you will not be required
to make your installment agreement payments while your offer is being
considered. If your offer is not accepted and you have not incurred any additional
tax debt, the IRS will reinstate your installment agreement.

PAYING FOR YOUR OFFER
Application Fee

Offers require a $205 application fee.
Exception: If you are an individual and meet the Low-Income Certification
guidelines, there is no requirement to send any money with your offer. You
are considered an individual if you are seeking compromise of a liability for which
you are personally responsible, including any liability you incurred as a sole
proprietor.

Payment Options

You must select a payment option and include the initial payment with your offer.
The amount of the initial payment and subsequent payments will depend on the
total amount of your offer and which of the following payment options you choose:
Lump Sum Cash: This option requires 20% of the total offer amount to be paid
with the offer and the remaining balance paid in 5 or fewer payments within 5 or
fewer months of the date your offer is accepted.
Periodic Payment: This option requires you to make the first payment with the
offer and the remaining balance paid in monthly payments within 6 to 24 months,
in accordance with your proposed offer terms.
Note: Under the periodic payment option, you must continue to make
monthly payments while the IRS is evaluating your offer. If you fail to make
these payments at any time prior to receiving a final decision letter, the IRS may
return your offer. You cannot appeal this decision. Total payments must equal the
total offer amount. Generally, payments made on an offer will not be returned.
The initial payment and monthly payments are not required if you meet the LowIncome Certification guidelines. If you qualified under the Low-Income Certification
and are not required to submit payments while the offer is under consideration,
your first payment will be due 30 calendar days after acceptance of the offer,
unless another date is agreed to in an amended offer or addendum.
If you do not have sufficient cash to pay for your offer, you may need to consider
borrowing money from a bank, friends, and/or family. Other options may include
borrowing against or selling other assets.
If you are an individual, use the OIC Pre-Qualifier tool at IRS.gov/OICtool to
assist in determining a starting point for your offer amount.
Note: You may not pay your offer amount with an expected or current tax
refund, money already paid, funds attached by any collection action, or
anticipated benefits from a capital or net operating loss. If you are planning to
use your retirement savings from an IRA or 401k plan, you may have future tax
debt as a result. Contact the IRS or your tax advisor before taking this action.

3

HOW TO APPLY
Application Process

The application must include:
• Form 656, Offer in Compromise
• Completed and signed Form 433-A (OIC), Collection Information Statement for
Wage Earners and Self-Employed Individuals, if applicable
• Completed and signed Form 433-B (OIC), Collection Information Statement for
Businesses, if applicable
• $205 application fee, unless you meet Low-Income Certification Guidelines
• Initial offer payment based on the payment option you choose, unless you
meet Low-Income Certification Guidelines
Note: Your offer(s) cannot be considered without the completed and signed
Form(s) 656, 433-A (OIC), 433-B (OIC) (if applicable), and supporting
documentation.

If You and Your Spouse Owe
Joint and Separate Tax Debts

If you and your spouse have joint tax debt(s) and you or your spouse are also
responsible for separate tax debt(s) (including Trust Fund Recovery Penalty), you
will each need to send in a separate Form 656. You will complete one Form 656
for yourself listing all your joint and any separate tax debts and your spouse will
complete one Form 656 listing all their joint tax debt(s) plus any separate tax debt
(s), for a total of two Forms 656.
If you and your spouse or ex-spouse have a joint tax debt and your spouse or exspouse does not want to be part of the offer, you may submit a Form 656 to
compromise your responsibility for the joint tax debt.
Each Form 656 will require the $205 application fee and initial payment
unless you are an individual and meet the Low-Income Certification
guidelines.

If You Owe Individual and
Business Tax Debt

If you have individual and business tax debt that you wish to compromise, you will
need to send in two Forms 656. Complete one Form 656 for your individual tax
debts and one Form 656 for your business tax debts. Each Form 656 will require
the $205 application fee and initial payment.
Note: A business is defined as a corporation, partnership, or any business that is
operated as other than a sole-proprietorship. You may not compromise an
individual's share of a partnership debt. The partnership must submit its own offer
based on the partnership's and partners' ability to pay.

4

COMPLETING THE APPLICATION PACKAGE
Step 1 – Gather Your Information

To calculate an offer amount, you will need to gather information about your
financial situation, including cash, investments, available credit, assets, income,
and debt.
You will also need to gather information about your household's average gross
monthly income and expenses. The household includes all those in addition to
yourself who contribute money to pay expenses relating to the household such as:
rent, utilities, insurance, groceries, etc. This is necessary for the IRS to accurately
evaluate your offer. The IRS may also use this to determine your share of the total
household income and expenses.
In general, the IRS will not consider expenses for tuition for private schools,
college expenses, charitable contributions, and other unsecured debt payments as
part of the expense calculation.

Step 2 – Fill out Form 433-A
(OIC), Collection Information
Statement for Wage Earners and
Self-Employed Individuals

Fill out Form 433-A (OIC) if you are an individual wage earner, operate or operated
as a sole proprietor, or are authorized to submit an offer on behalf of the estate of
a deceased individual. If you are married but living separately from your spouse
then you each must submit a Form 433-A (OIC). This will assist in the calculation
of an appropriate offer amount based on your assets, income, expenses, and
future earning potential. You will have the opportunity to provide a written
explanation of any special circumstances that affect your financial situation.

Step 3 – Fill out Form 433-B (OIC),
Collection Information Statement
for Businesses

Fill out Form 433-B (OIC) if the business is a Corporation, Partnership, or LLC.
This will assist in the calculation of an appropriate offer amount based on the
business assets, income, expenses, and future earning potential. If the business
has assets used to produce income (for example, a tow truck used in the business
for towing vehicles), the business may be allowed to exclude equity in these
assets.

Step 4 – Attach Required
Documentation

You will need to attach supporting documentation with Form(s) 433-A (OIC) and
433-B (OIC). See a list of the documents required at the end of each form. Include
copies of all required attachments. Do not send original documents.

Step 5 – Fill out Form 656, Offer
in Compromise

Fill out Form 656. The Form 656 identifies the tax years and type of tax you would
like to compromise. It also identifies your offer amount and the payment terms.
Your offer amount must be equal to or greater than the amount calculated in Form
433-A(OIC) or 433-B(OIC).

Step 6 – Include Initial Payment
and $205 Application Fee

Include a personal check, cashier's check, or money order for your initial payment
based on the payment option you selected (20% of the offer amount for a lump
sum cash offer or the first month's payment for a periodic payment offer).
Generally, initial payments will not be returned but will be applied to your tax debt if
your offer is not accepted.
If you choose to pay the user fee and offer payment by personal check,
cashier’s check, or money order, provide a separate personal check,
cashier’s check, or money order for each user fee and offer payment. Make
checks or money orders in U.S. dollars and payable to the "United States
Treasury." As an alternative to checks or money orders, you may pay the user fee
and offer payment through the Electronic Federal Tax Payment System (EFTPS),
which allows you to pay by direct debit from your bank account or by credit/debit
cards.
Reminder: If you meet the Low-Income Certification guidelines DO NOT send
any money.

Step 7 – Mail the Application
Package

Make a copy of your application package and keep it for your records.
Mail the completed application package to the appropriate IRS facility. See page
29, Application Checklist, for details.
Note: If you are working with an IRS employee, let them know you are
sending or have sent an offer to compromise your tax debt(s).
5

IMPORTANT INFORMATION
After You Mail Your Application:

We will contact you after we receive and review your offer application. Promptly
reply to any requests for additional information within the time frame specified.
Failure to reply timely will result in the return of your offer without appeal rights.
If the IRS accepts your offer, you must continue to timely file all required tax
returns and timely pay all estimated tax payments and federal tax payments that
become due in the future. If you fail to timely file and timely pay any tax obligations
that become due within the five years after your offer acceptance your offer may
be defaulted. If the IRS defaults your offer, you will be liable for the original tax
debt, less payments made, and all accrued interest and penalties. An offer does
not stop the accrual of interest and penalties. Please note that if your final payment
is more than the agreed amount, the IRS will not return the money but will apply it
to your tax debt.
In addition, the IRS may default your offer if you fail to promptly pay any tax debts
assessed after acceptance of your offer for any tax years prior to acceptance that
were not included in your original offer.

6

Form

433-A (OIC)
(April 2023)

Department of the Treasury — Internal Revenue Service

Collection Information Statement for Wage Earners and
Self-Employed Individuals

Use this form if you are
● An individual who owes income tax on a Form 1040, U.S.
Individual Income Tax Return

● An individual who is personally responsible for a partnership
liability (only if the partnership is submitting an offer)
● An individual who is submitting an offer on behalf of the
estate of a deceased person

● An individual with a personal liability for Excise Tax
● An individual responsible for a Trust Fund Recovery Penalty
● An individual who is self-employed or has self-employment
income. You are considered to be self-employed if you are in
business for yourself, or carry on a trade or business.

Note: Include attachments if additional space is needed to respond completely to any question. This form should only be used with the Form
656, Offer in Compromise.

Section 1

Personal and Household Information

Last name

First name

Social Security Number

Date of birth (mm/dd/yyyy)

Marital status

Home physical address (street, city, state, ZIP code)

Unmarried

Married

Own your home

If married, date of marriage (mm/dd/yyyy)

-

Do you
Rent

Other (specify e.g., share rent, live with relative, etc.)

If you were married and lived in AZ, CA, ID, LA, NM, NV, TX, WA or WI within the last ten years check here
County of residence

Primary phone
(

Secondary phone
(

)

)

Home mailing address (if different from above or post office box number)
-

FAX number
-

(

)

-

Provide information about your spouse.
Spouse's last name

Spouse's first name

Date of birth (mm/dd/yyyy)

Social Security Number

-

-

Provide information for all other persons in the household or claimed as a dependent.
Name

Section 2

Age

Relationship

Claimed as a dependent
on your Form 1040

Contributes to
household income

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Employment Information for Wage Earners

Complete this section if you or your spouse are wage earners and receive a Form W-2. If you or your spouse have self-employment income (that is
you file a Schedule C, E, F, etc.) instead of, or in addition to wage income, you must also complete Business Information in Sections 4, 5, and 6.
Your employer’s name

Pay period

Weekly

Bi-weekly

Monthly

Other

Employer’s address (street, city, state, ZIP code)

Do you have an ownership interest in this business
Yes (also complete and submit Form 433-B)

No

Your occupation

How long with this employer

Spouse’s employer's name

Pay period

(years)

(months)
Weekly

Bi-weekly

Monthly

Other

Employer’s address (street, city, state, ZIP code)

Does your spouse have an ownership interest in this business
Yes (also complete and submit Form 433-B)
Spouse's occupation

No
How long with this employer
(years)

Catalog Number 55896Q

(months)

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Page 2

Section 3

Personal Asset Information (Domestic and Foreign)

Use the most current statement for each type of account, such as checking, savings, money market and online accounts, stored value cards (such as a
payroll card from an employer), investment, retirement accounts (IRAs, Keogh, 401(k) plans, stocks, bonds, mutual funds, certificates of deposit) and
digital assets such as virtual currency (cryptocurrency), non-fungible token (NFT), and smart contracts you own or in which you have a financial interest
(e.g., Bitcoin, Ethereum, Litecoin, Ripple, etc.), life insurance policies that have a cash value, and safe deposit boxes including those located in foreign
countries or jurisdictions. Asset value is subject to adjustment by IRS based on individual circumstances. Enter the total amount available for each of the
following (if additional space is needed include attachments). Ensure you also include assets located in foreign countries or jurisdictions and add
attachment(s) if additional space is needed to respond.
Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0".

Cash and Investments (domestic and foreign)
Cash

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(1a) $

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(1b) $

Investment account

Stocks

Bonds

Total of bank accounts from attachment

(1c) $

Add lines (1a) through (1c) minus ($1,000) =

(1) $

Other

Name of Financial Institution and country location

Account number

Current market value

Minus loan balance

$

X .8 = $

Investment account

Stocks

– $
Bonds

=

(2a) $

Other

Name of Financial Institution and country location

Account number

Current market value

Minus loan balance

$

X .8 = $

– $

Name of digital asset such as virtual
currency wallet, exchange or digital
currency exchange (DCE)

Digital asset
Type of digital asset

Name of individual who has access to the private
key(s) and/or digital wallets

=

Email address used to set-up the digital
asset such as virtual currency exchange
or DCE

(2b) $
Location(s) of digital asset (mobile
wallet, online, and/or external
hardware storage)

Digital asset amount and value in US dollars as of today
$

=

(2c) $

Total investment accounts from attachment. [current market value minus loan balance(s)]

(2d) $

Add lines (2a) through (2d) =

(2) $

Retirement account

401K

IRA

Other

Name of Financial Institution and country location

Account number

Current market value
$

Minus loan balance
X .8 = $

– $

=

(3a) $

Total of retirement accounts from attachment. [current market value X .8 minus loan balance(s)]

(3b) $

Add lines (3a) through (3b) =

(3) $

Note: Your reduction from current market value may be greater than 20% due to potential tax consequences/withdrawal penalties.
Cash value of Life Insurance Policies
Name of Insurance Company

Current cash value
$
Total cash value of life insurance policies from attachment
$

Catalog Number 55896Q

Policy number

Minus loan balance
– $

=

(4a) $

=

(4b) $

Add lines (4a) through (4b) =

(4) $

Minus loan balance(s)
– $

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Page 3

Section 3 (Continued)

Personal Asset Information (Domestic and Foreign)

Real property (enter information about any house, condo, co-op, time share, etc. that you own or are buying including any assets owned by
your spouse if you live in a community property state)
Is your real property currently for sale or do you anticipate selling your real property to fund the offer amount
Yes

No

(listing price)

Property description (indicate if personal residence, rental property, vacant, etc.)

Purchase date (mm/dd/yyyy)

Amount of mortgage payment

How title is held (joint tenancy, etc.)

Date of final payment

Location (street, city, state, ZIP code, county, and country)

Lender/Contract holder name, address (street, city,
state, ZIP code) and phone

Minus loan balance (mortgages, etc.)

Current market value
$

X .8 = $

– $

(total value of real estate) =

Property description (indicate if personal residence, rental property, vacant, etc.)

Purchase date (mm/dd/yyyy)

Amount of mortgage payment

How title is held (joint tenancy, etc.)

Date of final payment

Location (street, city, state, ZIP code, county, and country)

(5a) $

Lender/Contract holder name, address (street, city,
state, ZIP code) and phone

Minus loan balance (mortgages, etc.)

Current market value
$

X .8 = $

– $

(total value of real estate) =

(5b) $

Total value of property(s) from attachment [current market value X .8 minus any loan balance(s)]

(5c) $

Add lines (5a) through (5c) =

(5) $

Vehicles (enter information about any cars, boats, motorcycles, etc. that you own or lease).
Include those located in foreign countries or jurisdictions. If additional space is needed, list on an attachment.
Vehicle make & model

Lease

Year

Date purchased

Name of creditor

Mileage

Date of final payment

Monthly lease/loan amount

Own

$

Current market value
$

Minus loan balance
X .8 = $

Vehicle make & model

Lease

Total value of vehicle (if the vehicle
is leased, enter 0 as the total value) =

(6a) $

Subtract $3,450 from line (6a)
(If line (6a) minus $3,450 is a negative number, enter "0")

(6b) $

– $

Year

Date purchased

Name of creditor

Mileage

Date of final payment

License/Tag number

Monthly lease/loan amount

Own

$

Current market value
$

License/Tag number

Minus loan balance
Total value of vehicle (if the vehicle
is leased, enter 0 as the total value) =

(6c) $

If you are filing a joint offer, subtract $3,450 from line (6c)
(If line (6c) minus $3,450 is a negative number, enter "0")
If you are not filing a joint offer, enter the amount from line (6c)

(6d) $

Total value of vehicles listed from attachment [current market value X .8 minus any loan balance(s)]

(6e) $

X .8 = $

– $

Total lines (6b), (6d), and (6e) =

Catalog Number 55896Q

www.irs.gov

(6) $

Form 433-A

(OIC) (Rev. 4-2023)

Page 4

Section 3 (Continued)

Personal Asset Information (Domestic and Foreign)

Other valuable items (artwork, collections, jewelry, items of value in safe deposit boxes, interest in a company or business that is not publicly traded, etc.)
Description of asset(s)
Current market value

Minus loan balance

$

X .8 = $

– $

=

(7a) $

=

(7b) $

Total value of valuable items listed from attachment [current market value X .8 minus any loan balance(s)]

(7c) $

Value of remaining furniture and personal effects (not listed above)
Description of asset
Minus loan balance

Current market value
$

X .8 = $

– $

Add lines (7a) through (7c) minus IRS deduction of $10,810 =
Do not include amount on the lines with a letter beside the number. Round to the nearest whole dollar.
Do not enter a negative number. If any line item is a negative, enter "0" on that line.

Add lines (1) through (7) and enter the amount in Box A =

(7) $
Box A
Available Individual Equity in Assets
$

NOTE: If you or your spouse are self-employed, Sections 4, 5, and 6 must be completed before continuing with Sections 7 and 8.

Section 4

Self-Employed Information

If you or your spouse are self-employed (e.g., files Schedule(s) C, E, F, etc.), complete this section.
Is your business a sole proprietorship
Yes

Address of business (if other than personal residence)

No

Name of business

Business telephone number
(

)

Employer Identification Number

Business website address

Total number of employees

Frequency of tax deposits

Description of business

Do you or your spouse have any other business interests? Include any
interest in an LLC, LLP, corporation, partnership, etc.
Yes

Trade name or DBA

-

(percentage of ownership:

Average gross monthly
payroll $

Business address (street, city, state, ZIP code)

) Title

No
Business name

Employer Identification Number

Business telephone number
(

)

-

Type of business (select one)
Partnership

LLC

Section 5

Corporation

Other

Business Asset Information (for Self-Employed) (Domestic and Foreign)

List business assets such as bank accounts, digital assets (cryptocurrency), tools, books, machinery, equipment, business vehicles and real property
that is owned/leased/rented. If additional space is needed, attach a list of items. Do not include personal assets listed in Section 3.
Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative number, enter "0".
Cash

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(8a) $

Cash

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(8b) $

Digital asset
Type of digital asset

Name of digital asset such as virtual
currency wallet, exchange or digital
currency exchange (DCE)

Name of individual who has access to the private
key(s) and/or digital wallets

Email address used to set-up the digital
asset such as virtual currency exchange
or DCE

Digital asset amount and value in US dollars as of today
$

Catalog Number 55896Q

Location(s) of digital asset (mobile
wallet, online, and/or external
hardware storage)

=

(8c) $

Total bank accounts from attachment

(8d) $

Add lines (8a) through (8d) =

(8) $

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Page 5

Section 5 (Continued)

Business Asset Information (for Self-Employed) (Domestic and Foreign)

Description of asset

Total value (if leased or used
in the production of income,
enter 0 as the total value)

=

(9a) $

Total value (if leased or used
in the production of income,
enter 0 as the total value)

=

(9b) $

Total value of assets listed from attachment [current market value X .8 minus any loan balance(s)]

(9c) $

Current market value
$

Minus loan balance
X .8 = $

– $

Description of asset:
Current market value
$

Minus Loan Balance
X .8 = $

– $

Add lines (9a) through (9c) =
IRS allowed deduction for professional books and tools of trade for individuals and sole-proprietors –

Enter the value of line (9) minus line (10). If less than zero enter zero. =

(9) $
(10) $

(11) $

Notes Receivable
Do you have notes receivable

Yes

No

If yes, attach current listing that includes name(s) and amount of note(s) receivable
Accounts Receivable
Do you have accounts receivable, including e-payment, factoring
companies, and any bartering or online auction accounts

Yes

No

If yes, provide a list of your current accounts receivable (include the age and amount)
Do not include amounts from the lines with a letter beside the number [for example: (9c)].
Round to the nearest whole dollar.
Do not enter a negative number. If any line item is a negative, enter "0" on that line.

Box B
Available Business Equity in
Assets

Add lines (8) and (11) and enter the amount in Box B = $

Section 6

Business Income and Expense Information (for Self-Employed)

If you provide a current profit and loss (P&L) statement for the information below, enter the total gross monthly income on line 17 and your monthly
expenses on line 29 below. Do not complete lines (12) - (16) and (18) - (28). You may use the amounts claimed for income and expenses on your most
recent Schedule C; however, if the amount has changed significantly within the past year, a current P&L should be submitted to substantiate the claim.
Period provided beginning

through
Round to the nearest whole dollar. Do not enter a negative number. If any line item is a negative number, enter "0".

Business income (you may average 6-12 months income/receipts to determine your gross monthly income/receipts)
Gross receipts

(12) $

Gross rental income

(13) $

Interest income

(14) $

Dividends

(15) $

Other income

(16) $

Add lines (12) through (16) = (17) $
Business expenses (you may average 6-12 months expenses to determine your average expenses)
Materials purchased (e.g., items directly related to the production of a product or service)

(18) $

Inventory purchased (e.g., goods bought for resale)

(19) $

Gross wages and salaries

(20) $

Rent

(21) $

Supplies (items used to conduct business and used up within one year, e.g., books, office supplies, professional equipment, etc.)

(22) $

Utilities/telephones

(23) $

Vehicle costs (gas, oil, repairs, maintenance)

(24) $

Business insurance

(25) $

Current business taxes (e.g., real estate, excise, franchise, occupational, personal property, sales and employer's portion of
employment taxes)

(26) $

Secured debts (not credit cards)

(27) $

Other business expenses (include a list)

(28) $

Add lines (18) through (28) = (29) $
Round to the nearest whole dollar.
Do not enter a negative number. If any line item is a negative, enter "0" on that line.

Box C
Net Business Income

Subtract line (29) from line (17) and enter the amount in Box C = $
Catalog Number 55896Q

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Page 6

Section 7

Monthly Household Income and Expense Information

Enter your household's average gross monthly income. Gross monthly income includes wages, social security, pension, unemployment, and other
income. Examples of other income include but are not limited to: agricultural subsidies, gambling income, oil credits, rent subsidies, sharing economy
income from providing on-demand work, services or goods (e.g., Uber, Lyft, AirBnB, VRBO), income through digital platforms like an app or website,
etc., and recurring capital gains from the sale of securities including cryptocurrency, non-fungible tokens, etc. The information below is for yourself, your
spouse, and anyone else who contributes to your household's income. The entire household includes spouse, non-liable spouse, significant other,
children, and others who contribute to the household. This is necessary for the IRS to accurately evaluate your offer.

Monthly Household Income
Note: Entire household income should also include income that is considered not taxable and may not be included on your tax return.
Round to the nearest whole dollar.
Primary taxpayer
Gross wages
Social Security
Pension(s)
Other income (e.g. unemployment)
Total primary
$
+ $
+ $
+ $
taxpayer income = (30) $
Spouse
Gross wages
Social Security
Pension(s)
Other Income (e.g. unemployment)
Total spouse
$
+ $
+ $
+ $
income = (31) $
Additional sources of income used to support the household, e.g., non-liable spouse, or anyone else who may
contribute to the household income, etc. List source(s)
(32) $
Interest, dividends, and royalties

(33) $

Distributions (e.g., income from partnerships, sub-S Corporations, etc.)

(34) $

Net rental income

(35) $

Net business income from Box C [Deductions for non-cash expenses on Schedule C (e.g., depreciation, depletion, etc.) are
not permitted as an expense for offer purposes and must be added back in to the net income figure]

(36) $

Child support received

(37) $

Alimony received

(38) $
Round to the nearest whole dollar.
Do not enter a negative number. If any line item is a negative, enter "0" on that line.

Box D
Total Household Income

Add lines (30) through (38) and enter the amount in Box D = $

Monthly Household Expenses
Enter your average monthly expenses.
Note: For expenses claimed in boxes (39) and (45) only, you should list the full amount of the allowable standard even if the
actual amount you pay is less. For the other boxes input your actual expenses. You may find the allowable standards at
http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Collection-Financial-Standards.
Round to the nearest whole dollar.
Food, clothing, and miscellaneous (e.g., housekeeping supplies, personal care products, minimum payment on credit card).
A reasonable estimate of these expenses may be used

(39) $

Housing and utilities (e.g., rent or mortgage payment and average monthly cost of property taxes, home insurance,
maintenance, dues, fees and utilities including electricity, gas, other fuels, trash collection, water, cable television and internet,
monthly rent payment
telephone, and cell phone)

(40) $

Vehicle loan and/or lease payment(s)

(41) $

Vehicle operating costs (e.g., average monthly cost of maintenance, repairs, insurance, fuel, registrations, licenses,
inspections, parking, tolls, etc.). A reasonable estimate of these expenses may be used
Public transportation costs (e.g., average monthly cost of fares for mass transit such as bus, train, ferry, etc.). A reasonable
estimate of these expenses may be used
Health insurance premiums

(42) $
(43) $
(44) $

Out-of-pocket health care costs (e.g. average monthly cost of prescription drugs, medical services, and medical supplies like
eyeglasses, hearing aids, etc.)

(45) $

Court-ordered payments (e.g., monthly cost of any alimony, child support, etc.)

(46) $

Child/dependent care payments (e.g., daycare, etc.)

(47) $

Life insurance premiums

(48) $

Life insurance policy amount

Current monthly taxes (e.g., monthly cost of federal, state, and local tax, personal property tax, etc.)

(49) $

Secured debts/Other (e.g., any loan where you pledged an asset as collateral not previously listed, government guaranteed
student loan, employer required retirement or dues) List debt(s)/expense(s)

(50) $

Enter the amount of your monthly delinquent state and/or local tax payment(s) . Total tax owed

(51) $

Round to the nearest whole dollar.
Do not enter a negative number. If any line item is a negative, enter "0" on that line.

Box E
Total Household Expenses

Add lines (39) through (51) and enter the amount in Box E = $
Round to the nearest whole dollar.
Do not enter a negative number. If any line item is a negative, enter "0" on that line.

Box F
Remaining Monthly Income

Subtract Box E from Box D and enter the amount in Box F = $
Catalog Number 55896Q

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Page 7

Section 8

Calculate Your Minimum Offer Amount

The next steps calculate your minimum offer amount. The amount of time you take to pay your offer in full will affect your minimum offer amount. Paying
over a shorter period of time will result in a smaller minimum offer amount.
Note: The multipliers below (12 and 24) and the calculated offer amount (which included the amount(s) allowed for vehicles and bank
accounts) do not apply if the IRS determines you have the ability to pay your tax debt in full within the legal period to collect.
Round to the nearest whole dollar.
If you will pay your offer in 5 or fewer payments within 5 months or less, multiply "Remaining Monthly Income" (Box F) by 12 to get "Future Remaining
Income" (Box G). Do not enter a number less than $0.

Enter the total from Box F

Box G Future Remaining Income

$

X 12 =

$

If you will pay your offer in 6 to 24 months, multiply "Remaining Monthly Income" (Box F) by 24 to get "Future Remaining Income" (Box H). Do not enter
a number less than $0.

Enter the total from Box F

Box H Future Remaining Income

$

X 24 =

$

Determine your minimum offer amount by adding the total available assets from Box A and Box B (if applicable) to the amount in either Box G or Box H.

Enter the amount from Box A
plus Box B (if applicable)

Enter the amount from either
Box G or Box H

+

$

Offer Amount
Your offer must be more than zero ($0). Do
not leave blank. Use whole dollars only.

=

$

$

Place the offer amount shown above on the Form 656, Section 4, Payment Terms, unless you cannot pay that amount due to
special circumstances. If you cannot pay that amount due to special circumstances, place the amount you can pay on the
Form 656, Section 4, Payment Terms, and explain your special circumstances on the Form 656, Offer in Compromise, Section
3, Reason for Offer.

Section 9

Other Information

Additional information IRS needs to consider settlement of your tax debt. If you or your business are currently in a bankruptcy proceeding,
you are not eligible to apply for an offer.
Are you a party to or involved in litigation (if yes, answer the following)
Plaintiff

Yes

Location of filing

Represented by

Possible completion date (mmddyyyy)

Subject of litigation

No

Docket/Case number

Defendant
Amount of dispute
$
Have you filed bankruptcy in the past 7 years (if yes, answer the following)
Date filed (mmddyyyy)

Date dismissed (mmddyyyy)

Date discharged (mmddyyyy)

Petition no.

In the past 10 years, have you lived outside of the U.S. for 6 months or longer (if yes, answer the following)
Dates lived abroad: From (mmddyyyy)

Yes

No

Yes

No

Location filed

To (mmddyyyy)

Are you or have you ever been party to any litigation involving the IRS/United States (including any tax litigation)

Yes

No

If yes and the litigation included tax debt, provide the types of tax and periods involved

Yes

Are you the beneficiary of a trust, estate, or life insurance policy, including those located in foreign countries or jurisdictions

No

(if yes, answer the following)

Place where recorded
Name of the trust, estate, or policy

EIN
Anticipated amount to be received

When will the amount be received

$
Are you a trustee, fiduciary, or contributor of a trust
Name of the trust

Yes

No

Yes

No

EIN

Do you have a safe deposit box (business or personal) including those located in foreign countries or jurisdictions (if yes, answer
the following)

Location (name, address and box number(s))

Value

Contents

$

Catalog Number 55896Q

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Page 8

Section 9 (Continued)

Other Information

In the past 10 years, have you transferred any asset with a fair market value of more than $10,000 including real property, for
less than their full value (if yes, answer the following)
Value at time of transfer

List asset(s)

Date transferred (mmddyyyy)

Yes

No

To whom or where was it transferred

$
Do you have any assets or own any real property outside the U.S.

Yes

No

Yes

No

If yes, provide description, location, and value

Do you have any funds being held in trust by a third party
If yes, how much $

Section 10

Where

Signatures

Under penalties of perjury, I declare that I have examined this offer, including accompanying documents, and to the best of my knowledge it
is true, correct, and complete.

Signature of Taxpayer

Date (mm/dd/yyyy)

Signature of Spouse

Date (mm/dd/yyyy)

Remember to include all applicable attachments listed below.
Copies of the most recent pay stub, earnings statement, etc., from each employer.
Copies of the most recent statement for each investment and retirement account.
Copies of the most recent statement, etc., from all other sources of income such as pensions, Social Security, rental income,
interest and dividends (including any received from a related partnership, corporation, LLC, LLP, etc.), court order for child
support, alimony, royalties, agricultural subsidies, gambling income, oil credits, rent subsidies, sharing economy income from
providing on-demand work, services or goods (e.g., Uber, Lyft, AirBnB, VRBO), income through digital platforms like an app or
website, etc., and recurring capital gains from the sale of securities including cryptocurrency, non-fungible tokens.
Copies of individual complete bank statements for the three most recent months. If you operate a business, copies of the six
most recent complete statements for each business bank account.
Completed Form 433-B (Collection Information Statement for Businesses) if you or your spouse have an interest in a business
entity other than a sole-proprietorship.
Copies of the most recent statement from lender(s) on loans such as mortgages, second mortgages, vehicles, etc., showing
monthly payments, loan payoffs, and balances.
List of Accounts Receivable or Notes Receivable, if applicable.
Verification of delinquent State/Local Tax Liability showing total delinquent state/local taxes and amount of monthly payments, if
applicable.
Copies of court orders for child support/alimony payments claimed in monthly expense section.
Copies of Trust documents if applicable per Section 9.
Documentation to support any special circumstances described in the “Explanation of Circumstances” on Form 656, if applicable.
Attach a Form 2848, Power of Attorney, if you would like your attorney, CPA, or enrolled agent to represent you and you do not
have a current form on file with the IRS. Ensure all years and forms involved in your offer are listed on Form 2848 and include the
current tax year. Check the appropriate box to ensure copies of communications are sent to your representative.
Completed and signed current Form 656.

Catalog Number 55896Q

www.irs.gov

Form 433-A

(OIC) (Rev. 4-2023)

Form

Department of the Treasury — Internal Revenue Service

433-B (OIC)

Collection Information Statement for Businesses

(April 2023)
Complete this form if your business is a
● Corporation

● Limited Liability Company (LLC) classified as a corporation

● Partnership

● Other LLC

Note: If your business is a sole proprietorship do not use this form. Instead, complete Form 433-A (OIC) Collection Information Statement for
Wage Earners and Self-Employed Individuals. This form should only be used with the Form 656, Offer in Compromise.
Include attachments if additional space is needed to respond completely to any question.

Section 1

Business Information (Domestic and Foreign)

Business name

Employer Identification Number

Business physical address (street, city, state, ZIP code)

County of business location

Description of business and DBA or "Trade Name"

Primary phone
(

Secondary phone

)

-

(

)

Business mailing address (if different from above or post office box number)
-

Business website address

FAX number
(

)

Yes

Total number of employees

Federal contractor
Yes

Does the business outsource its payroll processing and tax return
preparation for a fee

-

No

No

If yes, list provider name and address in box below
(street, city, state, ZIP code)

Check here if you are the only employee

Frequency of tax deposits

Average gross monthly payroll
$

Provide information about all partners, officers, LLC members, major shareholders (domestic and foreign), etc., associated with the business.
Include attachments if additional space is needed.
Last name

First name

Title

Percent of ownership and annual salary

Social Security Number

Primary phone
(

)

Secondary phone
-

(

)

-

Last name

First name

Percent of ownership and annual salary

Social Security Number

Primary phone

Secondary phone

Title

(

)

-

(

)

-

First name

Percent of ownership and annual salary

Social Security Number

Primary phone

Secondary phone

Title

)

-

Catalog Number 55897B

(

)

Home address (street, city, state, ZIP code)

-

Last name

(

Home address (street, city, state, ZIP code)

-

Home address (street, city, state, ZIP code)

-

www.irs.gov

Form

433-B (OIC) (Rev. 4-2023)

Page 2

Section 2

Business Asset Information (Domestic and Foreign)

Gather the most current statement from banks, lenders on loans, mortgages (including second mortgages), monthly payments, loan balances, and
accountant's depreciation schedules, if 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 (www.kbb.com), NADA (www.nada.com), 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. Asset value is subject to
adjustment by IRS. Enter the total amount available for each of the following (if additional space is needed, please include attachments).
Round to the nearest dollar. Do not enter a negative number. If any line item is a negative number, enter "0".
Cash and investments (domestic and foreign)
Cash

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(1a) $

Cash

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(1b) $

Cash

Checking

Savings

Money Market Account/CD

Bank name and country location

Online Account

Stored Value Card

Account number
(1c) $

Investment account

Stocks

Bonds

Total bank accounts from attachment

(1d) $

Add lines (1a) through (1d) =

(1) $

Other

Name of Financial Institution and country location

Account number

Current market value

Minus loan balance

$

X .8 = $

Investment Account:

Stocks

– $

Bonds

=

(2a) $

=

(2b) $

Other

Name of Financial Institution and country location

Account number

Current market value

Minus loan balance

$

X .8 = $

– $

Name of digital asset such as virtual
currency wallet, exchange or digital
currency exchange (DCE)

Digital asset
Type of digital asset

Name of individual who has access to the private
key(s) and/or digital wallets

Email address used to set-up the digital
asset such as virtual currency exchange
or DCE

Location(s) of digital asset (mobile
wallet, online, and/or external
hardware storage)

Digital asset amount and value in US dollars as of today
$

=

(2c) $

Total investment accounts from attachment. [current market value minus loan balance(s)]

(2d) $

Add lines (2a) through (2d) =

(2) $

Notes Receivable
Do you have notes receivable

Yes

No

If yes, attach current listing which includes name, age, and amount of note(s) receivable
Accounts Receivable
Do you have accounts receivable, including e-payment, factoring
companies, and any bartering or online auction accounts

Yes

No

If yes, provide a list of name, age, and amount of the current accounts receivable

Catalog Number 55897B

www.irs.gov

Form

433-B (OIC) (Rev. 4-2023)

Page 3

Section 2 (Continued)

Business Asset Information (Domestic and Foreign)

If the business owns more properties, vehicles, or equipment than shown in this form, please list on a separate attachment.
Real estate (buildings, lots, commercial property, etc.)
Is your real property currently for sale or do you anticipate selling your real property to fund the offer amount
Yes

No

(listing price)

Property address (street address, city,

Property description (indicate if rental property, vacant, etc.) Date purchased

state, ZIP code, county, and country)

Monthly mortgage payment

Date of final payment

Name of lender/contract holder

Current market value

Minus loan balance (mortgages, etc.)

$

X .8 = $

Property address (street address, city,

– $

Total value of real estate =

(3a) $

Property description (indicate if rental property, vacant, etc.) Date purchased

state, ZIP code, county, and country)

Monthly mortgage payment

Date of final payment

Name of lender/contract holder

Current market value

Minus loan balance (mortgages, etc.)

$

X .8 = $

– $

Total value of real estate =

(3b) $

Total value of property(s) listed from attachment [current market value X .8 minus any loan balance(s)]

(3c) $

Add lines (3a) through (3c) =

(3) $

Business vehicles (cars, boats, motorcycles, trailers, etc.). Include those located in foreign countries or jurisdictions. If additional space is needed, list on an
attachment
Vehicle make & model

Year

Lease

Monthly lease/loan amount

Own

$

Current market value
$

Vehicle make & model

Name of creditor

License/Tag number

Date of final payment

Total value of vehicle (if the vehicle
is leased, enter 0 as the total value) =

– $
Year

Lease

Monthly lease/loan amount

Own

$

Current market value

Date purchased

Mileage or use hours

Name of creditor

(4a) $

License/Tag number

Date of final payment

Minus loan balance
X .8 = $

Vehicle make & model

Total value of vehicle (if the vehicle
is leased, enter 0 as the total value) =

– $
Year

Lease

Monthly lease/loan amount

Own

$

Current market value
$

Mileage or use hours

Minus loan balance
X .8 = $

$

Date purchased

Date purchased

Mileage or use hours

Name of creditor

(4b) $

License/Tag number

Date of final payment

Minus loan balance
Total value of vehicle (if the vehicle
is leased, enter 0 as the total value) =

(4c) $

Total value of vehicles listed from attachment [current market value X .8 minus any loan balance(s)]

(4d) $

Add lines (4a) through (4d) =

(4) $

X .8 = $

Catalog Number 55897B

– $

www.irs.gov

Form

433-B (OIC) (Rev. 4-2023)

Page 4

Section 2 (Continued)

Business Asset Information (Domestic and Foreign)

Other business equipment
[If you have more than one piece of equipment, please list on a separate attachment and put the total of all equipment in box (5b)]
Type of equipment

Minus loan balance

Current market value

Total value of equipment
(if leased or used in the production of
income enter 0 as the total value) =

(5a) $

Total value of equipment listed from attachment [current market value X .8 minus any loan balance(s)]

(5b) $

$

X .8 = $

– $

Total value of all business equipment
(5) $

Add lines (5a) and (5b) =
Do not include amount on the lines with a letter beside the number. Round to the nearest dollar.
Do not enter a negative number. If any line item is a negative number, enter "0" on that line.

Box A
Available Equity in Assets

Add lines (1) through (5) and enter the amount in Box A = $

Section 3

Business Income Information

Enter the average gross monthly income of your business. To determine your gross monthly income use the most recent 6-12 months documentation of
commissions, invoices, gross receipts from sales/services, etc.; most recent 6-12 months earnings statements, etc., from every other source of income (such as
rental income, interest and dividends, or subsidies); or you may use the most recent 6-12 months Profit and Loss (P&L) to provide the information of income and
expenses.
Note: If you provide a current profit and loss statement for the information below, enter the total gross monthly income in Box B below. Do not
complete lines (6) - (10).

Period provided beginning

through

Gross receipts

(6) $

Gross rental income

(7) $

Interest income

(8) $

Dividends

(9) $
(10) $

Other income (specify on attachment)
Round to the nearest dollar.
Do not enter a negative number. If any line item is a negative number, enter "0" on that line.

Box B
Total Business Income

Add lines (6) through (10) and enter the amount in Box B = $

Section 4

Business Expense Information

Enter the average gross monthly expenses for your business using your most recent 6-12 months statements, bills, receipts, or other documents
showing monthly recurring expenses. Deductions for non-cash expenses (e.g., depreciation, depletion, etc.) are not permitted as an expense for
offer purposes.
Note: If you provide a current profit and loss statement for the information below, enter the total monthly expenses in Box C below. Do not
complete lines (11) - (20).
Period provided beginning

through

Materials purchased (e.g., items directly related to the production of a product or service)

(11) $

Inventory purchased (e.g., goods bought for resale)

(12) $

Gross wages and salaries

(13) $

Rent

(14) $

Supplies (items used to conduct business and used up within one year, e.g., books, office supplies, professional
equipment, etc.)

(15) $

Utilities/telephones

(16) $

Vehicle costs (gas, oil, repairs, maintenance)

(17) $

Insurance (other than life)

(18) $

Current taxes (e.g., real estate, state, and local income tax, excise franchise, occupational, personal property,
sales and employer's portion of employment taxes, etc.)

(19) $

Other expenses (e.g., secured debt payments. Specify on attachment. Do not include credit card payments)

(20) $

Round to the nearest dollar.
Do not enter a negative number. If any line item is a negative number, enter "0" on that line.

Box C
Total Business Expenses

Add lines (11) through (20) and enter the amount in Box C = $
Round to the nearest dollar.
Do not enter a negative number. If any line item is a negative number, enter "0" on that line.

Box D
Remaining Monthly Income

Subtract Box C from Box B and enter the amount in Box D = $
Catalog Number 55897B

www.irs.gov

Form

433-B (OIC) (Rev. 4-2023)

Page 5

Section 5

Calculate Your Minimum Offer Amount

The next steps calculate your minimum offer amount. The amount of time you take to pay your offer in full will affect your minimum offer amount. Paying
over a shorter period of time will result in a smaller minimum offer amount.
Note: The multipliers below (12 and 24) and the calculated offer amount do not apply if IRS determines you have the ability to pay your tax
debt in full within the legal period to collect.
If you will pay your offer in 5 or fewer payments within 5 months or less, multiply "Remaining Monthly Income" (Box D) by 12 to get "Future Remaining
Income." Do not enter a number less than zero.
Round to the nearest whole dollar.

Enter the total from Box D

Box E Future Remaining Income

X 12 =

$

$

If you will pay your offer in 6 to 24 months, multiply "Remaining Monthly Income" (Box D) by 24 to get "Future Remaining Income". Do not enter a
number less than zero.

Enter the total from Box D

Box F Future Remaining Income

X 24 =

$

$

Determine your minimum offer amount by adding the total available assets from Box A to the amount in either Box E or Box F. Your offer amount must
be more than zero.

Enter the amount from Box A*

Enter the amount from either
Box E or Box F

+

$

Offer Amount
Your offer must be more than zero ($0).
Do not leave blank. Use whole dollars only.
Place your offer amount on Form 656
Section 4, Payment Terms.

=

$

$

*You may exclude any equity in income producing assets (except real estate) shown in Section 2 of this form.

Section 6

Other Information

Additional information IRS needs to consider settlement of your tax debt. If this business is currently in a bankruptcy proceeding, the
business is not eligible to apply for an offer.
Is the business currently in bankruptcy
Yes

No

Has the business filed bankruptcy in the past 10 years
Yes

No

If yes, provide
Date dismissed or discharged (mm/dd/yyyy)

Date filed (mm/dd/yyyy)
Petition no.

Location filed

Does this business have other business affiliations (e.g., subsidiary or parent companies)
Yes

No

If yes, list the name and Employer Identification Number
Do any related parties (e.g., partners, officers, employees) owe money to the business
Yes

No

Is the business currently, or in the past, party to litigation
Yes

No

If yes, answer the following
Plaintiff

Location of filing

Represented by

Possible completion date (mmddyyyy)

Subject of litigation

Docket/Case number

Defendant
Amount in dispute
$
Are you or have you been party to litigation involving the IRS/United States (including any tax litigation)
Yes

No

If yes and the litigation included tax debt, provide the types of tax and periods involved.

Catalog Number 55897B

www.irs.gov

Form

433-B (OIC) (Rev. 4-2023)

Page 6

Section 6 (Continued)

Other Information

In the past 10 years, has the business transferred any asset with a fair market value of more than $10,000, including real property, for less than its full
value
Yes

No

If yes, provide date, value, and type of asset transferred
In the past 3 years have you transferred any real property (land, house, etc.)
Yes

No

If yes, list the type of property, value, and date of the transfer
Has the business been located outside the U.S. for 6 months or longer in the past 10 years
Yes

No

Do you have any assets or own any real property outside the U.S.
Yes

No

If yes, please provide description, location, and value
Does the business have any funds being held in trust by a third party
Yes

No

If yes, how much $

Where

Does the business have any lines of credit
Yes

No

If yes, credit limit $

Amount owed $

What property secu