Form DE999CA "Multi-Agency Form for Offer in Compromise" - California

What Is Form DE999CA?

This is a legal form that was released by the California Franchise Tax Board - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 3, 2018;
  • The latest edition provided by the California Franchise Tax Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form DE999CA by clicking the link below or browse more documents and templates provided by the California Franchise Tax Board.

ADVERTISEMENT
ADVERTISEMENT

Download Form DE999CA "Multi-Agency Form for Offer in Compromise" - California

767 times
Rate (4.7 / 5) 38 votes
State of California
California Department of Tax
and Fee Administration (CDTFA)
Franchise Tax Board (FTB)
Employment Development Department (EDD)
Multi-Agency Form for
Offer in Compromise
All offers will be evaluated independently by each agency.
Do not use this form to request FTB and CDTFA Offer in Compromise for:
Corporations
Use Forms:
Partnerships
CDTFA – 490-C
Limited Liability Companies
FTB – 4905BE
For privacy information, refer to:
California Department of Tax and Fee Administration
www.cdtfa.ca.gov/privacy.htm
Franchise Tax Board
www.ftb.ca.gov/aboutFTB/privacy/
Employment Development Department
www.edd.ca.gov/About_EDD/Privacy_Policy.htm
DE 999CA Rev. 3 (6-18) (INTERNET)
Page 1 of 13
CU
State of California
California Department of Tax
and Fee Administration (CDTFA)
Franchise Tax Board (FTB)
Employment Development Department (EDD)
Multi-Agency Form for
Offer in Compromise
All offers will be evaluated independently by each agency.
Do not use this form to request FTB and CDTFA Offer in Compromise for:
Corporations
Use Forms:
Partnerships
CDTFA – 490-C
Limited Liability Companies
FTB – 4905BE
For privacy information, refer to:
California Department of Tax and Fee Administration
www.cdtfa.ca.gov/privacy.htm
Franchise Tax Board
www.ftb.ca.gov/aboutFTB/privacy/
Employment Development Department
www.edd.ca.gov/About_EDD/Privacy_Policy.htm
DE 999CA Rev. 3 (6-18) (INTERNET)
Page 1 of 13
CU
Multi-Agency Form for Offer in Compromise
What you should know before preparing an Offer in Compromise.
Are you an OIC
The Offer in Compromise (OIC) program is for taxpayers who do not have, and will not have in the
candidate?
foreseeable future, the income, assets, or means to pay the tax liability. It allows the taxpayer to
offer a lesser amount for payment of an undisputed final tax liability.
Although each case is evaluated based on its own unique set of facts and circumstances, we give
the following factors strong consideration in the evaluation:
Ability to pay.
Equity in the taxpayer’s assets.
Present and future income.
Present and future expenses.
The potential for changed circumstances.
The offer is in the best interest of the state.
We will not recommend approval of offers if there are assets or income available to pay more than
the amount offered.
Can we process
Your offers will be evaluated independently by each agency. The CDTFA, FTB, and EDD have
your application?
different criteria for participation in their OIC programs. For:
All agencies — You must agree that you owe the amount of the liability. If you dispute the
liability, you should appeal through the appropriate agency’s appeal process.
FTB — Your application will be processed if all of the required FTB income tax returns have
been filed. If you have no filing requirement, note it on your application.
EDD — You must be out of business and must not have a controlling interest or an association
with the business or a successor to the business that incurred the liability. This includes
operating a business of the same nature.
CDTFA — You must be out of business and must not have a controlling interest or an
association with the business or a successor to the business that incurred the liability. This
includes operating a business of the same nature. However, effective January 1, 2009,
through January 1, 2023, an offer in compromise will be considered for open and active
businesses that have not received reimbursement for the taxes, fees, or surcharges owed;
successors of businesses that may have inherited tax liabilities from their predecessors; and
consumers, who are not required to hold a seller’s permit, but incurred a use tax liability.
EDD — You cannot have access to income to pay more than the accumulating interest and
6.7 percent of the outstanding liability on an annual basis.
EDD — An offer will not be considered for liabilities assessed for fraud or where the employer
has been convicted of a violation under the California Unemployment Insurance Code.
CDTFA — An offer for a liability with a fraud assessment will not be considered if there is a
criminal conviction of fraud. For other fraud assessments, an offer will be considered if a
minimum of the tax plus the fraud penalty is offered.
Will we require
All the agencies require that you continue making periodic payments as called for in any existing
you to continue
installment agreement while your offer is being considered.
payments on an
installment
agreement?
DE 999CA Rev. 3 (6-18) (INTERNET)
Page 2 of 13
Are collections
Submitting an offer does not automatically suspend collection activity. Wage garnishments already in
suspended?
place at the time of the offer will continue and will not be considered as partial payment of the
offered amount. However, in many cases, collection action will be suspended until the OIC
evaluation is completed. If delaying collection activity jeopardizes the state’s ability to collect,
collection efforts may continue. Interest will continue to accrue as prescribed by law.
When should the
Do not send any offered funds now. The agencies you have applied to will contact you once they
offered funds be
have evaluated your offer.
submitted?
DE 999CA Rev. 3 (6-18) (INTERNET)
Page 3 of 13
The following documentation must be submitted with your OIC application or your application may be returned as
incomplete. Please submit copies only. We will not return any documents that you send us. Additional documentation
may be required and requested as the evaluation of the OIC proceeds.
Check List of Required Items (Check only those boxes that apply.)
Verification of Income
Provide pay stubs for the past three months or financial statements for the past two years if you are
self-employed.
Verification of Expenses
Provide billing statements for the last three months (include copies of charge card statements, bills from other
creditors, and personal loan statements).
Bank Information
Provide bank statements for savings and checking accounts (for the last six months).
If you are self-employed, provide bank statements for the last 12 months.
If any accounts have been closed within the last two years, include bank statements for the last six months of
each account before the account was closed.
Investment Information
Submit investment account statements showing the value of stocks, bonds, mutual funds, and/or retirement or
profit sharing plans (IRA, 401[k], Keogh, Annuity).
Current Lease or Rental Agreements
Include all lease agreements, including property where you are the lessor or lessee.
Real Property Information
Submit mortgage statements and escrow statements for property you currently own, or property you sold or
gifted in the last five years.
IRS/FTB Information
Submit complete copies of Internal Revenue Service (IRS) or FTB returns for the past three years.
OIC Information
Submit copies of offers made to other government agencies and acceptance letters or other arrangements
made to resolve your debt.
Legal Documents
Submit marital settlement agreements, divorce decrees, marital property settlements, trust documents, and
bankruptcy documents.
Medical Documentation
Submit physician’s letter including diagnosis and prognosis and/or other documents to show any medical
condition that should be considered.
Power of Attorney
If a designated representative submits this offer, attach the appropriate Power of Attorney (POA) Declaration,
DE 48, CDTFA-392, or FTB 3520 PIT.
Submit your completed and signed application to CDTFA, FTB, or the EDD at the corresponding address below. The OIC
application must be sent to each separate agency for processing. You should receive an acknowledgement letter from the
receiving agency within 30 working days from the date your OIC application was received. Please contact us via phone
or website.
CALIFORNIA DEPARTMENT OF
FRANCHISE TAX BOARD
EMPLOYMENT DEVELOPMENT DEPARTMENT
TAX AND FEE ADMINISTRATION
OFFER IN COMPROMISE
PO BOX 826880, MIC 92S
OFFER IN COMPROMISE
PO BOX 2966, MS A453
SACRAMENTO, CA 94280-0001
PO BOX 942879, MIC 52
RANCHO CORDOVA, CA 95741-2966
SACRAMENTO, CA 94279-0052
Phone: 1-800-400-7115
Phone: 1-916-845-4787
Phone: 1-916-464-2739
Website: www.cdtfa.ca.gov
Website: www.ftb.ca.gov/oic
Website: www.edd.ca.gov
DE 999CA Rev. 3 (6-18) (INTERNET)
Page 4 of 13
Section 1 – Offer in Compromise
To make an offer, please check the box next to the corresponding agency. For all offers, you must complete Sections 1
through 8 of this application. You must also complete and sign the appropriate offer agreement in Section 9. For
corporations, partnerships, and limited liability companies, use form FTB-4905BE for FTB offers and CDTFA-490-C for
CDTFA offers.
CDTFA
I wish to make an Offer in Compromise to CDTFA for liabilities associated with the following CDTFA account
numbers:______________________________________.(You must complete Part I of Section 9, page 11.)
FTB
I wish to make an Offer in Compromise to FTB for liabilities associated with the following FTB account
numbers:______________________________________.(You must complete Part II of Section 9, page 12.)
EDD
I wish to make an Offer in Compromise to EDD for liabilities associated with the following EDD account
numbers:______________________________________.(You must complete Part III of Section 9, page 13.)
Section 2 – Personal Information
Note: Complete all blocks, except shaded areas. Write “N/A” (not applicable) in those blocks that do not apply. Attach additional pages as needed.
First Name
MI
Last Name
Social Security Number
Date of Birth
Other Name(s) or Alias(es) Used
First Name of Spouse or
Registered Domestic Partner
(RDP)
MI
Last Name of Spouse or RDP
Social Security Number
Date of Birth
Other Name(s) or Alias(es) Used
Taxpayer’s Driver License Number
State
Driver License Number of Spouse or RDP
State
Dependent’s Name
Date of Birth
Social Security Number
Relationship
Current Address
Previous Address (If current address is less than 2 years.)
Phone Number:
Phone Number:
Name and Address of Your Tax Representative (Please attach a Power of Attorney.)
Phone Number:
DE 999CA Rev. 3 (6-18) (INTERNET)
Page 5 of 13