1 Cash
13 Aircraft Watercraft (please list CF No or Hull ID No )
16 Partnership Interests
17 Other Assets (include description)
18 Other Assets
20 Other Assets
BOE 490 (S2F) REV 1 (1 06) STATE OF CALIFORNIA
PHYSICAL ADDRESS AND DESCRIPTION (single family dwelling multi family dwelling lot etc ) C)
SECTION 3 OFFER AMOUNT
STATE OF CALIFORNIA
taxpayers ) that do not have and will not have in the foreseeable future the income
The amount of equity in the taxpayer s assets
The potential for changed circumstances
The taxpayer s ability to pay
The taxpayer s present and future expenses
The taxpayer s present and future income
You are no longer associated with the business that incurred the liability to which
You have fully completed the Offer in Compromise Application and provided all
( Auto Insurance amount text)
( Auto Payments amount text)
( Court Ordered Payments (alimony child support restitution) amount text)
( Credit Card Payments (total monthly minimum) from section 6 amount text)
( DATE OF BIRTH)
( Delinquent Tax (non BOE) amount text)
( Electric: ( ) text)
( Estimated Tax Payments (if not deducted from your paycheck) amount text)
( Gas: ( ) text)
( Gasoline amount text)
( Gasoline Number of Miles to Work: ( ) text)
( Groceries number of people: ( ) text)
( Home Insurance: ( ) text)
( Life/Health Insurance (if not deducted from your paycheck) amount text)
( NET DIFFERENCE (TOTAL INCOME LESS EXPENSES text)
( Other Expenses (include description text)
( Real Estate Taxes amount text)
( Rent/Mortgage amount text)
( Trash: ( ) text)
( Utilities amount text)
(: biweekly) Unchecked
(: monthly) Unchecked
(: No) Unchecked
(: No) Unchecked
(: No) Unchecked
(: partner) Unchecked
(: semimonthly) Unchecked
(: sole proprietor) Unchecked
(: wage earner) Unchecked
(: weekly) Unchecked
(: Yes) Unchecked
(: Yes) Unchecked
(: Yes) Unchecked
(10 Notes text)
(11 Accounts Receivable text)
(12 Judgments/Settlements Receivable text)
(13 Aircraft Watercraft (please list CF No or Hull ID No ) text)
(14 Interest in Trusts text)
(15 Interest in Estates text)
(16 Partnership Interests text)
(17 Other Assets (include description) text)
(18 Other Assets text)
(19 Other Assets text)
(20 Other Assets)
(21 Sum Total of Assets (Immediate Equity and Other) text)
(22 lines of credit amount owed from section 6 text)
(23 taxes owed to IRS provide a copy of recent notices text)
(24 other liabilities include description)
(25 other liabilities text)
(26 other liabilities text)
(27 other liabilities text)
(56 Medicl Payments (not covered by insurance) amount text)
(A) PHYSICAL ADDRESS AND DESCRIPTION (single family dwelling multi family dwelling lot etc ) text)
(ALL OTHER NAMES OR ALIASES EVER USED BY YOUR SPOUSE/REGISTERED DOMESTIC PARTNER)
(ALL OTHER NAMES OR ALIASES EVER USED)
(amount owed to the board of equalization text field)
(applicant (please print) )
(area code)
(Area Code)
(assets held in a living trust from section 6 text)
(Association Fees: ( ) text)
(Attach additional pages as needed )
(B) PHYSICAL ADDRESS AND DESCRIPTION (single family dwelling multi family dwelling lot etc ) text)
(Bank Accounts/Balance from section 6 text)
(BOE 392 Power of Attorney may be used )
(boe account number(s) text field)
(BUSINESS PHONE NUMBER ( ))
(Cash text)
(CLEAR) CLEAR
(co applicant (please print))
(continued)
(Current Address (street city state zip code))
(DATE OF BIRTH)
(DATE)
(DESCRIBE THE SOURCE(S) OF THE OFFERED FUNDS (If the offered funds are from a loan please describe how you intend to repay the loan ))
(electric phone amount text)
(Garnishments (if not deducted from your paycheck) amount text)
(gas water amount text)
(Groceries number of people amount text)
(home insurance association fees amount text)
(HOW IS TITLE HELD text)
(HOW IS TITLE HELD text)
(how long employed)
(If applicable please include a copy of IRS FTB or EDD OIC and acceptance letter or other
(If yes is checked please provide dates and explanation and documentation for last three years text)
(If yes is checked please provide dates and explanation and documentation for last three years text)
(If yes is checked please provide dates and explanation and documentation for last three years text)
(Include a copy of the deed and list quit claims within the last five years Attach additional
(Include IRA and retirement plans certificates of deposit etc Attach additional pages as
(Lender's Name)
(loan/cash surrender value of life insurance from section 6 text)
(month(s))
(MORTGAGE LENDER S NAME AND ADDRESS text)
(MORTGAGE LENDER S NAME AND ADDRESS)
(NAME (first mdde initial last))
(NUMBER OF EXEMPTIONS CLAIMED ON FORM W 4 OR DE 4)
(occupation)
(Other Expenses amount text)
(PARCEL NUMBER text)
(PARCEL NUMBER text)
(period(s) of liability text field)
(PHONE NUMBER ( ))
(phone number)
(Phone: ( ) text)
(PHYSICAL ADDRESS AND DESCRIPTION (single family dwelling multi family dwelling lot etc ) text)
(Please include all lease agreements including property where you are the lessor or lessee )
(Please list all vehicles registered in your your spouse s or your registered domestic partner s name
(Please pro rate expenses if household expenses are shared and if income is not provided in items 28 43 )
(Previous Address (if at current address less than two years))
(PRINT) PRINT
(PURCHASE DATE text)
(PURCHASE DATE text)
(PURCHASE PRICE $ text)
(PURCHASE PRICE $ text)
(securities from section 6 text)
(Sewer: ( ) text)
(SOCIAL SECURITY NUMBER )
(SOCIAL SECURITY NUMBER)
(SPOUSE S/REGISTERED DOMESTIC PARTNER S DRIVER LICENSE NUMBER)
(SPOUSE/REGISTERED DOMESTIC PARTNER (first middle initial last))
(STATE)
(Stocks bonds mutual funds money market funds securities securities held in a trust etc Attach
(STREET ADDRESS (city state zip code))
(TAXPAYER S DRIVER LICENSE NUMBER)
(Taxpayer's Employer or business (name and addess))
(Telephone Number)
(text)
(text)
(The following facts and reasons are submitted as grounds for consideration and acceptance of this offer (Attach additional pages as needed ))
(the sum of $ text field)
(TOTAL AMOUNT OF THE LOAN $)
(TOTAL HOUSEHOLD EXPENSES text)
(TOTAL HOUSEHOLD INCOME text)
(total immediate assets text)
(total liabilities text)
(TOTAL OTHER ASSETS text)
(trash sewer amount text)
(vehicles/available equity from section 6 text)
(Water : ( ) text)
(year(s))
) Association Fees: (
10 Notes
11 Accounts Receivable
12 Judgments/Settlements Receivable
14 Interest in Trusts
15 Interest in Estates
19 Other Assets
2 Bank Accounts/Balance (from section 6)
21 Sum Total of Assets (Immediate Equity and Other) >>
22 Lines of Credit [amount owed] (from section 6)
23 Taxes Owed to IRS (provide a copy of recent notices)
24 Other Liabilities (include description)
25 Other Liabilities
26 Other Liabilities
27 Other Liabilities
28 Wages/Salaries (Taxpayer) wages/salaries taxpayer Gross Text
29 Pension (Taxpayer) pension taxpayer Gross Text
3 Vehicles/Available Equity (from section 6)
30 Overtime/Bonuses/Commissions (Taxpayer) overtime/bonuses/commissions taxpayer Gross Text
31 Wages/Salaries (Spouse/Reg Domestic Partner) wages/salaries spouse/registered domestic partner Gross Text
32 Pension (Spouse/Reg Domestic Partner) pension spouse/registered domestic partner Gross Text
33 Overtime/Bonuses/Commissions (Spouse/Reg
34 Business Income (Taxpayer or Spouse/Reg
35 Rental Incomerental income Gross Text
36 Interest/Dividends/Royalties (Average Monthly) interest/dividends/royalties average monthly Gross Text
37 Payments from Trusts/Partnerships/Entities payments from trusts/partnerships/entities Gross Text
38 Child Support child support Gross Text
39 Alimony Alimony Gross Text
4 Loan/Cash Surrender Value of Life Insurance (from section 6)
40 Unemployment unemployment Gross Text
41 Disability disability Gross Text
42 Other Income (include description) other income include description Gross Text
43 Other Income other income Gross Text
44 Rent/Mortgage
45 Real Estate Taxes
46 Home Insurance: (
47 Groceries number of people: ( )
48 Utilities
49 Electric: ( )
5 Securities (from section 6)
50 Gas: ( )
51 Trash: ( )
52 Auto Payments
53 Auto Insurance
54 Gasoline Number of Miles to Work: ( )
55 Life/Health Insurance (if not deducted from your paycheck)
56 Medical Payments (not covered by insurance)
57 Estimated Tax Payments (if not deducted from your paycheck)
58 Court Ordered Payments (alimony child support restitution)
59 Garnishments (if not deducted from your paycheck)
6 Assets Held in a Living Trust (from section 6)
60 Delinquent Tax (non BOE)
61 Credit Card Payments (total monthly minimum) from section 6
62 Other Expenses (include description)
63 Other Expenses
64 NET DIFFERENCE (TOTAL INCOME LESS EXPENSES)
A Generally an Offer in Compromise will be accepted when the amount offered is more than the Board can
A Question
A) PHYSICAL ADDRESS AND DESCRIPTION (single family dwelling multi family dwelling lot etc )
ability to make monthly payments that will exceed the amount offered we will work with you to establish an
account and to determine the most appropriate resolution For example if we determine that you have the
Account Number
Account Number Text
Account Number Text
Account Number Text
Additional documentation may be required and requested as the evaluation of the Offer in Compromise proceeds
additional pages as needed )
Address or Location
Address or Location Text
Address or Location Text
Address Text
Address Text
Address Text
Agent's Name
Agent's Name Text
agreement?
Alimony Net Text
ALL OTHER NAMES OR ALIASES EVER USED
ALL OTHER NAMES OR ALIASES EVER USED BY YOUR SPOUSE/REGISTERED DOMESTIC PARTNER
Although each case is evaluated based on its own unique set of facts and
Amount
amount compared to the total liability are taken into consideration when evaluating your Offer in Compromise Question
amount if your offer is denied
Amount Owed
Amount Owed Text
Amount Owed Text
Amount Owed Text
AMOUNTOWED TO THE BOARDOF EQUALIZATION
an I get relief from the tax liability by filing bankruptcy?
an I make installment payments on the offered amount?
and credits made to the account for the periods covered by this offer In addition prior to the offer being accepted
and fraud penalty is required for processing However if you have been convicted of
Answer
ANTICIPATED INCREASE IN INCOME
any accounts that have been closed within the last two years )
APPLICANT (please prnt)i
APPLICANT (signature)
Application
apply the deposit The case will be returned to the district with a recommendation for case handling
Are collections
Are you an OIC
assets or means to pay their tax liabilities This program allows a taxpayer to offer a
at a Board meeting Recommendations to accept offers for all other tax and fee programs are handled by the
Attach additional pages as needed )
Attorney General s Office (there are fees associated with the legal filing of the offer and you may be contacted for
Available Equity
Available Equity Text
Available Equity Text
B) PHYSICAL ADDRESS AND DESCRIPTION (single family dwelling multi family dwelling lot etc )
Balance
Balance Text
Balance Text
Balance Text
BANK ACCOUNTS
Bank Information
Bank statements for savings and checking accounts for the last six months (If you are self
BANKRUPTCIES/RECEIVERSHIPS
bankruptcy documents
be returned as incomplete Please submit copies only We will not return any documents that you send us
BENEFICIARY OF TRUST ESTATE PROFIT SHARING ETC
Billing statements for the last three months (Please include copies of charge card statements bills
Biweekly
Board compliance representative
Board of Equalization
BOARD OF EQUALIZATION
Board of Equalization Seal
BOE 490 (S1B) REV 1 (1 06)
BOE 490 (S1F) REV 1 (1 06) STATE OF CALIFORNIA
BOE 490 (S2B) REV 1 (1 06)
BOE 490 (S3B) REV 1 (1 06)
BOE 490 (S3F) REV 1 (1 06)
BOE 490 (S4B) REV 1 (1 06)
BOE 490 (S4F) REV 1 (1 06)
BOE 490 REV 1 (1 06)
BOE ACCOUNT NUMBER(S)
Brokerage Name
Brokerage Name Text
business income taxpayer or spouse registered domestic partner Net Text
business or a similar business A taxpayer wishing to compromise a liability
BUSINESS PHONE NUMBER
Can prior payments be applied to the offered amount?
Can we process
candidate?
CHARGE CARDS AND LINES OF CREDIT
Check List of Required Items (Check only those boxes that apply )
child support Net Text
circumstances we give the following factors strong consideration:
CO APPLICANT (please print)
CO APPLICANT (signature)
Collection action will usually be suspended until the Offer in Compromise evaluation is
complete
Complete copies of Internal Revenue Service (IRS) or Franchise Tax Board (FTB) returns for the
completed application along with the required documentation
completed However if delaying collection activity jeopardizes our ability to collect the
compliance with all agreements The Board may continue collection activities at its discretion
Compromise on an active permit or for a taxpayer who is involved in the same
compromised until all obligations of each taxpayer under the compromise agreement are completely performed In
COURT PROCEEDINGS
criteria:
CURRENT ADDRESS (street city state zip code)
Current Lease or Rental Agreements
CURRENT LIABILITIES (Include judgments notes and other charge accounts Do NOT include vehicle or home loans )
Current Market Value
Current Market Value Text
Current Market Value Text
Current Market Value Text
Current Market Value Text
Current Payoff
Current Payoff Text
Current Payoff Text
Current Value
Current Value Text
DATE OF BIRTH
Date of Birth Text
Date of Birth Text
Date Opened
Date Opened Text
Date Opened Text
Date Opened Text
DEPENDENT (Attach additional pages as needed )
Dependent's Name Text
Dependent's Name Text
deposits If a third party has posted the deposited amount staff must get written permission from the third party to
DESCRIBE THE SOURCE(S) OF THE OFFERED FUNDS (If the offered funds are from a loan please describe how you intend to repay the loan )
Description Year Make Model of Vehicle or Property Address
Description Year Make Model of Vehicle or Property Address Text
Director for a decision Recommendations to accept offers where the compromise is more than $7 500 in tax will be
disability Net Text
documents included with this offer and to the best of my knowledge and belief they are true correct and
Domestic Partner) business income taxpayer or spouse registered domestic partner Gross Text
Domestic Partner) overtime/bonuses/commissions spouse/registered domestic partner Gross Text
employed (Please include total household income )
employed provide bank statements for the last twelve months Please include bank statements for
Equity
Equity Text
Equity Text
Except for any amount deposited in connection with this offer it is agreed that the Board will retain all payments
existing installment payment agreement while your offer is being considered The Board
expect to collect within a reasonable period of time typically from five to seven years Question
EXPENSES
explanation and documentation Documentation should cover the last three years
Face Amount
Face Amount Text
felony tax evasion an offer will not be considered
formally considered The funds will be held in the form of a deposit and will be refunded
forwarded to the Legal Department Executive Director and to the Board Members for a decision to be determined
from other creditors and personal loan statements )
Generally if we accept your offer for processing we will have a decision to you within 180 days after receiving
Generally we approve an Offer in Compromise when the amount offered represents
gifted in the last five years (Please include quit claim deed transfers and property held in trust If a
HOW IS TITLE HELD
HOW IS TITLE HELD
HOW LONG EMPLOYED
If a designated representative submits this offer attach the appropriate power of attorney (POA) form
If any or all of the amount being offered is from a loan please provide the following information:
If my Offer in Compromise is rejected can I choose to apply the deposit to my liability?
If this Offer in Compromise is denied the Board is to:
If we reject or deny the offer we will refund any deposit already obtained or apply it to the liability at the request of
If you are self employed and are involved in the same or a similar business as the one that incurred this liability
If you have been assessed a fraud penalty a minimum offer of the outstanding tax
If you have questions other than those addressed on the last page of this booklet please contact your
ill collection action be suspended while my offer is being evaluated?
ill state tax liens be released if my Offer in Compromise is accepted?
IMMEDIATE ASSETS
INCOME Gross
Information should be typed or printed
installment
installment payment agreement that will allow you to pay the liability in full over time Question
interest/dividends/royalties average monthly Net Text
Investment account statements showing the value of stocks bonds mutual funds and/or retirement
Investment Information
IRS/FTB Information
IRS/FTB/EDD arrangements )
is offered in compromise (The Board will instruct you when to mail the
It is further agreed that upon notice to the taxpayer(s) of the acceptance of the offer the taxpayer(s) shall have no
It is understood that this offer will be considered and acted upon as quickly as possible It does not relieve the
Legal Documents
LENDER S NAME
Lender/Pink Slip Holder
Lender/Pink Slip Holder Text
Lender/Pink Slip Holder Text
lesser amount for payment of a non disputed final tax liability on a closed out
LICENSE NUMBER Purchase Price
LIFE INSURANCE
List any vehicles equipment or property sold given away or repossessed during the past three years
Loan/Cash Surrender Value
Loan/Cash Surrender Value Text
Marital settlement agreements divorce decrees marital property settlements trust documents and
Medical Documentation
Min Monthly Payment
Min Monthly Payment Text
Min Monthly Payment Text
Min Monthly Payment Text
MONTH(S)
Monthly
MORTGAGE LENDER S NAME AND ADDRESS
MORTGAGE LENDER S NAME AND ADDRESS
Mortgage Payoff Amount
Mortgage Payoff Amount Text
Mortgage statements and escrow statements for property you currently own or property you sold or
NAME (first middle initial last)
Name and Address of Creditor Grantor
Name and Address of Creditor Grantor Text
Name and Address of Creditor Grantor Text
Name and Address of Creditor Grantor Text
NAME OF INSTITUTION ADDRESS Type
Name of Institution Text
Name of Institution Text
Name of Institution Text
Name of Insurance Company
Name of Insurance Company Text
needed )
No Prior payments are not accepted towards the offered amount However prior payments and the offered
No We require full payment of the offered amount before we will forward the Offer in Compromise for finalconsideration Question
No Your Board offer will be evaluated separately from your IRS or FTB offer and generally if the amount of
Note: Complete all blocks
NUMBER OF EXEMPTIONS CLAIMED ON FORM W 4 OR DE 4
o I need to have someone represent me?
OCCUPATION
offer amount Do not send money now )
Offer In Compromise
OFFER IN COMPROMISE APPLICATION BOARD OF EQUALIZATION
offered funds be
or profit sharing plans (IRA 401K Keogh Annuity)
original liability
OTHER ASSETS (Please include names and addresses A separate listing may be attached if necessary )
other income include description Net Text
other income Net Text
our ability to collect the tax we may continue with collection efforts
overtime/bonuses/commissions spouse/registered domestic partner Net Text
overtime/bonuses/commissions taxpayer Net Text
Owner of Record
Owner of Record Text
pages as needed )
PARCEL NUMBER
PARCEL NUMBER
Part or all of your taxes may be dischargeable under the bankruptcy code If this is a consideration you may
Partner
past three years
Pay stubs for the past three months or financial statements for the past two years if you are self
payment
payments from trusts/partnerships/entities Net Text
payments if you are currently in an Installment Payment Agreement If delaying collection activity jeopardizes
payments on an
pension spouse/registered domestic partner Net Text
pension taxpayer Net Text
PERIOD(S) OF LIABILITY
permit that person s liability will not be canceled nor will the lien be released A partial release will be issued
permit The Board of Equalization (Board) will not entertain an Offer in
PHONE NUMBER
Phone: ( )
Physician s letter and/or other documents to show any medical condition that should be considered
Please complete all blocks except shaded areas Write N/A (Not Applicable) in those blocks that do not apply
please discontinue completing the application because you do not qualify for the OIC Program
Please provide documentation and verification of income and expenses listed above
Please provide other information relating to your financial condition If yes" is checked please provide dates
Please read the required Privacy Notice (BOE 324 OIC)
Policy Number
Policy Number Text
Power of Attorney (If you have representation)
PREVIOUS ADDRESS (if at current address less than two years)
PROCESSING ACCEPTED OFFERS
PROCESSING DENIED OFFERS
PURCHASE DATE
PURCHASE DATE
PURCHASE PRICE
PURCHASE PRICE
Purchase Price Text
Purchase Price Text
Q Answer
Q Answer
Q Answer
Q Answer
Q Answer
Q How long will it take to get a decision on my OIC?
Q What does the Board of Equalization consider a fair Offer in Compromise in relation to the amount
Quantity or Denomination
Quantity or Denomination Text
Questions and Answers Question
REAL PROPERTY
REAL PROPERTY (from section 6)
Real Property Information
RECENT TRANSFER OF ASSETS
Recommendations to accept offers for sales and use taxes underground storage fuel tax and use fuel tax where
RELATIONSHIP TEXT
RELATIONSHIP TEXT
rental income Net Text
REPOSSESSIONS
Representation is not required Offer in Compromise is available to all taxpayers whether or not they are
represented If you think you need representation there are many tax professionals who have experience withthe OIC process Question
Retain any amount deposited and credit it to the current tax liability
Return the amount deposited
right to contest in court or otherwise the amount of the liability sought to be compromised No liability will be
SECTION 1 BASIS FOR THE OFFER
SECTION 2 SOURCE OF FUNDS
SECTION 4 PERSONAL INFORMATION
SECTION 5 EMPLOYMENT INFORMATION
SECTION 6 GENERAL FINANCIAL INFORMATION
SECTION 7 ASSET AND LIABILITY ANALYSIS
SECTION 8 MONTHLY INCOME AND EXPENSE ANALYSIS
SECURITIES
Semimonthly
Sewer: ( )
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER TEXT
SOCIAL SECURITY NUMBER TEXT
Sole proprietor
SPOUSE S/REGISTERED DOMESTIC PARTNER S DRIVER LICENSE NUMBER
SPOUSE S/REGISTERED DOMESTIC PARTNER S EMPLOYER OR BUSINESS (name or address)
SPOUSE/REGISTERED DOMESTIC PARTNER (first middle initial last)
STATE
State of California
STREET ADDRESS (city state zip code)
Submit your completed and signed application to your designated Board compliance representative
submitted?
supporting documentation
suspended?
tax we may continue with collection efforts
TAXPAYER S DRIVER LICENSE NUMBER
TAXPAYER S EMPLOYER OR BUSINESS (name and address)
taxpayer(s) of the liability sought to be compromised until the Board accepts the offer and there has been full
the Board determines that my Offer in Compromise is not acceptable will I be contacted?
the Board will retain any and all amounts to which the taxpayer(s) may be entitled under the California law due
the compromise is less than $7 500 in tax will be forwarded to the Board s Legal Division and the Executive
the event of a default by the taxpayer(s) on the agreement it is agreed that the Board may disregard the amount of
The following documentation must be submitted with your Offer in Compromise Application or your application may
The following facts and reasons are submitted as grounds for consideration and acceptance of this offer (Attach
the most we can expect to receive from the taxpayer s current income or assets
the offer and retain all amounts previously deposited under the offer and proceed to collect the balance of the
the offer applies This includes operating the same type or similar business
The Offer in Compromise (OIC) program is for taxpayers/feepayers (hereinafter called
the offer represents the most that we can expect to collect within a reasonable period of time we will accept
The OIC Section will request that the offered funds be submitted at the time your offer is
The sum of $
the tax that could result in an additional tax or fee assessment
the taxpayer with an effective date as the date the funds were received No interest will be granted on returned
There is no formal appeal process for rejected or denied offers in compromise
these fees)
through overpayments of tax penalty or interest not to exceed the liability
through the OIC process must no longer own the personal property that incurred
to release you from the effects of the lien Question
to you if your offer is denied Credit interest will not be paid to you on the deposited
Total
Total [Enter this amount on line 22 section 7 (Asset and Liability Analysis)]>>
Total [Enter this amount on line 4 section 7 (Asset and Liability Analysis)]>>
Total [enter this amount on line 5 section 7 (Asset and Liability Analysis)]>>
Total [Entr this amount on line 3 section 7 (Asset and Liability Analysis)]>>
TOTAL AMOUNT OF THE LOAN
TOTAL EQUITY >> total equity text
TOTAL HOUSEHOLD EXPENSES >>
TOTAL HOUSEHOLD INCOME >>
TOTAL IMMEDIATE ASSETS >>
TOTAL LIABILITIES >>
TOTAL OTHER ASSETS >>
Total Text
trust exists please provide a copy of all trust documents )
Type of Account
Type of Account Text
Type of Account Text
Type of Account Text
Type Text
Type Text
Type Text
Type Text
Type Text
Under penalty of perjury I declare that I have examined the information given in this statement and all other
unemployment Net Text
Usually if we are in receipt of a relatively complete application You may also be required to continue
Value
Value Text
VEHICLES
Verification of Expenses
Verification of Income
Wage earner
wages/salaries spouse/registered domestic partnerNet Text
wages/salaries taxpayer net Text
want to seek legal advice Question
was posted by a third party we must obtain their approval before applying the payment Question
Water : ( )
We release state tax liens upon final approval of your Offer in Compromise If another partner existed on the
We will only process your Offer in Compromise Application if you meet the following
Weekly
What you should know before preparing an Offer in Compromise Application
When should
Who Took Title or Possession
Who Took Title or Possession Text
will strive to process your offer and provide a decision within 180 days of receiving a
Will we require
y IRS/FTB OIC has been accepted Will the Board automatically approve my Offer in Compromise?
YEAR MAKE MODEL
Year Make Model License Number Text
Year Make Model License Number Text
YEAR(S)
Yes A letter informing you of our discussion will be sent to you We may also contact you to discuss your
Yes If you choose to do so the effective date of the payment is the date the deposit was made If the deposit
Yes we will require you to continue making periodic payments as called for in any
you to continue
your application?
your Offer in Compromise If your account is more complex it may take longer than 180 days Answer
your Offer in Compromise question