IRS Form 9465 Installment Agreement Request is used to request a monthly installment plan if you cannot pay the full amount you owe shown on your federal tax return.
Form 9465, officially the Installment Agreement Request, is an Internal Revenue Service (IRS) document used to request a monthly installment payment plan if you can’t pay the full amount you owe on your tax return.
Use Form 9465 if:
Don’t use Form 9465 if:
Form 9465 is a two-page form divided into two parts.
Check the order of the names and social security numbers (SSNs) on your tax return and fill the information in with the same order. Enter your address on the appropriate line.
If the address you provided on line 1a is new since you filed your last tax return, check the box.
Provide the name and employer identification number (EIN) of your business that is no longer operating.
Provide your home phone number and preferred time for a call.
Provide your office phone number and preferred time for the IRS to call.
Enter the total amount you owe as reflected on your tax return.
List the total amount of any additional balances or charges that are not reported on the tax return or notice.
Add lines 5 and 6 and enter the result.
If you’re filing this form with your tax return, enter the amount of the payment you’re making with this request.
Subtract line 8 from line 7 and enter the result.
Divide the amount on line 9 by 72 and enter the result.
Enter the amount you can pay each month. If you have an existing installment agreement, this amount should represent your total proposed monthly payment. If nothing is listed here, payment will be determined for you by dividing the balance due by 72 months.
The IRS sets the minimum monthly payment at tax debt divided by 72. If the amount you entered on line 11a is less than this minimum monthly payment and you’re able to increase your payment to an amount that is equal to or greater than the said amount, you have to enter your revised monthly payment proposal here.
Enter the date you want to make your payment each month. Don’t enter a date later than the 28th.
Enter the routing number.
Enter the account number including hyphens, but omit spaces and special symbols.
If you’re a low-income taxpayer, check this box and your user fee will be reimbursed. If you don’t check this box and don’t provide the information on lines 13a and 13b, you’re indicating that you’re able but you choose not to make electronic payments.
Check this box and attach a completed and signed Form 2159, if you want to make your payments by payroll deduction.
Complete this part only if all three conditions apply:
1. you defaulted on an installment agreement in the past 12 months,
2. you owe more than $25,000 but not more than $50,000, and
3. the amount on line 11a (or 11b, if applicable) is less than line 10
Provide your country of primary residence.
Check your Marital status.
Select “Yes” if you share household expenses with your spouse. If not, select “No”.
Provide the number of dependents you will claim on this year’s tax return.
Provide the number of people in your household who are 65 or older.
Select how often you are paid.
Provide your net income per pay period.
Complete lines 21 and 22 only if you have a spouse and meet either of the following conditions:
If you don’t have a spouse, go to line 23.
Select how often your spouse is paid.
Provide your spouse’s net income per pay period.
Provide how many vehicles you own.
Enter the number of car payments you have each month.
Select “Yes” if you have health insurance and go to question 25b. If you don’t have health insurance, select “No” and skip question 25b and go to question 26a.
Select “Yes” if your health insurance premiums are deducted from your paycheck and skip question 25c and go to question 26a. Select “No” if your health insurance premiums are not deducted from your paycheck and go to question 25c.
Provide the amount of your monthly health insurance premiums.
Select “Yes” if you make court-ordered payments and go to question 26b. If not, select “No” and go to question 27.
Select “Yes” if your court-ordered payments are deducted from your paycheck and go to question 27. If not, select “No” and go to question 26c.
Provide the amount of your court-ordered payments each month.
Provide the amount of money you pay for child or dependent care each month, not including any court-ordered payments for child and dependent support.
You may file your Form 9465 online or by mail.
If the amount you owe on line 9 is greater than $50,000, you cannot file Form 9465 electronically and you must complete Form 433-F, Collection Information Statement, and file it with this form.
If you choose to make your payments by payroll deduction, you won’t be able to file Form 9465 electronically.
If you’ll file by mail, send your installment agreement request to the address shown in your tax return booklet.