Form DTF-4 "Offer in Compromise for Liabilities Not Fixed and Final, and Subject to Administrative Review" - New York

What Is Form DTF-4?

This is a legal form that was released by the New York State Department of Taxation and Finance - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2016;
  • The latest edition provided by the New York State Department of Taxation and Finance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DTF-4 by clicking the link below or browse more documents and templates provided by the New York State Department of Taxation and Finance.

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Download Form DTF-4 "Offer in Compromise for Liabilities Not Fixed and Final, and Subject to Administrative Review" - New York

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DTF-4
Department of Taxation and Finance
Offer in Compromise
(12/16)
For Liabilities Not Fixed and Final, and Subject to Administrative Review
Use Form DTF-4.1 instead if you do not have formal protest or appeal rights
.
(see instructions)
1.
Name of taxpayer(s)/trade or business name(s)
Telephone number
Social security number(s)
(
)
Physical home address
Employer identification number (EIN)
Mailing address
Entity type(s)
(if different from above, or if a PO box number)
Individual
Business address
Partnership
Name of taxpayer’s representative
Telephone number
(attach power of attorney; see instructions)
(
)
Corporation
Address of taxpayer’s representative
Other
2.
What is the offer based on? Mark an X in one or both boxes
(see instructions)
Doubt as to liability
Doubt as to collectibility or Collection in full would cause undue economic hardship
(must include Form DTF-5)
3.
$
Total amount offered
(must be more than $0)
Is the sum offered in compromise borrowed money? ..............................................................................................
Yes
No
(If Yes, enter name and address of lender and list of collateral, if any, pledged to secure the loan)
You do not have to include payment with this application. However, if you do, and
we do not accept your offer, we will use the money toward the amount you owe.
4.
Liabilities and payments
(Attach additional pages if needed, and submit copies of all notices)
Total payments
to date
Assessment I.D.
Type of tax or liability
Liability period
Amount due
5.
Provide the facts and reasons supporting the grounds for acceptance of this offer
(see instructions)
DTF-4
Department of Taxation and Finance
Offer in Compromise
(12/16)
For Liabilities Not Fixed and Final, and Subject to Administrative Review
Use Form DTF-4.1 instead if you do not have formal protest or appeal rights
.
(see instructions)
1.
Name of taxpayer(s)/trade or business name(s)
Telephone number
Social security number(s)
(
)
Physical home address
Employer identification number (EIN)
Mailing address
Entity type(s)
(if different from above, or if a PO box number)
Individual
Business address
Partnership
Name of taxpayer’s representative
Telephone number
(attach power of attorney; see instructions)
(
)
Corporation
Address of taxpayer’s representative
Other
2.
What is the offer based on? Mark an X in one or both boxes
(see instructions)
Doubt as to liability
Doubt as to collectibility or Collection in full would cause undue economic hardship
(must include Form DTF-5)
3.
$
Total amount offered
(must be more than $0)
Is the sum offered in compromise borrowed money? ..............................................................................................
Yes
No
(If Yes, enter name and address of lender and list of collateral, if any, pledged to secure the loan)
You do not have to include payment with this application. However, if you do, and
we do not accept your offer, we will use the money toward the amount you owe.
4.
Liabilities and payments
(Attach additional pages if needed, and submit copies of all notices)
Total payments
to date
Assessment I.D.
Type of tax or liability
Liability period
Amount due
5.
Provide the facts and reasons supporting the grounds for acceptance of this offer
(see instructions)
Page 2 of 4 DTF-4 (12/16)
6. Conditions
under the Tax Law and compounded from the date of
(please read)
default; or (c) disregard the amount of the offer and apply
6A. It is agreed (a) that the Commissioner of Taxation and
all amounts previously deposited under the offer against
Finance (“the Commissioner”) shall keep all payments,
the amount of the liability sought to be compromised,
sums collected, and other credits made to the liabilities
immediately and without further notice file a warrant
asserted for the periods covered by this offer, and
thereon and proceed to collect the balance of the
(b) that the Commissioner shall keep any and all
original liability. The taxpayer(s) agrees that any pending
amounts to which taxpayers may be entitled under the
conciliation conference or proceedings before the
Tax Law, due through overpayments of any tax or other
Division of Tax Appeals, or any right thereto, pursuant to
liability, offsets, credits, or funds payable to the taxpayers
Tax Law sections 170, 171, and Article 40 thereof, and
that are available to New York State (for example, lottery
the regulations adopted pursuant thereto, on the liability
offsets and unclaimed funds), for periods ending before,
compromised, are finally and irrevocably concluded or
or within, or as of the end of the calendar year in which
waived, as the case may be.
this offer is accepted (and which are not in excess
of the difference between the liability sought to be
6D. It is understood that this offer will be considered and
compromised and the amount offered).
acted upon in due course and does not relieve the
taxpayer(s) from the liability sought to be compromised,
6B. Any payments made under the terms of this offer shall
unless and until the offer is accepted in writing by the
be applied, unless otherwise agreed in writing, to the
Commissioner, and there has been full compliance with
liabilities of the taxpayer(s) in the order determined upon
the terms of the offer and any collateral agreements.
by the Commissioner.
6E. Taxpayers waive the benefit of any statute of limitations
6C. It is further agreed and consented to by the taxpayer(s)
applicable to the assessment and collection of liabilities
that upon notice of the acceptance of this offer, the
sought to be compromised, and agree to the suspension
taxpayer(s) shall have no right to contest in the Bureau
of the running of the statutory period of limitations on
of Conciliation and Mediation Services, the Division
assessment and collection for the period during which
of Tax Appeals, any court, or otherwise, at any time,
this offer is pending, and for one year thereafter. For
the amount of the liability sought to be compromised.
these purposes, the offer shall be deemed pending from
The Tax Department will not compromise any liability,
the date of acceptance of the waiver of the statutory
nor satisfy any warrant, until all obligations of each
period of limitations by an authorized Tax Department
taxpayer under the compromise agreement, or any
official, until the date on which the offer is formally
collateral agreement, are completely performed and
accepted, rejected, or withdrawn in writing.
satisfied. In the event of a default by any taxpayer on the
6F. Taxpayers waive any statute of limitations defenses to
compromise agreement, or on any collateral agreement,
the assessment and collection of the liability sought to be
or if this is a deferred payment offer and there is a
compromised, and further waive any statute of limitations
default in payment of any installment of principal or
interest due under its terms, or a default on any other
defenses against the issuance of new assessment(s) for
term that the taxpayer(s) may have agreed upon with the
the compromised liability in the event any taxpayer fails
Commissioner for acceptance of the deferred payments,
to comply with the terms of the offer in compromise.
New York State, at the option of the Commissioner or
6G. Taxpayers also agree to forfeit any current capital loss or
an official designated by him or her, may (a) proceed
net operating loss credits taken on any future New York
immediately by suit to collect the entire unpaid balance
State return.
of the offer; or (b) proceed immediately by suit to collect
as liquidated damages an amount equal to the liability
6H. Taxpayers agree that during the five-year period, beginning
sought to be compromised, minus any payments already
with the date we accept the offer, to comply with all
received under the terms of the offer, with interest on
provisions of the New York State Tax Law regarding filing tax
the unpaid balance at the annual rate(s) as established
returns and paying all required taxes on all required returns.
7. Signatures
Under penalties of perjury, I declare that I have examined this application, including accompanying documents, and to the best of my knowledge
it is true, correct, and complete. I also affirm that I have read, understand, and agree to the terms and conditions above.
I authorize the New York State Department of Taxation and Finance (DTF) to contact certain third parties, including but not limited to financial
institutions and consumer credit reporting agencies, and to obtain my consumer credit report for the purpose of verifying the information I
provided to DTF for determining my eligibility for the Offer-in-Compromise Program. In addition, I authorize DTF to use my social security
number when requesting my credit history from consumer reporting agencies or when verifying the information provided. I understand that DTF
will not notify me about which third parties, if any, are contacted by DTF as part of this review process.
Pursuant to Tax Law section 171, subdivision eighteenth (a), the undersigned submits this offer to the Commissioner to compromise any
liabilities.
Date
Signature of taxpayer(s)
Date
Signature of taxpayer(s)
Corporations: See instructions on page 4, Section 7.
DTF-4 (12/16) Page 3 of 4
Instructions
Use the correct form
authorized representative, and the representative will sign on
page 2 on behalf of the fiduciary, the fiduciary must also submit
Use Form DTF-4, Offer in Compromise: For Liabilities Not
a completed power of attorney along with the appropriate
Fixed and Final, and Subject to Administrative Review, to
documents. We recommend Form ET-14, Estate Tax Power
submit your request to compromise liabilities, where you still
of Attorney. If you use another power of attorney form, it must
have formal protest or appeal rights.
include the same information as the ET-14.
You may submit Form DTF-4 if there is doubt as to liability,
or doubt as to collectibility of the full amount owed (including,
Specific instructions
for individuals only, when full collection would cause undue
Section 1. Taxpayer information
economic hardship). For an explanation of doubt as to liability
and doubt as to collectibility, see the instructions for Section 2.
Enter the full name and phone number of the taxpayer(s). If the
taxpayer is a business, enter the name of the business or its
Use Form DTF-4.1, Offer in Compromise: For Fixed and Final
trade name (or both). If this is a joint income tax liability, both
Liabilities, where you do not have any formal protest or appeal
spouses may submit one application and enter both names.
rights. You do not have these rights if you:
However, for any other type of joint liability, such as a
• owe tax, interest, or penalties due to: a math or clerical
partnership, each must submit separate DTF-4 forms.
error on a return, a change the IRS made to your federal
return, or your failure to pay on time the tax that you
Enter the taxpayer’s social security number, or, for a business,
reported due on your return, or
the employer identification number.
• received a Statement of Proposed Audit Changes.
Enter the taxpayer’s physical home address, mailing address if
Your liabilities are fixed and final, and may be established by a
different or a PO box, and business address (if applicable).
valid warrant.
Mark an X in a box to indicate entity type(s). If Other, fill in the
Considerations for using Form DTF-4
blank.
You must be in compliance with all paying and filing
If the taxpayer has a representative, enter the name, phone
requirements for periods not included in your offer. This includes
number, and address of the representative, and attach a
estimated payments, tax deposits, and similar requirements.
completed power of attorney.
Submitting Form DTF-4 does not automatically suspend pending
Section 2. Basis for compromise
proceedings in the Bureau of Conciliation and Mediation
Mark an X to indicate what the offer is based on.
Services, nor does it suspend the time for you to take any action
about an assessment.
Doubt as to liability (you don’t agree with the amount the Tax
Department claims you owe).
Also, submitting Form DTF-4 does not affect the interest and
To support your claim, you must submit affidavits showing
penalties that continue to accrue on your liabilities. Interest is
the material facts of the case. You must also include certified
due at the rate set by the Tax Law, from the date of the notice or
copies of the documents of record, if any; true copies of all
agreement until we receive full payment.
other papers and documents referred to in any affidavit; and
We may require a written collateral agreement or other security,
a full list of the statutes, regulations, and case law you are
to protect the Tax Department’s interest.
relying on. You are responsible for completely presenting
all your facts and legal arguments. We may require you to
Generally, a taxpayer may make only one offer in compromise
provide additional documentation from third parties.
for a particular liability for a particular period.
Doubt as to collectibility (you have insufficient assets and
If we accept your offer
income to pay the full amount), or where collection in full
would cause undue economic hardship (individuals only).
If the Tax Department accepts your offer, and you satisfy all the
terms of the offer (for example, you paid in full the offer and
For there to be doubt as to collectibility, you must show that
complied with the terms of any collateral agreement), we will
you have been discharged in bankruptcy, you are insolvent,
eliminate the remaining balance of your liabilities included in this
or (for individuals only) that collection in full would cause you
offer.
undue economic hardship.
You are considered insolvent if all your liabilities (including
Taxpayer’s representative
your tax debt) exceed the fair market value of your assets.
If you have a representative, you must include a completed
Undue economic hardship generally means that you are
power of attorney. We recommend POA-1, Power of Attorney,
unable to pay reasonable basic living expenses, which are
available at www.tax.ny.gov. If you use another power of
those providing for the health, welfare, and production of
attorney, it must include the same information as the POA-1.
income for your family. We use Internal Revenue Service
(IRS) standards to help determine allowable living expenses.
Estates
We also consider other factors, including the taxpayer’s age,
When Form DTF-4 is submitted by an estate fiduciary (executor
employment status, and employment history; any inability to
or administrator), the fiduciary must submit a copy of the
earn income because of long-term illness, medical condition,
appropriate court appointment (for example, letters testamentary
or disability; and any obligation to dependents.
or letters of administration) or, if there is no court appointment,
appropriate documents as requested by the Tax Department. If
the offer in compromise will be handled by the fiduciary’s duly
Page 4 of 4 DTF-4 (12/16)
Corporations: Enter the corporate name. An authorized
All offers based on doubt as to collectibility or where collection
corporate signatory must sign. Print the signatory’s name and
in full would cause the taxpayer hardship, must include:
title immediately below the signature.
a completed Form DTF-5, Statement of Financial Condition
and Other Information (available at www.tax.ny.gov),
Mailing your Form DTF-4
including copies of:
Along with your completed Form DTF-4, be sure to include
• your last three federal income tax returns,
copies of all notices listed in Section 4, and all supporting
• a credit report less than 30 days old, and
documents.
• your last 12 months of statements from your bank or
If your offer is based on doubt as to collectibility or hardship,
financial institution.
remember to include a completed Form DTF-5. Include copies
of your federal income tax returns for the last three years, copies
Section 3. Amount offered
of the last 12 months of statements from your bank or financial
Enter the total amount you intend to offer. You must offer more
institution, and all other material required by Form DTF-5.
than $0, and you cannot include any amounts previously paid or
collected against the liabilities.
Mail all documents to:
NYS TAX DEPARTMENT
For an offer based on doubt as to liability, the amount acceptable
CED OFFER IN COMPROMISE UNIT
depends upon the degree of doubt found in the particular case.
W A HARRIMAN CAMPUS
For an offer based on doubt as to collectibility, the amount must
ALBANY NY 12227-5100
be a figure we realistically expect we could collect within a
More information
reasonable period of time. It is based on the total value of assets
and the amount we could expect to collect from anticipated
These instructions are intended only as a guide for preparing
future income. Otherwise, the amount proposed must be justified
Form DTF-4. For an overview, see Publication 220, Offer in
by information you submit.
Compromise Program. For specific details, see regulations
Title 20 NYCRR Part 5000, Compromises, available at
Mark an X in the Yes box if all or part of the money you are
www.dos.state.ny.us/info/nycrr.html.
offering for the compromise is borrowed. If Yes, enter the name
and address of the source of the borrowed money, and include a
For questions, call (518) 591-5000. For forms and more
list of any collateral you have pledged to secure the loan.
information, see www.tax.ny.gov.
Section 4. Liabilities and payments
Checklist
List all unpaid liabilities administered by the Tax Department
you wish to compromise. You may not submit an offer for a tax
Is DTF-4 the correct form for you?
year or period that has not been assessed. Include copies of
If you have a representative, did you enter their name,
all notices that you list. You can view all your unpaid liabilities
address and phone number? Did you include a completed
on your Online Services account. If you do not have an Online
power of attorney?
Services account, you can visit our website at www.tax.ny.gov
and create one.
Did you enter an offer of more than $0?
In the Type of tax or liability column, indicate whether the notice
is for income, sales, withholding, or some other tax or liability.
If your offer includes borrowed money, did you enter the
lender’s name and address, and collateral, if any?
If, for a particular liability, you are both personally liable and
jointly liable with another individual or separate entity such as
Did you include copies of notices of unpaid liabilities?
a corporation, you must submit your own Form DTF-4. For joint
liabilities, if only one taxpayer’s offer is accepted and paid, the
Did you include copies of all appropriate documents
remaining taxpayers remain liable for the outstanding balance of
to support your offer? If you fail to submit all required
the liability. An offer we accept forgives further payment only for
statements and documents, we will not process your
the taxpayer whose offer was accepted.
application.
Section 5. Grounds for the offer
Did you sign and date the bottom of page 2?
Provide all the facts and reasons supporting the grounds for
If your offer is based on doubt as to collectibility or
acceptance of your offer. If needed, attach additional pages, and
hardship, did you include a completed Form DTF-5,
copies of appropriate documents, to fully and completely explain
including copies of:
the details of your offer. For individuals only, if your offer is based
on undue economic hardship, explain your situation and provide
your last three federal income tax returns (if you are not
supporting documentation.
required to file, include an explanation),
Section 6. Conditions
a credit report less than 30 days old, and
By submitting this application, you have read, understand, and
your last 12 months of statements from your
agree to the terms and conditions in this section.
bank or financial institution?
Section 7. Signatures
Sign and date. If you and your spouse seek to compromise a
joint income tax liability, both must sign.