Instructions For Form 9465 - Installment Agreement Request (Page 4 of 5) in pdf

Line 1b

pay in full. If no payment amount is listed on line 10, a

payment will be determined for you by dividing the

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

balance due by 72 months. If you have an existing

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

installment agreement, this amount should represent your

total proposed monthly payment amount for all your

Line 2

liabilities.

Show the name and employer identification number (EIN)

of your business (must be no longer operating).

Line 11

Divide the amount on line 9 by 72 and enter the result.

Line 7

If the amount on line 10 is less than the amount on

Enter the total amount you owe as shown on your tax

line 11 and you’re unable to increase your payment to the

return(s) (or notice(s)). Include in this total amount all

amount on line 11, complete and attach Form 433-F,

balances that you owe even if they are included in an

Collection Information Statement.

existing installment agreement.

If the amount on line 10 is equal to or greater than the

amount on line 11 but the amount you owe is greater than

Note. Electronic filing of Form 9465 isn’t available if the

$25,000 but not more than $50,000, you must complete

amount you owe is greater than $50,000. If you don’t

either line 13 or 14, if you don’t want to complete Form

agree to make your payments by direct debit or payroll

433-F. If you have defaulted on an installment agreement

deduction, complete Form 433-F, Collection Information

within the last 12 months, and the amount you owe is

Statement, and file it with this form.

greater than $25,000 but not more than $50,000, you

If the amount you owe is greater than $50,000,

must complete Part II on page 2 of Form 9465.

you must complete Form 433-F, and file it with this

If the amount on line 9 is greater than $50,000,

form. You can download Form 433-F at IRS.gov

complete and attach Form 433-F.

CAUTION

or order it by calling 1-800-TAX-FORM (1-800-829-3676).

Line 12

If the total amount you owe isn’t more than

You can choose the day of each month your payment is

$50,000 (including any amounts you owe from

TIP

due. This can be on or after the 1st of the month, but no

prior years), you don’t need to file Form 9465; you

later than the 28th of the month. For example, if your rent

can request an installment agreement online. For more

or mortgage payment is due on the 1st of the month, you

information, see Applying online for a payment

may want to make your installment payments on the 15th.

agreement, earlier.

When we approve your request, we will tell you the month

and day that your first payment is due.

Line 8

If we haven’t replied by the date you chose for your first

Even if you can’t pay the full amount you owe now, you

payment, you can send the first payment to the Internal

should pay as much as possible to limit the penalty and

Revenue Service Center at the address shown earlier that

interest charges. If you’re filing this form with your tax

applies to you. See the instructions for line 8 above for

return, make the payment with your return. For details on

details on what to write on your payment.

how to pay, see your tax return instructions.

Lines 13a and 13b

If you’re filing this form by itself, such as in response to

a notice, attach a check or money order payable to

Making your payments by direct debit will help

“United States Treasury.” Don’t send cash. Be sure to

ensure that your payments are made timely and

TIP

include:

that you aren’t in default of this agreement.

Your name, address, SSN/EIN, and daytime phone

To pay by direct debit from your checking account at a

number.

bank or other financial institution (such as a mutual fund,

The tax year and tax return (for example, “2016 Form

brokerage firm, or credit union), fill in lines 13a and 13b.

1040”) for which you’re making this request.

Check with your financial institution to make sure that a

direct debit is allowed and to get the correct routing and

Line 9

account numbers.

Subtract line 8 from line 7 and enter the result.

Line 13a. The routing number must be nine digits. The

If the total amount you owe is greater than

first two digits of the routing number must be 01 through

$25,000 but not more than $50,000, you must

12 or 21 through 32. Use a check to verify the routing

either: (1) Complete lines 13a and 13b and agree

number. On the sample check on this page, the routing

CAUTION

to make payments by direct debit, or (2) Check box 14 to

number is 250250025. But if your check is payable

make your payments by payroll deduction and attach a

through a financial institution different from the one at

completed, signed Form 2159, Payroll Deduction

which you have your checking account, don’t use the

Agreement. A payroll deduction agreement isn't available

routing number on that check. Instead, contact your

if you file Form 9465 electronically.

financial institution for the correct routing number.

Line 13b. The account number can be up to 17

Line 10

characters (both numbers and letters). Include hyphens

Enter on line 10 the amount you can pay each month.

but omit spaces and special symbols. Enter the number

Make your payments as large as possible to limit interest

from left to right and leave any unused boxes blank. On

and penalty charges. The charges will continue until you

-4-

Instructions For Form 9465 - Installment Agreement Request Page 4

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