Specific Instructions

Part I

Line 1a

If you are making this request for a joint tax return, show the names and social security numbers (SSNs) in the same order as on your tax return.

Line 2

If you are requesting an installment agreement for a business tax liability, enter the business name and employer identification number on this line.

Line 7

Enter the total amount you owe as shown on your tax return(s) (or notice(s)).

If the total amount you owe is greater than $25,000 but not more than $50,000, you must complete Part II and agree to a Direct Debit Installment Agreement (DDIA) to qualify for an IA without completing a financial statement. If you do not agree to a DDIA, you must complete Form 433-F, Collection Information Statement, and mail it with this form. 
 
If the amount you owe is greater than $50,000, you must complete Form 433-F and mail it with this form. You can download Form 433-F at IRS.gov or order it by calling 1-800-TAX-FORM (1-800-829-3676).

If the total amount you owe is not more than $50,000 (including any amounts you owe from prior years), you do not need to file Form 9465-FS; you can request an installment agreement online. For more information see Applying online for a payment agreement, earlier.

Line 8

Even if you cannot pay the full amount you owe now, you should pay as much as possible to limit penalty and interest charges. If you are filing this form with your tax return, make the payment with your return. For details on how to pay, see your tax return instructions.

If you are filing this form by itself, such as in response to a notice, attach a check or money order payable to the “United States Treasury.” Do not send cash. Be sure to include:

  • Your name, address, SSN/EIN, and daytime phone number.

  • The tax year and tax return (for example,“ 2009 Form 1040”) for which you are making this request.

Line 9

Enter on line 9 the amount you can pay each month. Make your payments as large as possible to limit interest and penalty charges. The charges will continue until you pay in full. If a payment amount is not shown on line 9, one will be determined for you by dividing the balance due by 72 months.

Line 10

You can choose the day of each month your payment is due. This can be on or after the 1st of the month, but no later than the 28th of the month. For example, if your rent or mortgage payment is due on the 1st of the month, you may want to make your installment payments on the 15th. When we approve your request, we will tell you the month and day that your first payment is due.

If we have not replied by the date you chose for your first payment, you can send the first payment to the Internal Revenue Service Center at the address shown earlier that applies to you. See the instructions for line 8 above for details on what to write on your payment.

Lines 11a and 11b

Making your payments by electronic funds withdrawal will help ensure that your payments are made timely and that you are not in default of this agreement.

To pay by electronic funds withdrawal from your checking account at a bank or other financial institution (such as mutual fund, brokerage firm, or credit union), fill in lines 11a and 11b. Check with your financial institution to make sure that an electronic funds withdrawal is allowed and to get the correct routing and account numbers.

If the total amount you owe is greater than $25,000 but not more than $50,000, you must agree to a Direct Debit Installment Agreement (DDIA) to qualify for an IA without completing a financial statement. If you do not agree to a DDIA, you must complete Form 433-F, Collection Information Statement, and mail it with this form.

Line 11a.   The routing number must be nine digits. The first two digits of the routing number must be 01 through 12 or 21 through 32. Use a check to verify the routing number. On the sample check on this page, the routing number is 250250025. But if your check is payable through a financial institution different from the one at which you have your checking account, do not use the routing number on that check. Instead, contact your financial institution for the correct routing number.

Line 11b.   The account number can be up to 17 characters (both numbers and letters). Include hyphens but omit spaces and special symbols. Enter the number from left to right and leave any unused boxes blank. On the sample check below, the account number is 20202086. Do not include the check number.

Note.

We may have filed a notice of federal tax lien against your property. If so, you may be able to get the notice of lien withdrawn. To learn more about lien withdrawals and to see if you qualify, visit IRS.gov and enter "lien withdrawal" in the search box.

  
The electronic funds withdrawal from your checking account will not be approved unless you (and your spouse if filing a joint return) sign Form 9465-FS.

  

Sample Check—Lines 11a and 11b

Sample Check - Lines 11a and 11b

  
The routing and account numbers may be in different places on your check.

Part II

Lines 12—24

Complete Part II only if your balance due is greater than $25,000 but not more than $50,000.


More Online Instructions