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Fillable Form 9465 (Rev. December 2011)

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Form (Rev. December 2009) Department of the Treasury Internal Revenue Service 9465 Installment Agreement Request If you are filing this form with your tax return, attach it to the front of the return. Otherwise, see instructions. OMB No. 1545-0074 Caution: Do not file this form if you are currently making payments on an installment agreement or can pay your balance due in full within 120 days. Instead, call 1-800-829-1040. If you are in bankruptcy or we have accepted your offer-in-compromise, see Bankruptcy or offer-in-compromise on page 2 More

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