9465 FS Form – Fill Out and Use This PDF

IRS Form 9465 is the Installment Agreement Request, used to set up a monthly payment plan for federal tax debt you cannot pay in full. Taxpayers who owe $50,000 or less in taxes, penalties, and interest may qualify for an online payment plan without filing this form. Those with larger balances use Form 9465 to propose a monthly payment amount, select a preferred payment date, and optionally authorize direct debit from a bank account.

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IRS Form 9465 PDF Details

Form 9465 lets individuals and businesses ask the IRS for a monthly installment plan on unpaid federal taxes. You propose a payment amount and a preferred due date each month. Paying by direct debit from a bank account lowers your IRS setup fee and reduces the risk of a missed payment.

Eligibility depends on your total balance. If you owe $50,000 or less in combined taxes, penalties, and interest, you may qualify for a streamlined agreement online. If your balance is between $50,001 and $100,000, you can still apply online for an extended installment agreement. Balances above $100,000 typically require a separate financial statement on Form 433-A to give the IRS a full picture of your finances.

The IRS generally sends an approval notice within 30 days of receiving your completed Form 9465. Your first payment is due within 30 days of that approval. Penalties and interest continue to accrue on your unpaid balance while the agreement is in effect, so submitting Form 9465 promptly after receiving an IRS bill reduces your total cost.

The standard user fee to set up an installment agreement is $225. Low-income taxpayers and those who choose direct debit pay a reduced fee of $43. If you miss a scheduled payment, the IRS may default your agreement and pursue collection actions. You can request a modification if your financial situation changes significantly.

Question	Answer
Form Name	9465 FS Form
Form Number	IRS Form 9465
Issuing Authority	Internal Revenue Service (IRS)
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Last Revised	September 2020
Streamlined Agreement Threshold	$50,000 or less
Setup Fee (standard)	$225
Setup Fee (direct debit)	$43
Other names	tax 9465 printable form, irs form 9465, irs installment agreement form 9465, tax 9465

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Form 9465

(Rev. September 2020)

Department of the Treasury

Internal Revenue Service

Installment Agreement Request

▶Go to www.irs.gov/Form9465 for instructions and the latest information.

▶If you are filing this form with your tax return, attach it to the front of the return.

▶See separate instructions.

OMB No. 1545-0074

Tip: If you owe $50,000 or less, you may be able to avoid filing Form 9465 and establish an installment agreement online, even if you haven’t yet received a tax bill. Go to www.irs.gov/OPA to apply for an Online Payment Agreement. If you establish your installment agreement using the Online Payment Agreement application, the user fee that you pay will be lower than it would be with Form 9465.


Part I	Installment Agreement Request
This request is for Form(s) (for example, Form 1040 or Form 941) ▶

Enter tax year(s) or period(s) involved (for example, 2018 and 2019, or January 1, 2019, to June 30, 2019) ▶
1a Your first name and initial		Last name	Your social security number

If a joint return, spouse’s first name and initial

Last name

Spouse’s social security number

Current address (number and street). If you have a P.O. box and no home delivery, enter your box number.

Apt. number

City, town or post office, state, and ZIP code. If a foreign address, also complete the spaces below (see instructions).

	Foreign country name	Foreign province/state/county	Foreign postal code

1b	If this address is new since you filed your last tax return, check here				. . . . . . . . . . ▶
2	Name of your business (must no longer be operating)					Employer identification number (EIN)

3			4

	Your home phone number	Best time for us to call		Your work phone number	Ext.			Best time for us to call
5	Enter the total amount you owe as shown on your tax return(s) (or notice(s))				. . .		5
6	If you have any additional balances due that aren’t reported on line 5, enter the amount here (even if
	the amounts are included in an existing installment agreement)				. . .		6
7	Add lines 5 and 6 and enter the result				. . .		7
8	Enter the amount of any payment you’re making with this request. See instructions . .				. . .		8
9	Amount owed. Subtract line 8 from line 7 and enter the result				. . .		9
10	Divide the amount on line 9 by 72.0 and enter the result				. . .		10
11a	Enter the amount you can pay each month. Make your payment as large as possible to limit interest
	and penalty charges, as these charges will continue to accrue until you pay in full. If you have
	an existing installment agreement, this amount should represent your total proposed monthly
	payment amount for all your liabilities. If no payment amount is listed on line 11a, a payment will
	be determined for you by dividing the balance due on line 9 by 72 months . . . .				. . .		11a $

bIf the amount on line 11a is less than the amount on line 10 and you’re able to increase your payment

to an amount that is equal to or greater than the amount on line 10, enter your revised monthly payment 11b $

• If you can’t increase your payment on line 11b to more than or equal to the amount shown on line 10, check the box. Also, complete and attach Form 433-F, Collection Information Statement . . . . . . . . . . . . . . . . . . .

•If the amount on line 11a (or 11b, if applicable) is more than or equal to the amount on line 10 and the amount you owe is over $25,000 but not more than $50,000, then you don’t have to complete Form 433-F. However, if you don’t complete Form 433-F, then you must complete either line 13 or 14.

•If the amount on line 9 is greater than $50,000, complete and attach Form 433-F.

12 Enter the date you want to make your payment each month. Don’t enter a date later than the 28th

13If you want to make your payments by direct debit from your checking account, see the instructions and fill in lines 13a and 13b. This is the most convenient way to make your payments and it will ensure that they are made on time.

▶a Routing number

▶b Account number

I authorize the U.S. Treasury and its designated Financial Agent to initiate a monthly ACH debit (electronic withdrawal) entry to the financial institution account indicated for payments of my federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the U.S. Treasury Financial Agent to terminate the authorization. To revoke payment, I must contact the U.S. Treasury Financial Agent at

1-800-829-1040 no later than 14 business days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payments of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payments.

cLow-income taxpayers only. If you’re unable to make electronic payments through a debit instrument by providing your banking information on lines 13a and 13b, check this box and your user fee will be reimbursed upon completion of your

installment agreement. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14 If you want to make payments by payroll deduction, check this box and attach a completed Form 2159 . . . . . . .

By signing and submitting this form, I authorize the IRS to contact third parties and to disclose my tax information to third parties in order to process this request and administer the agreement over its duration. I also agree to the terms of this agreement, as provided in the instructions, if it’s approved by the IRS.

Your signature	Date	Spouse’s signature. If a joint return, both must sign.		Date

For Privacy Act and Paperwork Reduction Act Notice, see instructions.		Cat. No. 14842Y	Form 9465 (Rev. 9-2020)

Form 9465 (Rev. 9-2020)

Page 2

Part II Additional Information

Complete this Part only if all three conditions below apply:

1.You defaulted on an installment agreement in the past 12 months;

2.You owe more than $25,000 but not more than $50,000; and

3.The amount on line 11a (or 11b, if applicable) is less than line 10.

Note: If you owe more than $50,000, also complete and attach Form 433-F.

15In which county is your primary residence?

16a Marital status:

Single. Skip question 16b and go to question 17. Married. Go to question 16b.

bDo you share household expenses with your spouse? Yes.

No.

17How many dependents will you be able to claim on this year’s tax return?. . . . . . . . .

18 How many people in your household are 65 or older? . . . . . . . . . . . . . . .

19How often are you paid? Once a week.

Once every 2 weeks.

Once a month.

Twice a month.

20 What is your net income per pay period (take home pay)? . . . . . . . . . . . . . .

20$

Note: Complete lines 21 and 22 only if you have a spouse and meet certain conditions (see instructions). If you don’t have a spouse, go to line 23.

21How often is your spouse paid? Once a week.

Once every 2 weeks.

Once a month.

Twice a month.

22What is your spouse’s net income per pay period (take home pay)? . . . . . . . . . . .

23 How many vehicles do you own? . . . . . . . . . . . . . . . . . . . . . .

24 How many car payments do you have each month? . . . . . . . . . . . . . . . . . . .

22$

25a Do you have health insurance? Yes. Go to question 25b.

No. Skip question 25b and go to question 26a.

bAre your health insurance premiums deducted from your paycheck?

Yes. Skip question 25c and go to question 26a.

No. Go to question 25c.

cHow much are your monthly health insurance premiums? . . . . . . . . . . . . . .

26a Do you make court-ordered payments?
Yes. Go to question 26b.	No. Go to question 27.

25c $

bAre your court-ordered payments deducted from your paycheck?

Yes. Go to question 27.

No. Go to question 26c.

c How much are your court-ordered payments each month? . . . . . . . . . . . . .

26c $

27Not including any court-ordered payments for child and dependent support, how much do you pay for child or dependent care each month? . . . . . . . . . . . . . . . . . . .

Form 9465 (Rev. 9-2020)

How to Edit 9465 FS Form Online for Free

This PDF editor is designed to be simple and fast. Before you start, gather the following: your Social Security Number or Employer Identification Number, the total tax balance from your IRS notice, your bank account and routing number (if you want direct debit), and your proposed monthly payment amount.

Step 1: Click the orange button "Get Form Here" on the following web page.

Step 2: You can now begin editing Form 9465. The toolbar lets you insert, delete, highlight, and modify content in the form. Fill in the required information for each field.

writing agreement irs printable form part 1

Complete the fields for total amount owed, routing number, account number, IRS authorization, low-income taxpayer section, signature, and date. A spouse signature is required on joint returns.

part 2 to entering details in agreement irs printable form

Enter your county of primary residence, marital status, number of dependents, household size, pay frequency, and net income per pay period.

step 3 to finishing agreement irs printable form

Provide details about your spouse's income, the number of vehicles you own, car payments, and health insurance coverage.

stage 4 to completing agreement irs printable form

Fill in court-ordered payments, child or dependent care costs per month, and any other required fields in the final section.

agreement irs printable form c How much are your courtordered, Not including any courtordered, for child or dependent care each, and Form Rev fields to complete

Step 3: Click Done when finished. The completed form is ready to download to your device or send by mail.

Step 4: Make copies for your records. We do not share or monitor your personal information.

Related IRS forms that are commonly used with Form 9465:

Form 433-A – Collection Information Statement, required when your tax balance exceeds $100,000
Form 1040 – Individual Income Tax Return, used to report the liability that created your balance
Form 1040-ES – Estimated Tax for Individuals, helpful for taxpayers who also need to pay quarterly taxes

How long does IRS installment agreement approval take?

The IRS typically sends an approval notice within 30 days of receiving Form 9465. Direct debit agreements are often approved faster. Your first payment is due within 30 days of approval.

What is the minimum monthly payment for an IRS installment agreement?

The IRS sets a minimum based on your total balance divided by 72 months. For streamlined agreements on balances of $50,000 or less, the minimum is generally $25 or more per month.

Can I change my installment agreement after approval?

Yes. You can request a modification if your financial situation changes. Contact the IRS by phone or use the Online Payment Agreement tool at IRS.gov. A $10 fee applies to most modifications requested online.

What happens if I miss a payment?

Missing a payment can cause your installment agreement to default. The IRS may then begin collection actions, including liens or levies. Contact the IRS as soon as possible if you cannot make a payment to discuss your options.

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