Can you confirm that each of the following is true by selecting the checkbox?

I am not in an open bankruptcy proceeding which is a legal process in which an individual or business that cannot repay its debts seeks protection and relief from the court. During this process, the court oversees how debts are reorganized, reduced, or eliminated, while ensuring creditors are treated fairly under the law.

I have filed all required federal tax returns, including Form 1040 and any associated schedules that report my income, deductions, credits, and other financial information to the Internal Revenue Service. This means I have submitted every annual return I was obligated to file, along with all supporting forms—such as Schedules A, B, C, or others—ensuring the IRS has a complete and accurate record of my tax filings for each applicable year.

I have made all required estimated tax payments, meaning I submitted quarterly payments to the IRS throughout the year to cover income that was not subject to withholding—such as self-employment income, interest, dividends, or business earnings. These payments were made according to IRS guidelines using the estimated tax system outlined in Form 1040-ES, ensuring that I met my obligations to pay taxes as income was earned.

Date in MM/DD/YYYY format
9-digit SSN, digits only
Date in MM/DD/YYYY format
9-digit SSN, digits only

Warning: The IRS will not compromise any amounts of restitution assessed by the IRS or any tax periods the IRS has referred to the DOJ. Any liability arising from restitution is excluded from this offer. Also, the IRS will not compromise any liability for which an election under IRC § 965(i) is made; such liabilities are excluded from this offer. Any offer containing a liability for which payment is being deferred under IRC § 965(h)(1) can only be processed for investigation 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).

4-digit tax year, e.g., 2023
4-digit tax year, e.g., 2023

4-digit tax year, e.g., 2023
Note: If you need more space, use attachment and title it “Attachment to Form 656. Make sure to sign and date the attachment.

Email address of the person submitting the form