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Form 9465-Installment Agreement Request

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taxman taxman

The document is an IRS form for requesting an installment agreement to pay back taxes owed. It provides instructions for taxpayers to set up a monthly payment plan rather than paying their full tax balance immediately. Key details include the monthly payment amount, date each payment will be due, and option to have payments automatically withdrawn from a checking account. The IRS will generally respond within 30 days to approve or deny the request, and set up the installment agreement if approved.

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9465 Installment Agreement Request Form OMB No. 1545-0074 (Rev. December 2008) If you are filing this form with your tax return, attach it to the Department of the Treasury front of the return. Otherwise, see instructions. Internal Revenue Service Caution: Do not file this form if you are currently making payments on an installment agreement or can pay your balance due in full within 120 days. Instead, call 1-800-829-1040. If you are in bankruptcy or we have accepted your offer-in-compromise, see Bankruptcy or offer-in-compromise on page 2. This request is for Form(s) (for example, Form 1040) and for tax year(s) (for example, 2007 and 2008) 1 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, enter city, province or state, and country. Follow the country’s practice for entering the postal code. 2 If this address is new since you filed your last tax return, check here ( ) ( ) 3 4 Your home phone number Best time for us to call Your work phone number Ext. Best time for us to call 5 6 Name of your bank or other financial institution: Your employer’s name: Address Address City, state, and ZIP code City, state, and ZIP code 7 7 Enter the total amount you owe as shown on your tax return(s) (or notice(s)) 8 Enter the amount of any payment you are making with your tax return(s) (or notice(s)). See instructions 8 9 Enter the amount you can pay each month. Make your payments as large as possible to limit 9 interest and penalty charges. The charges will continue until you pay in full 10 Enter the day you want to make your payment each month. Do not enter a day later than the 28th 11 If you want to make your payments by electronic funds withdrawal from your checking account, see the instructions and fill in lines 11a and 11b. 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 electronic funds 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 9 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. Your signature Date Spouse’s signature. If a joint return, both must sign. Date ● You want to request an online payment agreement. See General Instructions Applying online for a payment agreement on page 2. Section references are to the Internal Revenue Code. Guaranteed installment agreement. Your request for an Purpose of Form installment agreement cannot be turned down if the tax you owe is not more than $10,000 and all three of the following Use Form 9465 to request a monthly installment plan if you apply. cannot pay the full amount you owe shown on your tax return ● During the past 5 tax years, you (and your spouse if filing a (or on a notice we sent you). Generally, you can have up to 60 joint return) have timely filed all income tax returns and paid months to pay. In certain circumstances, you can have longer any income tax due, and have not entered into an installment to pay or your agreement can be approved for an amount that agreement for payment of income tax. is less than the amount of tax you owe. However, before ● The IRS determines that you cannot pay the tax owed in requesting an installment agreement, you should consider full when it is due and you give the IRS any information other less costly alternatives, such as getting a bank loan or needed to make that determination. using available credit on a credit card. If you have any ● You agree to pay the full amount you owe within 3 years questions about this request, call 1-800-829-1040. and to comply with the tax laws while the agreement is in Do not use Form 9465 if: effect. ● You can pay the full amount you owe within 120 days (see page 2), or 9465 For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 14842Y Form (Rev. 12-2008)
2 Form 9465 (Rev. 12-2008) Page A Notice of Federal Tax Lien may be filed to protect After we receive each payment, we will send you a notice the government’s interests until you pay in full. showing the remaining amount you owe, and the due date CAUTION and amount of your next payment. But if you choose to have Can you pay in full within 120 days? If you can pay the full your payments automatically withdrawn from your checking amount you owe within 120 days, call 1-800-829-1040 to account, you will not receive a notice. Your bank statement establish your request to pay in full. If you can do this, you is your record of payment. We will also send you an annual can avoid paying the fee to set up an installment agreement. statement showing the amount you owed at the beginning of Instead of calling, you can apply online. the year, all payments made during the year, and the amount Applying online for a payment agreement. Instead of filing you owe at the end of the year. Form 9465, you can apply online for a payment agreement. If you do not make your payments on time or do not pay To do that, go to www.irs.gov, use the pull-down menu any balance due on a return you file later, you will be in under “I need to . . .” and select “Set Up a Payment Plan.” default on your agreement and we may take enforcement Bankruptcy or offer-in-compromise. If you are in actions, such as the filing of a Notice of Federal Tax Lien or bankruptcy or we have accepted your offer-in-compromise, an IRS levy action, to collect the entire amount you owe. To do not file this form. Instead, call 1-800-829-1040 to get the ensure that your payments are made timely, you should number of your local IRS Insolvency function for bankruptcy consider making them by electronic funds withdrawal (see or Technical Support function for offer-in-compromise. the instructions for lines 11a and 11b). For additional information on the IRS collection process, see How the Installment Agreement Works Pub. 594, The IRS Collection Process. We will usually let you know within 30 days after we receive Where To File your request whether it is approved or denied. However, if this request is for tax due on a return you filed after March Attach Form 9465 to the front of your return and send it to 31, it may take us longer than 30 days to reply. If we the address shown in your tax return booklet. If you have approve your request, we will send you a notice detailing the already filed your return or you are filing this form in terms of your agreement and requesting a fee of $105 ($52 if response to a notice, file Form 9465 by itself with the Internal you make your payments by electronic funds withdrawal). Revenue Service Center at the address below that applies to However, you may qualify to pay a reduced fee of $43 if your you. No street address is needed. income is below a certain level. The IRS will let you know IF you live in . . . THEN use this address . . . whether you qualify for the reduced fee. If the IRS does not say you qualify for the reduced fee, you can request the Department of the Treasury reduced fee using Form 13844, Application For Reduced Alabama, Florida, Georgia, North Internal Revenue Service Center User Fee For Installment Agreements. Carolina, South Carolina, Virginia Atlanta, GA 39901 You will also be charged interest and may be charged a late payment penalty on any tax not paid by its due date, District of Columbia, Maine, Department of the Treasury even if your request to pay in installments is granted. Interest Maryland, Massachusetts, Internal Revenue Service Center and any applicable penalties will be charged until the balance New Hampshire, Vermont Andover, MA 05501 is paid in full. To limit interest and penalty charges, file your return on time and pay as much of the tax as possible with Department of the Treasury Kentucky, Louisiana, Mississippi, Internal Revenue Service Center your return (or notice). Tennessee, Texas, APO, FPO Austin, TX 73301 By approving your request, we agree to let you pay the tax you owe in monthly installments instead of immediately Alaska, Arizona, California, Colorado, paying the amount in full. All payments received will be Hawaii, Idaho, Illinois, Iowa, Kansas, applied to your account in the best interests of the United Minnesota, Montana, Nebraska, Department of the Treasury States. In return, you agree to make your monthly payments Nevada, New Mexico, North Internal Revenue Service Center on time. You also agree to meet all your future tax liabilities. Dakota, Oklahoma, Oregon, South Fresno, CA 93888 This means that you must have enough withholding or Dakota, Utah, Washington, Wisconsin, Wyoming estimated tax payments so that your tax liability for future years is paid in full when you timely file your return. Your Arkansas, Connecticut, Delaware, request for an installment agreement will be denied if all Department of the Treasury Indiana, Michigan, Missouri, New required tax returns have not been filed. Any refund due you Internal Revenue Service Center Jersey, New York, Ohio, in a future year will be applied against the amount you owe. Kansas City, MO 64999 Pennsylvania, Rhode Island, If your refund is applied to your balance, you are still West Virginia required to make your regular monthly installment payment. Payment methods. You can make your payments by check, If you live in American Samoa or Puerto Rico (or exclude income under section 933); are a nonpermanent resident of Guam or the money order, credit card, or one of the other payment Virgin Islands*, have a foreign address; are a dual-status alien; or file methods shown next. The fee for each payment method is Form 2555, 2555-EZ, or 4563, use this address: Department of the also shown. Treasury, Internal Revenue Service Center, Austin, TX 73301, USA Payment method Applicable fee * Permanent residents of Guam or the Virgin Islands cannot use Form 9465. Check, money order, or credit card $105 Electronic funds withdrawal $ 52 Payroll deduction installment agreement $105 For details on how to pay, see your tax return instructions, visit www.irs.gov, or call 1-800-829-1040.
3 Form 9465 (Rev. 12-2008) Page institution different from the one at which you have your Specific Instructions checking account, do not use the routing number on that check. Instead, contact your financial institution for the Line 1 correct routing number. If you are making this request for a joint tax return, show the Line 11b. The account number can be up to 17 characters names and social security numbers (SSNs) in the same order (both numbers and letters). Include hyphens but omit spaces as on your tax return. and special symbols. Enter the number from left to right and Line 7 leave any unused boxes blank. On the sample check on this page, the account number is 20202086. Do not include the Enter the total amount you owe as shown on your tax return check number. (or notice). The electronic funds withdrawal from your checking If the total amount you owe is more than $25,000 TIP account will not be approved unless you (and your (including any amounts you owe from prior years), spouse if a joint return) sign Form 9465. complete and attach Form 433-F, Collection CAUTION Information Statement. You can get Form 433-F by visiting Sample Check—Lines 11a and 11b the IRS website at www.irs.gov. 1234 Line 8 DWAINE MAPLE ROBYN MAPLE 15-0000/0000 123 Pear Lane Even if you cannot pay the full amount you owe now, you E Anyplace, VA 20000 PL should pay as much as possible to limit penalty and interest PAY TO THE charges. If you are filing this form with your tax return, make M $ ORDER OF SA the payment with your return. For details on how to pay, see DOLLARS Routing Account your tax return instructions. number number ANYPLACE BANK Do not include If you are filing this form by itself, such as in response to a Anyplace, VA 20000 (line 11a) (line 11b) the check number. notice, attach a check or money order payable to the “United For States Treasury.” Do not send cash. Be sure to include: 1234 |:250250025| :202020quot;’86quot;. ● Your name, address, SSN, and daytime phone number. ● The tax year and tax return (for example, “2008 Form The routing and account numbers may be in TIP 1040”) for which you are making this request. different places on your check. Line 9 You should try to make your payments large enough so that Privacy Act and Paperwork Reduction Act Notice. Our your balance due will be paid off as quickly as possible legal right to ask for the information on this form is sections without causing you a financial burden. 6001, 6011, 6012(a), 6109, and 6159 and their regulations. We will use the information to process your request for an Line 10 installment agreement. The reason we need your name and You can choose the day of each month your payment is due. social security number is to secure proper identification. We This can be on or after the 1st of the month, but no later require this information to gain access to the tax information than the 28th of the month. For example, if your rent or in our files and properly respond to your request. You are not mortgage payment is due on the 1st of the month, you may required to request an installment agreement. If you do want to make your installment payments on the 15th. When request an installment agreement, you are required to we approve your request, we will tell you the month and day provide the information requested on this form. Failure to that your first payment is due. provide this information may prevent processing your If we have not replied by the date you chose for your first request; providing false information may subject you to fines payment, you can send the first payment to the Internal or penalties. Revenue Service Center at the address shown on page 2 You are not required to provide the information requested that applies to you. See the instructions for line 8 above for on a form that is subject to the Paperwork Reduction Act details on what to write on your payment. unless the form displays a valid OMB control number. Books Lines 11a and 11b or records relating to a form or its instructions must be retained as long as their contents may become material in Making your payments by electronic funds withdrawal the administration of any Internal Revenue law. Generally, tax will help ensure that your payments are made timely TIP and that you are not in default of this agreement. returns and return information are confidential, as required by section 6103. However, we may give this information to the To pay by electronic funds withdrawal from your checking Department of Justice for civil and criminal litigation, and to account at a bank or other financial institution (such as cities, states, and the District of Columbia to carry out their mutual fund, brokerage firm, or credit union), fill in lines 11a tax laws. We may also disclose this information to other and 11b. Check with your financial institution to make sure countries under a tax treaty, to federal and state agencies to that an electronic funds withdrawal is allowed and to get the enforce federal nontax criminal laws, or to federal law correct routing and account numbers. enforcement and intelligence agencies to combat terrorism. Note. We will send you a bill for the first payment and the The average time and expenses required to complete and fee. You must send us your first payment. All other payments file this form will vary depending on individual circumstances. will be electronically withdrawn. For the estimated averages, see the instructions for your Line 11a. The routing number must be nine digits. The first income tax return. two digits of the routing number must be 01 through 12 or If you have suggestions for making this form simpler, we 21 through 32. Use a check to verify the routing number. On would be happy to hear from you. See the instructions for the sample check on this page, the routing number is your income tax return. 250250025. But if your check is payable through a financial

More Related Content

Form 9465-Installment Agreement Request

  • 1. 9465 Installment Agreement Request Form OMB No. 1545-0074 (Rev. December 2008) If you are filing this form with your tax return, attach it to the Department of the Treasury front of the return. Otherwise, see instructions. Internal Revenue Service Caution: Do not file this form if you are currently making payments on an installment agreement or can pay your balance due in full within 120 days. Instead, call 1-800-829-1040. If you are in bankruptcy or we have accepted your offer-in-compromise, see Bankruptcy or offer-in-compromise on page 2. This request is for Form(s) (for example, Form 1040) and for tax year(s) (for example, 2007 and 2008) 1 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, enter city, province or state, and country. Follow the country’s practice for entering the postal code. 2 If this address is new since you filed your last tax return, check here ( ) ( ) 3 4 Your home phone number Best time for us to call Your work phone number Ext. Best time for us to call 5 6 Name of your bank or other financial institution: Your employer’s name: Address Address City, state, and ZIP code City, state, and ZIP code 7 7 Enter the total amount you owe as shown on your tax return(s) (or notice(s)) 8 Enter the amount of any payment you are making with your tax return(s) (or notice(s)). See instructions 8 9 Enter the amount you can pay each month. Make your payments as large as possible to limit 9 interest and penalty charges. The charges will continue until you pay in full 10 Enter the day you want to make your payment each month. Do not enter a day later than the 28th 11 If you want to make your payments by electronic funds withdrawal from your checking account, see the instructions and fill in lines 11a and 11b. 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 electronic funds 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 9 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. Your signature Date Spouse’s signature. If a joint return, both must sign. Date ● You want to request an online payment agreement. See General Instructions Applying online for a payment agreement on page 2. Section references are to the Internal Revenue Code. Guaranteed installment agreement. Your request for an Purpose of Form installment agreement cannot be turned down if the tax you owe is not more than $10,000 and all three of the following Use Form 9465 to request a monthly installment plan if you apply. cannot pay the full amount you owe shown on your tax return ● During the past 5 tax years, you (and your spouse if filing a (or on a notice we sent you). Generally, you can have up to 60 joint return) have timely filed all income tax returns and paid months to pay. In certain circumstances, you can have longer any income tax due, and have not entered into an installment to pay or your agreement can be approved for an amount that agreement for payment of income tax. is less than the amount of tax you owe. However, before ● The IRS determines that you cannot pay the tax owed in requesting an installment agreement, you should consider full when it is due and you give the IRS any information other less costly alternatives, such as getting a bank loan or needed to make that determination. using available credit on a credit card. If you have any ● You agree to pay the full amount you owe within 3 years questions about this request, call 1-800-829-1040. and to comply with the tax laws while the agreement is in Do not use Form 9465 if: effect. ● You can pay the full amount you owe within 120 days (see page 2), or 9465 For Privacy Act and Paperwork Reduction Act Notice, see page 3. Cat. No. 14842Y Form (Rev. 12-2008)
  • 2. 2 Form 9465 (Rev. 12-2008) Page A Notice of Federal Tax Lien may be filed to protect After we receive each payment, we will send you a notice the government’s interests until you pay in full. showing the remaining amount you owe, and the due date CAUTION and amount of your next payment. But if you choose to have Can you pay in full within 120 days? If you can pay the full your payments automatically withdrawn from your checking amount you owe within 120 days, call 1-800-829-1040 to account, you will not receive a notice. Your bank statement establish your request to pay in full. If you can do this, you is your record of payment. We will also send you an annual can avoid paying the fee to set up an installment agreement. statement showing the amount you owed at the beginning of Instead of calling, you can apply online. the year, all payments made during the year, and the amount Applying online for a payment agreement. Instead of filing you owe at the end of the year. Form 9465, you can apply online for a payment agreement. If you do not make your payments on time or do not pay To do that, go to www.irs.gov, use the pull-down menu any balance due on a return you file later, you will be in under “I need to . . .” and select “Set Up a Payment Plan.” default on your agreement and we may take enforcement Bankruptcy or offer-in-compromise. If you are in actions, such as the filing of a Notice of Federal Tax Lien or bankruptcy or we have accepted your offer-in-compromise, an IRS levy action, to collect the entire amount you owe. To do not file this form. Instead, call 1-800-829-1040 to get the ensure that your payments are made timely, you should number of your local IRS Insolvency function for bankruptcy consider making them by electronic funds withdrawal (see or Technical Support function for offer-in-compromise. the instructions for lines 11a and 11b). For additional information on the IRS collection process, see How the Installment Agreement Works Pub. 594, The IRS Collection Process. We will usually let you know within 30 days after we receive Where To File your request whether it is approved or denied. However, if this request is for tax due on a return you filed after March Attach Form 9465 to the front of your return and send it to 31, it may take us longer than 30 days to reply. If we the address shown in your tax return booklet. If you have approve your request, we will send you a notice detailing the already filed your return or you are filing this form in terms of your agreement and requesting a fee of $105 ($52 if response to a notice, file Form 9465 by itself with the Internal you make your payments by electronic funds withdrawal). Revenue Service Center at the address below that applies to However, you may qualify to pay a reduced fee of $43 if your you. No street address is needed. income is below a certain level. The IRS will let you know IF you live in . . . THEN use this address . . . whether you qualify for the reduced fee. If the IRS does not say you qualify for the reduced fee, you can request the Department of the Treasury reduced fee using Form 13844, Application For Reduced Alabama, Florida, Georgia, North Internal Revenue Service Center User Fee For Installment Agreements. Carolina, South Carolina, Virginia Atlanta, GA 39901 You will also be charged interest and may be charged a late payment penalty on any tax not paid by its due date, District of Columbia, Maine, Department of the Treasury even if your request to pay in installments is granted. Interest Maryland, Massachusetts, Internal Revenue Service Center and any applicable penalties will be charged until the balance New Hampshire, Vermont Andover, MA 05501 is paid in full. To limit interest and penalty charges, file your return on time and pay as much of the tax as possible with Department of the Treasury Kentucky, Louisiana, Mississippi, Internal Revenue Service Center your return (or notice). Tennessee, Texas, APO, FPO Austin, TX 73301 By approving your request, we agree to let you pay the tax you owe in monthly installments instead of immediately Alaska, Arizona, California, Colorado, paying the amount in full. All payments received will be Hawaii, Idaho, Illinois, Iowa, Kansas, applied to your account in the best interests of the United Minnesota, Montana, Nebraska, Department of the Treasury States. In return, you agree to make your monthly payments Nevada, New Mexico, North Internal Revenue Service Center on time. You also agree to meet all your future tax liabilities. Dakota, Oklahoma, Oregon, South Fresno, CA 93888 This means that you must have enough withholding or Dakota, Utah, Washington, Wisconsin, Wyoming estimated tax payments so that your tax liability for future years is paid in full when you timely file your return. Your Arkansas, Connecticut, Delaware, request for an installment agreement will be denied if all Department of the Treasury Indiana, Michigan, Missouri, New required tax returns have not been filed. Any refund due you Internal Revenue Service Center Jersey, New York, Ohio, in a future year will be applied against the amount you owe. Kansas City, MO 64999 Pennsylvania, Rhode Island, If your refund is applied to your balance, you are still West Virginia required to make your regular monthly installment payment. Payment methods. You can make your payments by check, If you live in American Samoa or Puerto Rico (or exclude income under section 933); are a nonpermanent resident of Guam or the money order, credit card, or one of the other payment Virgin Islands*, have a foreign address; are a dual-status alien; or file methods shown next. The fee for each payment method is Form 2555, 2555-EZ, or 4563, use this address: Department of the also shown. Treasury, Internal Revenue Service Center, Austin, TX 73301, USA Payment method Applicable fee * Permanent residents of Guam or the Virgin Islands cannot use Form 9465. Check, money order, or credit card $105 Electronic funds withdrawal $ 52 Payroll deduction installment agreement $105 For details on how to pay, see your tax return instructions, visit www.irs.gov, or call 1-800-829-1040.
  • 3. 3 Form 9465 (Rev. 12-2008) Page institution different from the one at which you have your Specific Instructions checking account, do not use the routing number on that check. Instead, contact your financial institution for the Line 1 correct routing number. If you are making this request for a joint tax return, show the Line 11b. The account number can be up to 17 characters names and social security numbers (SSNs) in the same order (both numbers and letters). Include hyphens but omit spaces as on your tax return. and special symbols. Enter the number from left to right and Line 7 leave any unused boxes blank. On the sample check on this page, the account number is 20202086. Do not include the Enter the total amount you owe as shown on your tax return check number. (or notice). The electronic funds withdrawal from your checking If the total amount you owe is more than $25,000 TIP account will not be approved unless you (and your (including any amounts you owe from prior years), spouse if a joint return) sign Form 9465. complete and attach Form 433-F, Collection CAUTION Information Statement. You can get Form 433-F by visiting Sample Check—Lines 11a and 11b the IRS website at www.irs.gov. 1234 Line 8 DWAINE MAPLE ROBYN MAPLE 15-0000/0000 123 Pear Lane Even if you cannot pay the full amount you owe now, you E Anyplace, VA 20000 PL should pay as much as possible to limit penalty and interest PAY TO THE charges. If you are filing this form with your tax return, make M $ ORDER OF SA the payment with your return. For details on how to pay, see DOLLARS Routing Account your tax return instructions. number number ANYPLACE BANK Do not include If you are filing this form by itself, such as in response to a Anyplace, VA 20000 (line 11a) (line 11b) the check number. notice, attach a check or money order payable to the “United For States Treasury.” Do not send cash. Be sure to include: 1234 |:250250025| :202020quot;’86quot;. ● Your name, address, SSN, and daytime phone number. ● The tax year and tax return (for example, “2008 Form The routing and account numbers may be in TIP 1040”) for which you are making this request. different places on your check. Line 9 You should try to make your payments large enough so that Privacy Act and Paperwork Reduction Act Notice. Our your balance due will be paid off as quickly as possible legal right to ask for the information on this form is sections without causing you a financial burden. 6001, 6011, 6012(a), 6109, and 6159 and their regulations. We will use the information to process your request for an Line 10 installment agreement. The reason we need your name and You can choose the day of each month your payment is due. social security number is to secure proper identification. We This can be on or after the 1st of the month, but no later require this information to gain access to the tax information than the 28th of the month. For example, if your rent or in our files and properly respond to your request. You are not mortgage payment is due on the 1st of the month, you may required to request an installment agreement. If you do want to make your installment payments on the 15th. When request an installment agreement, you are required to we approve your request, we will tell you the month and day provide the information requested on this form. Failure to that your first payment is due. provide this information may prevent processing your If we have not replied by the date you chose for your first request; providing false information may subject you to fines payment, you can send the first payment to the Internal or penalties. Revenue Service Center at the address shown on page 2 You are not required to provide the information requested that applies to you. See the instructions for line 8 above for on a form that is subject to the Paperwork Reduction Act details on what to write on your payment. unless the form displays a valid OMB control number. Books Lines 11a and 11b or records relating to a form or its instructions must be retained as long as their contents may become material in Making your payments by electronic funds withdrawal the administration of any Internal Revenue law. Generally, tax will help ensure that your payments are made timely TIP and that you are not in default of this agreement. returns and return information are confidential, as required by section 6103. However, we may give this information to the To pay by electronic funds withdrawal from your checking Department of Justice for civil and criminal litigation, and to account at a bank or other financial institution (such as cities, states, and the District of Columbia to carry out their mutual fund, brokerage firm, or credit union), fill in lines 11a tax laws. We may also disclose this information to other and 11b. Check with your financial institution to make sure countries under a tax treaty, to federal and state agencies to that an electronic funds withdrawal is allowed and to get the enforce federal nontax criminal laws, or to federal law correct routing and account numbers. enforcement and intelligence agencies to combat terrorism. Note. We will send you a bill for the first payment and the The average time and expenses required to complete and fee. You must send us your first payment. All other payments file this form will vary depending on individual circumstances. will be electronically withdrawn. For the estimated averages, see the instructions for your Line 11a. The routing number must be nine digits. The first income tax return. two digits of the routing number must be 01 through 12 or If you have suggestions for making this form simpler, we 21 through 32. Use a check to verify the routing number. On would be happy to hear from you. See the instructions for the sample check on this page, the routing number is your income tax return. 250250025. But if your check is payable through a financial