Irs Form 656 PDF Details

The Irs form 656 is a document used to apply for an Offer in Compromise. This form can be used by individuals or businesses to request that the Internal Revenue Service (IRS) consider a reduction in the amount of taxes owed. The form must be completed correctly and accurately in order to be considered by the IRS. The Offer in Compromise program is often used as a way to reduce tax debt when other methods, such as payment plans, are not available or feasible. Completing the Irs form 656 correctly is critical, as any mistakes may delay or prevent your application from being approved. For more information on how to complete this form, consult an experienced tax professional.

If you would like first understand how much time you will need to fill in the irs form 656 and what number of pages it's got, here is some basic information that may be useful.

QuestionAnswer
Form NameIrs Form 656
Form Length8 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min
Other namesform 656 a, 656, low income certification guidelines form 656, 656 form

Form Preview Example

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 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 no guarantee of offer acceptance. The Pre-Qualifier tool is located on our website at https://irs.treasury.gov/ oic_pre_qualifier/.

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 at 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 that helps taxpayers and protects taxpayer rights. TAS helps taxpayers whose problems with the IRS are causing financial difficulties, who've tried but haven't been able to resolve their problems with the IRS or believe an IRS system or procedure isn't working as it should. The service is free. Your local advocate's number is in your local directory and at taxpayeradvocate.irs.gov. You can also call us at 877-777-4778. For more information about TAS and your rights under the Taxpayer Bill of Rights, go to taxpayeradvocate.irs.gov. TAS is your voice at the IRS.

Low-Income Taxpayer Clinics (LITCs) are independent from the IRS. LITCs serve individuals whose income is below a certain level and who need to resolve a tax problem with the IRS. LITCs provide professional representation before the IRS or in court on audits, appeals, tax collection disputes, and other issues for free or for a small fee. For more information and to find a LITC near you, see the LITC page at www.taxpayeradvocate.irs.gov/litcmap or IRS Publication 4134, Low-Income Taxpayer Clinic List. This publication is also available by calling the IRS toll-free at 800-829-3676 or visiting your local IRS office.

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)

 

make all required federal tax deposits for the current quarter if you are a business

 

owner with employees. The IRS will immediately return your offer without further

 

consideration if you have not filed all legally required tax returns.

 

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

If you or your business is currently in an open bankruptcy proceeding, you are not

Innocent Spouse Claim

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 Future Tax Refunds

The IRS will keep any refund, including interest, for tax periods extending through

 

the calendar year that the IRS accepts the offer. For example, the IRS accepts

 

your offer in 2020 and you file your 2020 Form 1040 on April 15, 2021 showing a

 

refund; the IRS will apply your refund to your 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-TAX-

 

FORM (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. If the tax lien(s) has/

 

have not been released, the IRS may be entitled to any proceeds from the sale of

 

property subject to the lien(s). 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.

 

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 enters

 

into a compromise with an employer for a portion of the trust fund tax liability, the

 

remainder of the trust fund taxes must 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.

 

Penalties and interest will continue to accrue.

 

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

 

(including any extensions).

 

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, include a complete 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).

 

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".

2

 

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 will

 

return your offer. You cannot appeal this decision. Total payments must equal the

 

total offer amount.

 

Reminder: The initial payment and monthly payments are not required if you meet

 

the Low-Income Certification guidelines.

 

Generally, payments made on an offer will not be returned. You may make a

 

deposit, as described in Form 656, Section 5, which may be returned if the offer is

 

not accepted. If the IRS accepts your offer, your payments made during the offer

 

process, including any money designated as a deposit, will be applied to your offer

 

amount.

 

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 located on our website

 

at http://irs.treasury.gov/oic_pre_qualifier/ 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

If you and your spouse have joint tax debt(s) and you or your spouse are also

Joint and Separate Tax Debts

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 his or her 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 ex-

 

spouse 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

If you have individual and business tax debt that you wish to compromise, you will

Business Tax Debt

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

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

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 gross monthly income and average expenses. The entire 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.

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

You will need to attach supporting documentation with Form(s) 433-A (OIC) and

Documentation

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

Step 6 – Include Initial Payment and $205 Application Fee

Step 7 – Mail the Application Package

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.

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.

Include a separate personal check, cashier's check, or money order for the application fee. Make both payments (in U.S. dollars) payable to the “United States Treasury”.

You may choose to make your initial offer payment and application fee through the Electronic Federal Tax Payment System (EFTPS).

Reminder: If you meet the Low-Income Certification guidelines DO NOT send any money.

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 him or her 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 (including any extensions) 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 2021)

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 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.

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

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

 

 

Date of birth (mm/dd/yyyy)

 

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-

-

Marital status

 

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

Do you

 

 

 

 

 

 

Unmarried

Married

 

 

 

 

 

 

 

 

Own your home

 

 

 

Rent

 

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

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

County of residence

 

Primary phone

 

 

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

 

 

 

 

(

)

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Secondary phone

 

 

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

 

 

 

Age

 

Relationship

 

Claimed as a dependent

Contributes to

 

 

 

 

 

 

 

on your Form 1040

 

household income

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

No

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

No

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

No

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

No

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 2

 

 

 

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

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

 

 

 

Monthly

Other

 

 

 

 

 

 

 

Do you have an ownership interest in this

If yes, check the business interest that applies

 

 

business

 

Partner

Sole proprietor

 

 

Yes

No

Officer (complete Form 433-B (OIC))

 

 

 

 

 

 

 

 

Your occupation

How long with this employer

 

 

 

 

 

 

 

(years)

(months)

 

 

 

 

 

 

 

 

Spouse’s employer's name

Pay period

Weekly

Bi-weekly

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

 

 

 

Monthly

Other

 

 

 

 

 

 

Does your spouse have an ownership

If yes, check the business interest that applies

 

 

interest in this business

Partner

Sole proprietor

 

 

Yes

No

Officer (complete Form 433-B (OIC))

 

 

 

 

 

 

 

 

Spouse's occupation

How long with this employer

 

 

 

 

 

 

 

(years)

(months)

 

 

 

 

 

 

 

 

Catalog Number 55896Q

 

www.irs.gov

 

 

Form 433-A (OIC) (Rev. 4-2021)

 

Page 2

Section 3

Personal Asset Information

 

 

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 virtual currency (such as Bitcoin, Ripple, Ethereum, etc.), life insurance policies that have a cash value, and safe deposit boxes. 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).

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

Online Account

Stored Value Card

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bank name

 

 

 

 

 

 

 

 

 

 

 

Account number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1a)

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Checking

 

Savings

Money Market Account/CD

Online Account

Stored Value Card

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bank name

 

 

 

 

 

 

 

 

 

 

 

Account number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1b)

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total of bank accounts from attachment

(1c)

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

(1)

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Investment account

 

 

Stocks

 

 

Bonds

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Financial Institution

 

 

 

 

 

Account number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current market value

 

 

 

 

 

 

 

 

 

 

 

Minus loan balance

 

 

 

 

$

 

 

 

 

 

 

X .8 = $

 

 

 

 

 

 

– $

 

 

 

=

(2a)

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Investment account

 

 

Stocks

 

 

Bonds

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Financial Institution

 

 

 

 

 

Account number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current market value

 

 

 

 

 

 

 

 

 

 

 

Minus loan balance

 

 

 

 

$

 

 

 

 

 

 

X .8 = $

 

 

 

 

 

 

– $

 

 

 

=

(2b)

$

 

 

 

 

 

 

 

 

 

 

 

 

Virtual currency

 

 

Name of virtual currency

 

Email address used to

Location(s) of virtual

 

 

 

 

 

 

 

 

wallet, exchange or digital

set-up with the virtual

currency

 

 

 

Type of virtual currency

 

 

 

 

 

currency exchange (DCE)

currency exchange or DCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current market value in U.S. dollars as of today

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

X .8 = $

 

 

 

 

 

 

 

 

 

 

 

=

(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

 

 

 

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

Policy number

 

 

 

 

 

 

 

 

 

 

Current cash value

Minus loan balance

 

 

 

$

 

– $

 

=

(4a)

$

 

 

 

 

 

Total cash value of life insurance policies from attachment

Minus loan balance(s)

 

 

 

$

 

– $

 

=

(4b)

$

 

 

 

 

 

 

 

 

 

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

(4)

$

 

 

 

 

Catalog Number 55896Q

www.irs.gov

 

Form 433-A (OIC) (Rev. 4-2021)

Watch Irs Form 656 Video Instruction

If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .