4905 Form Ftb – Fill Out and Use This PDF

The FTB 4905 PIT form, officially called the Offer in Compromise for Individuals, lets California taxpayers propose settling income tax debts for less than the full balance when full payment is not financially possible now or in the future. You submit this form to the California Franchise Tax Board (FTB) along with documentation of your income, assets, expenses, and employment. The FTB evaluates your offer based on your ability to pay and asset equity.

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4905 Form Ftb PDF Details

The FTB 4905 PIT Offer in Compromise (OIC) program helps California residents resolve outstanding income tax debts when full repayment is not possible. The FTB evaluates each application based on the applicant's ability to pay, equity in assets, and current and future income and expenses.

To be eligible to apply, you must meet these basic requirements:

All required California income tax returns must be filed and current.

You must agree with the FTB on the total tax amount owed.

You must not be in an active bankruptcy proceeding.

Your proposed offer amount must represent the most the FTB can realistically collect.

The application package requires personal identification, income and employment details, a three-year income summary, a complete list of assets and liabilities, monthly household expenses, and your proposed offer amount with the planned source of funds. The FTB returns incomplete applications without review, so gather all documentation before submitting.

If an Offer in Compromise is not the right fit, California taxpayers may also consider filing an installment agreement request for a structured repayment plan. For other FTB-related filings, see FTB Form 3519 (extension payment) or FTB Form 3539.

Question	Answer
Form Name	4905 Form Ftb
Form Length	16 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	4 min
Other names	4905 california form, ftb offer in compromise, ftb form 4905 pit, california form offer

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FTB 4905 PIT BOOKLET

Offer in Compromise

for Individuals

Table of Contents

What You Need to Know Before You Prepare an Offer in Compromise . . . . . . . . . . . . . . . . . . . . . . . . 1 Offer in Compromise Application Form – Checklist of Required Items. . . . . . . . . . . . . . . . . . . . . . . . . 2 Section 1 – Personal Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Section 2 – Employment or Business Income Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Section 3 – General Financial Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Section 4 – Asset and Liability Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Section 5 – Monthly Household Income and Expense Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Section 6 – Three Year Income Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Section 7 – Basis for the Offer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Section 8 – Source of Funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Section 9 – Offer Amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Section 10 – Statement of Agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Frequently Asked Questions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

An Offer in Compromise (OIC) provides an alternative for individuals who are unable to pay their outstanding California income tax liabilities, and who won’t be able to in the foreseeable future.

What You Need to Know Before Preparing an Offer in Compromise

Eligibility: If you are an individual without the income, assets, or means to pay your tax liability now or in the foreseeable future, you may be eligible for an OIC. The OIC Program allows you to offer a lesser amount for payment of a nondisputed ﬁnal tax liability.

Generally, we approve an OIC when the amount offered represents the most we can expect to collect within a reasonable period of time.

Although each case is evaluated based on its own unique set of facts and circumstances, we give the following factors strong consideration in the evaluation:

•Your ability to pay.

•Your equity in assets.

•Your present and future income.

•Your present and future expenses.

•The potential for changed circumstances.

•The offer is in the best interest of the state.

Your	We will only process your OIC application once you:
Application:

•File all required tax returns. If you have no ﬁling requirement, note it on the application.

•Fully complete the OIC application and provide all supporting documentation.

•You agree with the Franchise Tax Board (FTB) on the amount of tax you owe.

Collateral	Upon approval of your offer, we may require you to enter into a collateral agreement. If you
Agreement:	have a signiﬁcant potential for increased earnings, we may require that you pay a greater
	portion or all of your original tax liability if you earn more than anticipated during the ﬁve
	year period following FTB’s approval of your OIC.
Collection	Submitting an offer does not automatically suspend collection activity. If delaying collection
Activity:	activity jeopardizes our ability to collect the tax, we may continue collection efforts. Interest,
	fees, and penalties continue to accrue as prescribed by law.
When to pay:	Do not submit the offer amount until we request it. When we ask for the funds, submit them
	by cashier’s check or money order.

FTB 4905 PIT CI (REV 04-2009) PAGE 1

STATE OF CALIFORNIA

OIC GROUP MS A453

FRANCHISE TAX BOARD

PO BOX 2966

RANCHO CORDOVA CA 95741-2966 916.845.4787 (not toll-free) ftb.ca.gov

OFFER IN COMPROMISE APPLICATION FORM

Checklist of Required Items

You must submit the following documentation with your Offer in Compromise Application Form or we will return your application as incomplete. You must include the information for you and your spouse/Registered Domestic Partner (RDP). Please submit copies only. Indicate if any of the items below are not applicable (N/A). We may request additional documentation.

N/A Included

mm Veriication of Income

Complete pay stubs for the past three months, or ﬁnancial statements for the past two years if self-employed. Include any investment or ownership in any business entity or trust, and income derived from these sources (dividends, K-1 income, distributions, etc.).

mm Veriication of Expenses

Billing statements for the last three months. (Include copies of revolving charge card statements, bills from other creditors, and personal loan statements.)

mm Bank Information

Complete bank statements for savings and checking accounts for the last six months. If self-employed, provide bank statements for the last twelve months. Include accounts that have been closed during that period.

mm Securities

Investment account statements showing the value of stocks, bonds, mutual funds, and/or retirement or proﬁt sharing plans, e.g., IRA, 401(k), Keogh, or Annuity.

mm Current Lease or Rental Agreements

mm Real Property Information

Mortgage statements and escrow statements for property you currently own, sold, or gave away in the last ﬁve years.

mm Internal Revenue Service (IRS) Information

IRS OIC application and acceptance letter or other IRS arrangements.

mm Legal Documents

Marital settlement agreements, divorce decrees, marital property settlements, trust documents, and bankruptcy documents.

mm Medical Information

Physician’s letter including diagnosis and prognosis and/or other documents to show any medical condition that should be considered.

mm Power of Attorney

Power of Attorney if a designated representative submits this offer.

Mail your completed and signed application to the address listed above.

If you have any questions, contact the OIC group at 916.845.4787 (not toll-free).

FTB 4905 PIT C1 (REV 04-2009) PAGE 2

Note: Complete all areas that are not shaded. Write “n/a” in those blocks that do not apply. For Privacy Notice information, please read the enclosed FTB 1131. To get additional copies of this notice, call us at 800.338.0505; from outside the United States call 916.845.6600 (not toll-free) or download it at ftb.ca.gov.

Section 1 – Personal Information

First name	MI	Last name				Social security number		Date of birth


Other names and aliases ever used


First name of spouse or Registered Domestic	MI	Last name of spouse or RDP				Social security number		Date of birth
Partner (RDP)


Other names and aliases ever used


Taxpayer’s driver’s license number		State	Spouse or RDP driver’s license number					State


Dependent’s names				Date of birth	Social security number		Relationship

Current mailing address

Phone number

()

Cell phone number

()

Current physical address

Previous address if at current address less than two years

Name and address of your tax representative (attach a Power of Attorney)

Phone number

()

Cell phone number

()

Fax phone number

()

FTB 4905 PIT CI (REV 04-2009) PAGE 3

Section 2 – Employment or Business Income Information

Taxpayer’s employer or business (name and address):
		How long employed: _______ Years		_______ Months
		Occupation: __________________________________
		m Wage earner	m฀Sole proprietor
		m฀Partner	m฀Ofﬁcer
		Paid:	m฀Biweekly
		m Weekly	m฀Biweekly
Business phone number: (	)	m฀Monthly	m฀Semimonthly
Business phone number: (	)

Spouse’s or RDP’s employer or business (name and address):
		How long employed: _______ Years		_______ Months
		Occupation: __________________________________
		m Wage earner	m฀Sole proprietor
		m฀Partner	m฀Ofﬁcer
		Paid:	m฀Biweekly
		m Weekly	m฀Biweekly
Business phone number: (	)	m฀Monthly	m฀Semimonthly
Business phone number: (	)

Section 3 – General Financial Information

Bank accounts: (include IRA and retirement plans, certiﬁcates of deposit, etc.). Attach additional pages if needed.

Name of Institution

Address

Type

Date

Opened

Account Number

Balance

Total. Enter this amount on line 2, Section 4 (Asset and Liability Analysis) of this application . . .

Vehicles: Attach additional pages if needed.

Year, Make, Model,

License Number

Lender/Pink Slip

Holder

Current Market

Value

Current Payoff

Available Equity

Total. Enter this amount on line 3, Section 4 (Asset and Liability Analysis) of this application . . .

FTB 4905 PIT C1 (REV 04-2009) PAGE 4

Section 3 – General Financial Information (continued)

Life insurance. Attach additional pages if needed.

Name of Insurance

Agent’s Name

and Phone Number

Policy Number

Type

Face Amount

Loan/Cash

Surrender

Value

Total. Enter this amount on line 4, Section 4 (Asset and Liability Analysis) of this application . . .

Securities. (Stocks, bonds, mutual funds, money market funds, etc.) Attach additional pages if needed.

Type

Where Located

Owner of Record

Quantity or

Denomination

Current Value

Total. Enter this amount on line 5, Section 4 (Asset and Liability Analysis) of this application . .

Safe deposit boxes rented or accessed locations, box numbers, and contents. Attach additional pages if needed.

Name of Institution

Address

Box Identiﬁcation

Current Value

of Assets

Total. Enter this amount on line 6, Section 4 (Asset and Liability Analysis) of this application . .

Real property. Attach additional pages if needed.

A) Physical address and description: (Single family dwelling, multi-family dwelling, lot, etc.) Mortgage lender’s name and address:

	How is title held: _________________________________
	Purchase Price: _______________
Parcel Number:	Purchase Date: _______________

B) Physical address and description: (Single family dwelling, multi-family dwelling, lot, etc.)	Mortgage lender’s name and address:

	How is title held: _________________________________
	Purchase Price: _______________
Parcel Number:	Purchase Date: _______________

FTB 4905 PIT CI (REV 04-2009) PAGE 5

Who Took Possession

Section 3 – General Financial Information (continued)

C) Physical address and description: (Single family dwelling, multi-family dwelling, lot, etc.)

Parcel Number:

Mortgage lender’s name and address:

How is title held: ____________________________

Purchase Price: _______________

Purchase Date: _______________

Charge cards and lines of credit. Attach additional pages if needed.

Type of	Name and Address of	Minimum Monthly	Credit Limit	Credit	Amount Owed
Account	Creditor Grantor	Payment	Credit Limit	Availability	Amount Owed
Account	Creditor Grantor	Payment		Availability

Total Payments.

Enter total of payments on line 61,

Section 5 of this application. . . . . . . . . . . . . . . . . .

Total Owed.

Enter total owed on line 22, Section 4 of this application. . .

Provide the following information relating to you and your spouse/RDP’s ﬁnancial condition. If you check “Yes”, provide dates, explanation, and documentation.

Court proceedings	m฀No m฀Yes
Repossessions	m฀No m฀Yes
Anticipated increase in income	m฀No m฀Yes
Bankruptcies/receiverships	m฀No m฀Yes
Recent transfer of assets	m฀No m฀Yes
Beneﬁciary to trust, estate, proﬁt sharing, etc. .	m฀No	m฀Yes
Last California income tax return ﬁled	Year	_____
Total exemptions you claim from return:	___________
Adjusted gross income from return:	___________

List any vehicles, equipment, or property sold, given away, or repossessed during the past ﬁve years.

DescriptionValue (Year, make, model of vehicle, or property address)

FTB 4905 PIT C1 (REV 04-2009) PAGE 6

Section 4 – Asset and Liability Analysis

Immediate assets

1. Cash. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Bank accounts/balance (from Section 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Vehicles/available equity (from Section 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Loan/cash surrender value of life insurance (from Section 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Securities (from Section 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6. Safe deposit box value of contents (from Section 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Immediate Assets . . . . . . . . . . . .

Real property (from Section 3)

	Address or Location	Current Market	Mortgage	Equity
	Address or Location	Value	Payoff Amount	Equity
		Value	Payoff Amount
7.	A)
8.	B)
9.	C)

Total Equity . . . . . . . . . . . . . . . . . . . . . .

Other assets

10. Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. Accounts receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12. Judgements/settlements receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13. Aircraft, watercraft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14. Interest in trusts, e.g., trustee, trustor, beneﬁciary, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15. Interest in estates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16. Interest in business entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17. Other assets ______________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18. Other assets ______________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19. Other assets ______________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20. Other assets ______________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Other Assets. . . . . . . . . . . . . . . . .

21. Sum Total of Assets (Immediate, Equity, and Other). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Current liabilities including judgements, notes and other charge accounts. Do not include vehicle or home loans.

22. Total owed for lines of credit (from Section 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23. Taxes owed to IRS (provide a copy of recent notices) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

24. Other liabilities _____________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25. Other liabilities _____________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26. Other liabilities _____________________________________. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27. Other liabilities _____________________________________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total Liabilities . . . . . . . . . . . . . . . . . .

FTB 4905 PIT CI (REV 04-2009) PAGE 7

How to Edit 4905 Form Ftb Online for Free

Filling out the FTB 4905 PIT form online is straightforward using our PDF editor. Follow these steps to complete your Offer in Compromise application.

Steps to Fill Out the FTB 4905 Form

Step 1: Select the button "Get Form Here" to open the form in the editor.

Step 2: Now you will be on your form edit page. You can include, update, highlight, check, cross, insert or delete fields or phrases.

To fill out the ftb offer in compromise PDF, provide the information for all of the parts:

Provide the required details in the Internal Revenue Service IRS, Legal Documents Marital settlement, Medical Information Physicians, Power of Attorney Power of, Mail your completed and signed, If you have any questions contact, and FTB PIT C REV PAGE box.

You may be requested to provide personal details including your first name, last name, Social Security number, date of birth, any other names or aliases used, and your spouse or Registered Domestic Partner (RDP) information in the Personal Information section.

The Current mailing address, Phone number, Cell phone number, Current physical address, Previous address, and Name and address of your tax representative fields must be completed accurately.

forms Current mailing address, Phone number, Cell phone number, Current physical address, Previous address if at current, Name and address of your tax, Phone number, and Cell phone number blanks to fill

End by reading these sections and filling in the required particulars: Fax phone number, and FTB PIT CI REV PAGE.

Step 3: Once you hit the Done button, the finalized document is ready to export to any device. You can also send it by email or download it directly.

Step 4: Make two copies of the document to prevent misunderstandings and keep one for your records.

What You Need Before You Start

Gather these items before opening the FTB 4905 PIT form to complete your application without interruptions:

Social Security numbers for yourself and your spouse or registered domestic partner (RDP)
Three years of California income tax returns (most recent)
A complete list of all assets and their current fair market values
Monthly income and expense documentation
Bank statements and documentation of any outstanding liabilities
Your proposed offer amount and planned source of funds

Common Mistakes to Avoid

Applications returned as incomplete are the most frequent cause of delay. Avoid these errors when filling out the FTB 4905 form:

Leaving any required field blank. The FTB returns incomplete applications without review.
Failing to attach all supporting documentation for income and assets.
Submitting an offer amount lower than what the FTB calculates as your ability to pay.
Not including a signed statement of agreement with the total tax amount owed.

After You Submit the Form

Once you submit the 4905 FTB form, the California Franchise Tax Board will review your financial details and evaluate your proposed offer. During this review period, collection activities may continue. If your offer is accepted, you must comply with all future California tax filing and payment requirements, including filing all returns on time and paying all taxes due.

If you need an alternative payment option, consider an installment agreement for structured monthly payments, or review the California FTB 626 form for related tax relief options.

4905 Form Ftb – Fill Out and Use This PDF

4905 Form Ftb PDF Details

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