Form 9465: Installment Agreement Request

About this Form:

Use Form 9465 to request a monthly installment plan if you cannot pay the full amount you owe shown on your tax return that was sent to you.

How do I fill out Form 9465?

There are two parts of this form. Starting with Part 1 on line 1a, enter the names and social security numbers (SSNs) in the same order as they appear on your tax return. Still on line 1a, enter your current address. If you have a foreign address, enter the city’s name, full name of the country, and the country’s practice for entering the postal code and the name of the province, county, or state. Moving to line 1b, enter check the box if this address is new since you filed your last return. If this is not a new address, leave the box blank. Onto line 2, enter the full name and employer identification number (EIN) of your business that must no longer be in operation. For line 3, fill in your contact number and best time to call you. Line 4 is asking for your work number and best time to call you. If you do not have a work number, leave this field blank. Moving to line 5, enter the total amount your owe. This is listed on your tax return or notice, and can include more than one tax year. For line 6, enter any additional balances that are due and not shown on line 5, which includes adjustments or other charges that are not reported on the tax return or notice. For line 7, add together lines 5 and 6 and enter the results. On line 8, enter the payment amount you have sent with this request. Line 9 needs you to subtract line 8 from line 7 and enter the total. This is the amount owed. Moving along to line 10, take the amount on line 9 and divide it by 72, and enter the result. Enter the amount you can pay each month on line 11a. It is recommended you make payments as large as possible to limit interest and penalty charges. For line 11b, if the amount on line 11a is less than the amount on line 10, increase your payment to an amount that is equal to or greater than the amount on line 10. If you cannot increase your payment to the amount shown on line 10, then check the box on 11b, and fill out *Form 433-F*. Line 12 wants to know what date you want to start making payments each month. You get to choose the date. For example, if you would like to make payments when you get paid on the 15th, you can choose the 15th, however, the date cannot be after the 28th. If you are making payments by direct deposit from your checking account, you will enter the routing and account number on line 13a and 13b respectively. If you are a low-income taxpayer and unable to make electronic payments, check the box for line 13c. By checking this box, you will have your user fee reimbursed when you complete the installment agreement. If you would prefer your payments coming out of your payroll as a deduction, check the box on line 14 and attach *Form 2159*. Sign and date with today’s date and have your spouse also sign and date if you are married, filing jointly. Only complete Part 2 if you have defaulted on an installment agreement within the last 12 months, the amount you owe is greater than $25,000 but not more than $50,000, and the amount on line 11a or line 11b (if applicable) is less than line 10. If you meet these conditions, start on line 15 by entering which country you primarily reside in. For line 16a, check the appropriate box if you are single or married, and follow the prompts. If you are single, skip line 16b and go to line 17. If you are married, check the correct box for 16b. If you share household expenses, check yes, if not, check no. On line 17, enter how many dependent you will claim on this year’s tax return. For line 18, enter how many people in your household are 65 or older. Moving down to 19, check the box to indicate how often you are paid. For line 20, enter your net income per day, this is the amount you take home, not the full amount you are paid. Only answer lines 21 and 22 if you have a spouse and filed jointly. For line 21, enter how often your spouse gets paid, and for line 22, enter their net take home pay per day. Again, this is the amount they take home, not the full amount they are paid per day. For line 23, enter how many vehicles you own, and on line 24, enter how many car payments you pay each month. Down to line 25a, check the correct box that answers if you have health insurance. If you do, check the box and go to line 25b, if not, skip question 25b and go to 26a. For line 25b, check the box indicating if your health insurance premiums are deducted from your paycheck. If yes, move to question 26a, and if not, go to question 25c. For line 25c enter the total amount you pay in monthly health insurance premiums. Moving to line 26a, check the correct box indicating if you make court-ordered payments. If yes, move to question 26b, if no, go to question 27. For line 26b, check if your court-ordered payments are deducted from your paycheck. If yes, go to line 27, if no, go to line 26c. Line 26c needs you to enter your total court-ordered monthly payments. Finally, for line 27, enter how much you paid for child or dependent care each month. This total cannot include court-ordered payments. You have now completed Form 9465. *You can find Form 433-F here: * *You can find Form 2159 here: *  

Form 9465: Installment Agreement Request: FAQs

  • Form 9465 is used to request a monthly installment plan if you cannot pay the full amount you owe shown on your tax return that was sent to you.

  • Yes, if your balance due is not more than $50,000, you can apply online for a payment agreement at without having to file Form 9465.

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