Form 656-L (Rev. 5-2024)

Catalog Number 47516R www.irs.gov

Form

656-L (Rev. 5-2024)

Form 656-L

Offer in Compromise

Doubt as to Liability (DATL)

CONTENTS

■ What you need to know................................................................................. 2

■ Important information .................................................................................... 2

■ DATL Pre-qualifier ........................................................................................ 4

■ Form 656-L ................................................................................................... 6

IRS contact information

If you have questions regarding qualifications for an offer in compromise, please call our toll-free number at

1-800-829-1040. You can get forms and publications by calling 1-800-TAX-FORM (1-800-829-3676), by visiting

your local IRS office, or at www.irs.gov.

Taxpayer resources

The Taxpayer Advocate Service (TAS) is an independent organization within the Internal Revenue Service (IRS)

that helps taxpayers and protects taxpayer rights. We can offer you free help if your tax problem is causing a

financial difficulty, if you’ve tried and been unable to resolve your issue with the IRS, or if you believe an IRS

system, process, or procedure just isn't working as it should. Learn more at www.TaxpayerAdvocate.irs.gov or

call 877-777-4778.

Low Income Taxpayer Clinics (LITCs) assist individuals whose income is below a certain level who need to

resolve tax problems with the IRS. They also provide education, outreach, and information on taxpayer rights to

individuals who speak English as a second language. LITCs represent taxpayers in disputes before the IRS and

courts and help taxpayers respond to IRS notices and correct account problems. Services are offered for free or

a small fee. LITCs are independent from the IRS and TAS. For more information or to find an LITC near you, see

https://www.taxpayeradvocate.irs.gov/litc or IRS Publication 4134, Low Income Taxpayer Clinic List. You can

also request Pub. 4134 by calling 800-TAX-FORM (800-829-3676).

Your Rights as a Taxpayer

The Internal Revenue Code (IRC) provides taxpayers specific rights. The Taxpayer Bill of Rights groups these

rights into ten fundamental rights. See IRC 7803(a)(3). IRS employees are responsible for being familiar with

and following these rights. For additional information about your taxpayer rights, please see: Publication 1, Your

Rights as a Taxpayer or visit: irs.gov/taxpayer-bill-of-rights.

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Catalog Number 47516R www.irs.gov

Form

656-L (Rev. 5-2024)

INSTRUCTIONS FOR FORM 656−L, OFFER IN COMPROMISE (DOUBT AS TO LIABILITY)

WHAT YOU NEED TO KNOW

What is a Doubt as to

Liability (DATL) Offer in

Compromise (offer)?

DATL exists where there is a genuine dispute as to the existence or amount of the correct

tax debt under the law. If you have a legitimate doubt that you owe part or all of the tax debt,

you will need to complete a Form 656-L, Offer in Compromise (Doubt as to Liability).

DATL cannot be disputed or considered if the tax debt has been established by a final court

decision or judgment concerning the existence or amount of the assessed tax debt or if the

assessed tax debt is based on current law.

Submitting Form 656-L does not guarantee that the IRS will accept your offer. It begins a

process of evaluation and verification by the IRS.

If you have supplied information to the IRS or are responding to a notice you received

relating to the same matter for which you are submitting your offer, you should resolve the

outstanding issues prior to filing the offer. If your issue is being worked by another area, for

example you have requested an audit reconsideration to resolve whether you are liable for

the tax, then an offer should not be filed until the issue is resolved. Failure to follow-up and

resolve an issue may lead to the IRS returning the offer without further consideration.

Note: If you agree that you owe the tax but cannot afford to pay, DON'T FILE a Form

656-L. See "What if I agree with the tax debt but cannot afford to pay in full?"

What documentation or

support is needed?

You must provide a written statement explaining why the tax debt or portion of the tax debt

is incorrect. In addition, you should provide supporting documentation or evidence that will

help the IRS identify the reason(s) you doubt the accuracy of the tax debt. If you are unable

to reconstruct your books and records, you can provide an explanation that supports

reasonable doubt justifying a reduction to a portion or all of your tax debt.

Note: Failing to provide a written statement explaining why the tax debt or a portion

of the debt is incorrect will cause your offer to be returned without further

consideration.

How much should I offer?

You must make an offer that is $1 or more, and it should be based on what you believe the

correct amount of tax should be. If you believe you don't owe any tax, see the DATL Pre-

Qualifier Assessment below, for additional information.

Note: Don't include any payment(s) with the Form 656-L. No deposit or application fee

is required for a DATL offer. Payments received will not be returned and will be applied to

the tax liability in the best interest of the government.

IMPORTANT INFORMATION

What alternatives do I have to

sending in a DATL, Offer in

Compromise

When you disagree with the accuracy of a tax debt, depending on the situation and the type

of tax, the IRS has other available remedies. If your tax debt is other than a Trust Fund

Recovery Penalty (TFRP) or Personal Liability Excise Tax (PLET), you should pursue the

options below first before submitting an offer.

You DON’T qualify for a DATL offer

if ANY of the following conditions

apply:

You are in an open bankruptcy. Once your bankruptcy proceedings have been completed or

discharged, you may file a DATL offer.

If you are paying or owe restitution to the Department of Justice, the IRS does not have the

authority to compromise restitution assessments.

If you already have an accepted Doubt as to Collectibility (DATC) offer or DATL offer for the

same tax year and tax liability.

You have made an election under IRC § 965(i) for the liability at issue; the IRS will not

compromise such liabilities. Furthermore, any liability for which payment is being deferred

under IRC § 965(h)(1) will be compromised only if an acceleration of payment under section

965(h)(3) and the regulations thereunder has occurred and no portion of the liability to be

compromised resulted from entering into a transfer agreement under section 965(h)(3).

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Form

656-L (Rev. 5-2024)

The IRS will not consider an offer with a deactivated Individual Tax Identification Number

(ITIN). If you have a deactivated ITIN, you will need to complete the Form W-7, Application

for IRS Individual Taxpayer Identification Number, and have it reactivated or go to your local

Social Security office and obtain a Social Security Number. Once completed, you may

submit a DATL offer.

Notice of Federal Tax Lien (NFTL) A lien is a legal claim against all your current and future property. When you don’t pay your

first bill for taxes due, a lien is created by law and attaches to your property. An NFTL

provides public notice to creditors and is filed to establish priority of the IRS claim versus the

claims of certain other creditors. The IRS may file an NFTL while your offer is being

considered. If you have not finished paying your offer amount, then the IRS may be entitled

to any proceeds from the sale of real property if the tax lien(s) has/have not been released.

You may be entitled to file an appeal under the Collection Appeals Program (CAP) before

an NFTL occurs or request a Collection Due Process (CDP) hearing after an NFTL filing

occurs. See Publication 1660 for more information on CAP and CDP rights.

Note: An NFTL will not be filed on any individual shared responsibility penalty under the

Affordable Care Act.

Examples of when you should

submit a DATL offer

You should only submit a DATL offer if you are unable to dispute the amount of tax the IRS

claims you owe during the time allowed by the Internal Revenue Code or IRS guidelines.

Possible reasons for submitting a DATL offer in compromise include the following: the

examiner made a mistake interpreting the tax law; the examiner failed to consider the

evidence presented; new evidence is available to support a change to the assessment.

Below are some examples of when it may be appropriate to submit an offer based on doubt

as to liability.

Example 1: You were audited by the IRS. When this happened, you moved and did not get

the notification, or you suffered a disaster (such as your home was destroyed in a fire, flood

or other natural disaster) causing you to miss the meeting with the auditor. The IRS

disallowed all expenses and now you have a tax debt. You discover the problem when you

try to borrow some money and find there is a federal tax lien filed. You are unable to

reconstruct your books and records, but you can provide an explanation that supports

reasonable doubt justifying a reduction to a portion or all of your tax debt. You will need to

request a audit reconsideration prior to filing a DATL offer. If you receive an adverse

determination and you did not appeal, you may file a DATL offer once the audit

reconsideration is closed.

Example 2: You filed your tax return reporting stock options as valued by your employer,

which created a tax liability including Alternative Minimum Tax (AMT). You paid part of the

tax debt but could not pay the full amount owed. You later discovered that the stocks were

not worth as much as you originally reported. This was due to fraudulent acts by the broker

and/or your employer. IRS informed you the full amount of the tax debt must be paid before

they can consider your claim for refund. You must file a Form 1040-X, U.S. Individual

Income Tax Return, to correct the value of the stocks originally claimed. If you receive an

adverse determination and you did not appeal, you may file a DATL offer.

What if I agree with the tax debt

but cannot afford to pay in full?

A DATC offer is when you agree that you owe the taxes but you cannot pay your tax debt in

full. To be considered for a DATC offer you must make an appropriate offer based on what

the IRS considers your true ability to pay. To request consideration under DATC, don't use

this form. You must complete a Form 656, Offer in Compromise, found in 656-B, Offer in

Compromise Booklet. For additional assistance in calculating your DATC offer amount, use

the online Offer In Compromise Pre-Qualifier tool at http://irs.treasury.gov/oic_pre_qualifier/.

IMPORTANT NOTE

You cannot submit an offer based on DATL (Form 656-L) and a separate offer based on

DATC (Form 656) at the same time.

It is in your best interest to resolve any disagreements about the validity of the tax debt

before filing an offer based on DATC. If you send a DATC offer and DATL offer, at the

same time, the DATC offer will be returned to you without further consideration. Any

initial payments submitted with the DATC offer will not be returned and will be applied to the

tax liability in the best interest of the government.

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Catalog Number 47516R www.irs.gov

Form

656-L (Rev. 5-2024)

DOUBT AS TO LIABILITY (DATL) PRE-QUALIFIER ASSESSMENT

Review the questions below to see if you may be eligible for a DATL Offer in Compromise. These questions are a guide to

help determine if you may be eligible and if you are requesting the correct type of resolution.

1. Do you want to file an Offer in Compromise because you cannot afford to pay the amount you owe or paying in full would

cause a hardship?

• Yes, DON’T FILE FORM 656-L, Doubt as to Liability, see Form 656-B, Doubt as to Collectibility (DATC) booklet:

• No, continue to next question

2. Do you believe your tax debt is incorrect due to items that were not reported correctly on your originally filed tax return,

including: Form 1040, U.S. Individual Income Tax Return, Form 1120, U.S. Corporation Income Tax Return, Form 706, United

States Estate (and Generation-Skipping transfer) Tax Return, Form 709, United States Gift (and Generation-Skipping

Transfer) Tax Return?

• Yes, DON’T FILE FORM 656-L Doubt as to Liability. You must file an amended tax return, following the instructions for amending

the applicable return. e.g., Form 1040-X, Amended U.S. Individual Income Tax Return. You can find the instructions on IRS.gov.

• No, continue to next question

3. Do you believe your tax debt is incorrect because the IRS filed your Form 1040, U.S. Individual Income Tax Return, or the

IRS prepared and filed your business tax returns (940, 941 etc.)?

• Yes, DON’T FILE FORM 656-L Doubt as to Liability. Submit a signed original tax return for processing to the appropriate IRS

Center as listed in the Form 1040 instructions. Form 1040, U.S. Individual Income Tax Return, Instruction 1040 and 1040-SR

or visit Tax Information for Businesses for forms and instructions.

• No, continue to next question

4. Do you believe your tax debt is incorrect because an audit was performed on your tax return?

• Yes, DON’T FILE FORM 656-L Doubt as to Liability. Submit a request for audit reconsideration. See Publication 3598, What you

should know about the Audit Reconsideration process and where to file.

• No, continue to next question

5. Do you believe you should be entitled to a reduction or forgiveness of a penalty only?

• Yes, DON’T FILE FORM 656-L Doubt as to Liability - You may be eligible for penalty abatement. See the following links and call

the number listed: https://www.irs.gov/pub/irs-pdf/f843.pdf or https://www.irs.gov/businesses/small-businesses-self-employed/

penalty-relief-due-to-first-time-penalty-abatement-or-other-administrative-waiver

• No, continue to next question

6. Do you disagree with an IRS adjustment made to your tax based on unreported income?

• Yes, DON’T FILE FORM 656-L, Doubt as to Liability. Please respond to the CP2000 notice sent to you by the IRS.

• No, continue to next question

7. Do you believe your tax debt is incorrect because there is a discrepancy between Forms 941, 943, 944, 945, 1040 or 1040

Schedule H and the data reported to social security administration on Form W-2, W-3?

• Yes, DON’T FILE FORM 656-L, Doubt as to Liability. Submit a corrected W-2 and/or W-3 or corrected 941/943

etc. Combined Annual Wage Reporting (CAWR).

• No, continue to next question

8. Do you believe you don’t owe for the Affordable Care Act or marketplace tax?

• Yes, DON'T FILE FORM 656-L, Doubt as to Liability, file Form 1040-X, Amended U.S. Individual Tax Return. See www.irs.gov for

Form 1040-X and instructions

• No, continue to next question

9. Are you submitting an SS-8 Workers Classification Determination?

• Yes, DON'T FILE FORM 656-L, Doubt as to Liability, see the instructions on how to resolve your SS-8 found at

SS-8 Forms and Instructions.

• No, continue to next question

10. Is the offer solely for an Injured Spouse?

• Yes, DON'T FILE FORM 656-L, Doubt as to Liability, follow the instructions found on IRS.gov Form 8379, Injured Spouse

Allocation.

• No, continue to next question

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Catalog Number 47516R www.irs.gov

Form

656-L (Rev. 5-2024)

11. Do you wish to file an Offer in Compromise because you don’t believe that you owe all or part of the tax debt and you have

already pursued any of the applicable alternatives above?

• Yes, Complete Form 656-L, Doubt as to Liability.

Note: If you don’t have a tax debt, you are not eligible for an offer until you have received a balance due notice.

If you answered ”NO” for questions

1 – 10 above, you may qualify to file

a DATL offer. Please make sure to

include the following when filing

your Form 656-L.

You must make an offer for $1.00 or more and should be based on what you believe you

owe.

You must provide a written statement explaining why the tax debt or portion of the debt is

incorrect.

You must provide supporting documentation or evidence that will help the IRS identify the

reason(s) you doubt the accuracy of the tax debt. Sign the Form 656-L.

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Catalog Number 47516R www.irs.gov

Form

656-L (Rev. 5-2024)

Form 656-L

(May 2024)

Department of the Treasury - Internal Revenue Service

Offer in Compromise (Doubt as to Liability)

OMB Number

1545-1686

►

To: Commissioner of Internal Revenue Service

In the following agreement, the pronoun "we" may be assumed in place of "I" when there are joint liabilities and both parties are

signing this agreement.

I submit this offer to compromise the tax liabilities plus any interest, penalties, additions to tax, and additional amounts required by

law for the tax type and period(s) marked below in section 1 or section 2

IRS Received Date

(COIC use only)

Section 1 Individual Information (Form 1040 filers)

Your first name, middle initial, last name Social Security Number (SSN)

- -

Individual Tax Identification Number (ITIN) (if applicable)

- -

If a Joint Offer: spouse's first name, middle initial, last name Social Security Number (SSN)

- -

Individual Tax Identification Number (ITIN) (if applicable)

- -

Your physical home address (street, city, state, ZIP code) Your mailing address (if different from your physical home address or post office box number)

Is this a new address

Yes No

If yes, would you like us to update our records to this address

Yes No

Employer Identification Number (for self-employed individuals only)

Individual Tax Periods

1040 U.S. Individual Income Tax Return [List all year(s); for example, 2018, 2019, etc.]

941 Employer's Quarterly Federal Tax Return [List all quarterly period(s); for example, 03/31/2019, 06/30/2019, 09/30/2019, etc.]

940 Employer’s Annual Federal Unemployment (FUTA) Tax Return [List all year(s); for example, 2018, 2019, etc.]

Trust Fund Recovery Penalty as a responsible person of (enter business name)

for failure to pay withholding and Federal Insurance Contributions Act taxes (Social Security taxes), for period(s) ending [List all quarterly period(s);

for example, 03/31/20019, 06/30/2019, etc.]

Other Federal Tax(es) [specify type(s) and period(s)]

Section 2 Business Information (Form 1120, 940, 941, etc., filers)

Business name

Is this a new address Yes No Would you like us to update our records to this address Yes No

Business physical address (street, city, state, ZIP code) Business mailing address (street, city, state, ZIP code)

Employer Identification Number (EIN)

Name and title of primary contact Telephone number

( ) -

Business Tax Periods

1120 U.S. Corporate Income Tax Return [List all year(s); for example, 2018, 2019, etc.]

941 Employer's Quarterly Federal Tax Return [List all quarterly period(s); for example, 03/31/2019, 06/30/2019, 09/30/2019, etc.]

940 Employer’s Annual Federal Unemployment (FUTA) Tax Return [List all year(s); for example, 2018, 2010, etc.]

Other Federal Tax(es) [specify type(s) and period(s)]

Note: If you need more space, use a separate sheet of paper and title it “Attachment to Form 656-L Dated .” Sign and date

the attachment following the listing of the tax periods.

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Catalog Number 47516R www.irs.gov

Form

656-L (Rev. 5-2024)

Section 3 Amount of the Offer

I offer to pay $

Must be $1 or more and payable within 90 days of the notification of acceptance, unless an alternative payment term is approved at the time the offer is

accepted. Don't send any payment with this form. If you don't offer at least $1, your offer will be returned without consideration.

Section 4 Terms

By submitting this offer, I have read, understand, and agree to the following terms and conditions:

Terms, Conditions, and Legal

Agreement

a) The IRS will apply payments made under the terms of this offer in the best interest of the government. I request

that the IRS accept the offer amount listed in this offer application as payment of my outstanding tax debt arising

under Title 26 (including interest, penalties, and any additional amounts required by law) as of the date listed on

this form.

b) I voluntarily submit all payments made on this offer.

IRS will keep my payments

and fees

c) The IRS will keep all payments and credits made, received, or applied to the total original tax debt before I

send in the offer or while it is under consideration, including any refunds from tax returns and/or credits from tax

years prior to the year in which the offer was accepted.

d) The IRS may levy under section 6331(a) up to the time that the IRS official signs and acknowledges my offer

as pending, which is accepted for processing, and the IRS may keep any proceeds arising from such a levy.

e) If the Doubt as to Liability offer determines that I don't owe the taxes, or the IRS ultimately over-collected the

assessed tax liability, the IRS will return the over-collected amount to me, unless such refund is legally prohibited

by statute. If my offer is accepted and my final payment is more than the agreed amount, the IRS will not return

the difference, but will apply the entire payment to my tax debt.

f) The IRS will keep any monies it has collected prior to this offer. Under section 6331(k), the IRS may levy on my

property and rights to property up to the time that the IRS official signs and acknowledges my offer as pending.

The IRS may keep any proceeds arising from such a levy. No levy will be issued on individual shared

responsibility payments. However, if the IRS served a continuous levy on wages, salary, or certain federal

payments under sections 6331(e) or (h), then the IRS could choose to either retain or release the levy.

I agree to the time extensions

allowed by law

g) To have my offer considered, I agree to the extension of time limit provided by law to assess my tax debt

(statutory period of assessment). I agree that the date by which the IRS must assess my tax debt will now be the

date by which my debt must currently be assessed plus the period of time my offer is pending plus one additional

year if the IRS rejects, returns, or terminates my offer, or I withdraw it. [Paragraph (l) of this section defines

pending and withdrawal]. I understand I have the right not to waive the statutory period of assessment or to limit

the waiver to a certain length or certain periods or issues. I understand, however, the IRS may not consider my

offer if I decline to waive the statutory period of assessment or if I provide only a limited waiver. I also understand

the statutory period for collecting my tax debt will be suspended during the time my offer is pending with the IRS,

for 30 days after any rejection of my offer by the IRS, and during the time any rejection of my offer is being

considered by the Independent Office of Appeals.

I understand I remain

responsible for the full

h) The IRS cannot collect more than the full amount of the tax debt under this offer.

amount of the tax liability i) I agree that I will remain liable for the full amount of the tax liability, accrued penalties and interest, until I have

met all of the terms and conditions of this offer. Penalties and interest will continue to accrue until all payment

terms of the offer have been met. If I file for bankruptcy before the terms and conditions of the offer are met, I

agree that the IRS may file a claim for the full amount of the tax liability, accrued penalties and interest, and that

any claim the IRS files in the bankruptcy proceeding will be a tax claim.

j) I understand the tax I offer to compromise is and will remain a tax debt until I meet all the terms and conditions

of this offer. If I file bankruptcy before the terms and conditions of this offer are completed, any claim the IRS files

in bankruptcy proceedings will be a tax claim.

k) Once the IRS accepts the offer in writing, I have no right to contest, in court or otherwise, the amount of the tax

debt.

Pending status of an offer and

right to appeal

l) The offer is pending starting with the date an authorized IRS official signs this form. The offer remains pending

until an authorized IRS official accepts, rejects, returns, or acknowledges withdrawal of the offer in writing. If I

appeal an IRS rejection decision on the offer, the IRS will continue to treat the offer as pending until the

Independent Office of Appeals accepts or rejects the offer in writing. If an offer is rejected, no levy may be made

during the 30 days of rejection. If I don't file a protest within 30 days of the date the IRS notifies me of the right to

protest the decision, I waive the right to a hearing before the Independent Office of Appeals about the offer.

I understand if IRS fails to

make a decision in 24-months

my offer will be accepted

m) I understand that my offer will be accepted, by law, unless the IRS notifies me otherwise, in writing, within 24

months of the date my offer was received by IRS centralized offer in compromise unit, located in Brookhaven, NY.

See mailing instructions at the bottom of this form on page 9.

I understand what will happen

if I fail to meet the terms of

my offer (e.g. default)

n) If I fail to meet any of the terms of this offer, the IRS may levy or sue me to collect any amount ranging from the

unpaid balance of the offer to the original amount of the tax debt (less payments made) plus penalties and interest

that have accrued from the time the underlying tax liability arose. The IRS will continue to add interest, as

required by Section § 6601 of the Internal Revenue Code, on the amount the IRS determines is due after default.

I understand the IRS may file

a Notice of Federal Tax Lien

on my/our property

o) The IRS may file a Notice of Federal Tax Lien during consideration of the offer or for offers that will be paid

over time. If the offer is accepted, the tax lien(s) for the periods and taxes listed in Section 1 will generally be

released within 45 days after the final payment has been received and verified. The time it takes to transfer funds

to the IRS from commercial institutions varies based on the form of payment. If I have not finished paying my offer

amount, then the IRS may be entitled to any proceeds from the sale of my property. The IRS will not file a Notice

of Federal Tax Lien on any individual shared responsibility debt.

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Form

656-L (Rev. 5-2024)

I authorize the IRS to contact

relevant third parties in order

to process my/our offer

p) By authorizing the IRS to contact third parties, I understand that I will not be notified of which third parties the

IRS contacts as part of the offer application process, including tax periods that have not been assessed, as

stated in §7602 (c ) of the Internal Revenue Code. In addition, I authorize the IRS to request a consumer report

on me from a credit bureau.

Secure Messaging q) By sending and receiving IRS encrypted messages through the Secure Messaging platform, I agree to accept

offer final determination letters on this platform.

Section 5 Explanation of Circumstances

THIS SECTION MUST BE COMPLETED.

Explain why you believe the tax is incorrect. Reminder: if your explanation indicates you cannot afford to pay, don't file a Form 656-L. Refer to page 4

"What if I agree with the tax debt but cannot afford to pay in full?", for additional information. Note: You may attach additional sheets if necessary.

Include your name and SSN, EIN and/or ITIN on all additional sheets or supporting documentation.

Section 6 Signature(s)

Taxpayer Attestation: If I submit this offer on a substitute form, I affirm this form is a verbatim duplicate of the official Form 656-L, and I agree

to be bound by all the terms and conditions set forth in the official Form 656-L. Under penalties of perjury, I declare that I have examined this

offer, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.

►

Signature of Taxpayer/Corporation name Daytime telephone number

( ) -

Today's date (mm/dd/yyyy)

The IRS may contact you by telephone about this offer. By checking this box, you authorize the IRS to leave detailed messages concerning your

offer on your voice mail or answering machine.

►

Signature of Spouse/Authorized Corporate Officer

Today's date (mm/dd/yyyy)

The IRS may contact you by telephone about this offer. By checking this box, you authorize the IRS to leave detailed messages concerning your

offer on your voice mail or answering machine.

Section 7 Application Prepared by Someone Other than the Taxpayer

If this application was prepared by someone other than you (the taxpayer), please fill in that person’s name and address below.

Name

Address (street, city, state, ZIP code) Daytime telephone number

( ) -

Section 8 Paid Preparer Use Only

Signature of Preparer

The IRS may contact you by telephone about this offer. By checking this box, you authorize the IRS to leave detailed messages concerning your

offer on your voice mail or answering machine.

Name of Preparer

Today's date (mm/dd/yyyy)

Preparer's CAF no. or PTIN

Firm's name, address, and ZIP code Daytime telephone number

( ) -

If you would like to have someone represent you during the offer investigation, include a valid, signed Form 2848 or 8821 with

this application, or a copy of a previously filed form.

Form 8821 allows a third party to receive confidential information only, however, they cannot represent you before the IRS in a

collection matter.

IRS Use Only

I accept the waiver of the statutory period of limitations on assessment for the Internal Revenue Service, as described in Section 4(g).

Signature of Authorized IRS Official Title

Today's date (mm/dd/yyyy)

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Form

656-L (Rev. 5-2024)

Privacy Act Statement

We ask for the information on this form to carry out the internal revenue laws of the United States. Our authority to request this information is contained

in Section 7801 of the Internal Revenue Code.

Our purpose for requesting the information is to determine if it is in the best interests of the IRS to accept an offer. You are not required to make an offer;

however, if you choose to do so, you must provide all of the information requested. Failure to provide all of the information may prevent us from

processing your request.

If you are a paid preparer and you prepared the Form 656-L for the taxpayer submitting the offer, we request that you complete and sign Section 8 on

the Form 656-L and provide identifying information. Providing this information is voluntary. This information will be used to administer and enforce the

internal revenue laws of the United States and may be used to regulate practice before the Internal Revenue Service for those persons subject to

Treasury Department Circular 230, https://www.irs.gov/pub/irs-pdf/pcir230.pdf. Regulations Governing the Practice of Attorneys, Certified Public

Accountants, Enrolled Agents, Enrolled Actuaries, and Appraisers before the Internal Revenue Service. Information on this form may be disclosed to the

Department of Justice for civil and criminal litigation.

We may also disclose this information to cities, states, and the District of Columbia for use in administering their tax laws and to combat terrorism.

Providing false or fraudulent information on this form may subject you to criminal prosecution and penalties.

APPLICATION CHECKLIST

Did you use the pre-qualifier assessment tool on page 4 to see if you are eligible for a DATL offer

Did you include supporting documentation and an explanation as to why you doubt you owe the tax

Did you complete all fields on the Form 656-L

Did you make an offer amount that is $1 or more

Note: The amount of your offer should be based on what you believe the correct amount of the tax debt

should be. However, you must offer at least $1. If you offer $0, your offer will be returned to you without any

further consideration.

If someone other than you completed the Form 656-L, did that person sign it

Did you sign and include the Form 656-L

If you want a third party to represent you during the offer process, did you include a Form 2848 or Form 8821 unless

one is already on file

Note: There is no application fee or deposit required for a Doubt as to Liability offer. Don't send any

payments with this offer.

Mail your package to:

Brookhaven Internal Revenue Service

COIC Unit

P.O. Box 9008

Stop 681-D

Holtsville, NY 11742-9008