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         Illinois Department of Revenue 

         CPP-1                       Installment Payment Plan Request 

Step 1:  Identify yourself (and spouse, if applicable)                                    B     If business debt, identify your business or organization 
 A ___ ___ ___ - ___ ___ - ___ ___ ___ ___                                                      ___ ___  - ___ ___ ___ ___ ___ ___ ___ 
   Your Social Security number                                                                  Federal employer identifcation number (FEIN) 
   ___ ___ ___ - ___ ___ - ___ ___ ___ ___                                                      ___ ___ ___ ___ - ___ ___ ___ ___ 
   Your spouse’s Social Security number                                                         Illinois account ID 
   __________________________________________________ 
   Your frst name and middle initial                                 Last name                  Legal business name:  ________________________________ 
   _________________________________________________________________                            Doing-business-as (DBA), assumed, or trade name, if different 
   Your spouse’s frst name and middle initial                        Last name                  from the legal business name on the line above: 
   _________________________________________________________________ 
   Street address - No PO Box number                       Apartment or suite number        __________________________________________________ 
   _________________________________________________________________                            __________________________________________________ 
   City                                                        State      ZIP                   Business mailing address 
   _________________________________________________________________                        __________________________________________________ 
   Your email address                                                                           City                            State                                      ZIP 
   (_____)______________                (_____)______________                                   __________________________________________  
   Your home phone number               Your work phone number                                  Name of person responsible for remitting payments 
   (_____)______________                (_____)______________                                   (_____)______________ 
   Your mobile phone number             Your spouse’s phone number                              Phone number   

Step 2: Describe your debt and installment payment plan request 
 1  Identify the tax periods covered by this agreement.                                   _________  _________  _________  _________  _________ 
 2  Write the amount of your good faith downpayment. See instructions.                                                                                                   2 $_____________ 
   3  Write the remaining amount of debt to be covered by this installment payment plan request.                                                                         3 $_____________ 
      If your unpaid liability is over $10,000, complete and attach Form EG-13-I or Form EG-13-B. See instructions. 
    4 Write the date of your frst installment payment __ __ /__ __ /__ __ __ __ and payment amount.                                                                      4 $_____________ 
  5  Check one of the following options to describe how often you will make payments. 
            One payment per month                                           One payment per week                         One payment every other week
             Date of month ___ ___                                           Day of week _______________                 Day of week _______________ 
Step 3: Provide your fnancial institution and account information 
   6  ______________________________________________________                                               Check  this  box  if you do not have a bank account.  
      Financial institution’s name 
     ____________________________________________________________________________________________________________________ 
      Mailing address                                                                           City                     State  ZIP 
     ____________________________________________________________________________________________________________________ 
      Name(s) on the account (list all names) 
      Routing number ___ ___ ___ ___ ___ ___ ___ ___ ___                                               Checking   or       Savings 
      Find your routing number at the bottom of your check (for checking accounts) or contact your fnancial institution for the routing number (for savings accounts). 
      Account number ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 

Step 4: Read the statement and sign below 
I agree to, and understand, that (1) the Illinois Department of Revenue (IDOR) is authorized to use the information on this form to make withdrawals  
(ACH debits) at the frequency I selected in Line 5 and from the account listed on Line 6 in accordance with the Department of Revenue Law of the Civil  
Administrative Code of Illinois and all applicable Illinois tax acts, and that this authorization remains in effect until the debt is paid or I notify IDOR in writing  
to cancel ;(2) IDOR may request additional information about my fnancial condition and I may be required to pay a higher amount than the payment plan 
described above; (3) IDOR has the discretion to fle a lien at any time, including, but not limited to, when IDOR determines there is a risk of non-
payment; (4) IDOR may contact me about this payment plan at any address and phone number listed in Step 1 (this includes electronic communication  
by email or text);  and (5) if I do not remit the scheduled payment, fle all required returns, and pay all taxes when due, IDOR may cancel my installment  
payment plan, my entire unpaid balance will become due immediately, and IDOR may take enforcement action, including levy of my bank account or wages. 
Under penalties of perjury, I state that I have examined this form and, to the best of my knowledge, it is true, correct, and complete. 
______________________________________________________________________  __ __ / __ __ / __ __ __ __ 
Your signature or authorized offcer (if offcer, write title)                                                              Month,  day,  year 
Department use only 
_________________________________ __ / __ __ / __ __ __ __                                  ______________________________ __ __ / __ __ / __ __ __ __ 
Approved by assignee                                           Date approved by assignee    Approved by supervisor                                                  Date approved by supervisor 
                              This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this    Printed by the authority of the state 
CPP-1 (R-06/23)              information is REQUIRED. Failure to provide information may result in this form not being processed and may result in a penalty.          of Illinois — Web only, One copy 
                                                                            Reset               Print

                     See instructions on next page. 

CPP-1 back (R-06/23) 

Instructions for Form CPP-1,  Installment Payment Plan Request 

General Information                        approval and the conditions of the                              may make payments using your 
                                           installment payment plan.                                       Visa, Discover, MasterCard, or 
Who should fle this form?                                                                                  American Express. The credit card 
                                         How must I make my 
You should fle Form CPP-1,                                                                                 service provider will assess a 
Installment Payment Plan Request,        installment plan payments?                                        convenience fee. Each service 
if you have tax delinquencies that       ACH debit — If you have a checking                                provider charges its own rate.  The 
you cannot pay in full because of a      or savings account, you may be                                    rates can vary daily.  The Department  
fnancial hardship and you would like     required to make your installment                                 of Revenue receives no money from 
to enter into an installment payment     payments using the ACH debit                                      these fees. Please note that this is 
plan with us.                            program. It is the recommended form                               the only payment option where you 
                                         of payment for installment payments.                              will be charged a convenience fee. 
What is an installment                   The ACH debit program allows you                                  To make a credit card payment, visit 
payment plan?                            to have the installment payments                                  our website at tax.illinois.gov  or call 
An installment payment plan is an        automatically withdrawn from a                                    1 866-490-2061 and choose the 
agreement between you and the            savings or checking account.                                      credit card payment option. If your 
Illinois Department of Revenue to pay                                                                      payment is for a prior year, select 
                                         Note: If we approve your installment 
your tax delinquencies using regularly                                                                     “prior year.” 
                                         payment plan request, your plan 
scheduled payments. Your scheduled 
                                         approval letter will describe the 
payment amount and the length of time                                                                      Where do I send my 
                                         requirements for your payments. 
that you have to pay is based on your                                                                      completed form? 
fnancial condition.                                                                                        Please fax your completed form to us 
                                         How must I make my frst  
                                                                                                           at 217 785-2635 or mail it to 
When is this form due?                   payment or extra payments? 
                                                                                                           INSTALLMENT CONTRACT UNIT 
There is no specifc due date.  We        To make your frst payment or if you                               ILLINOIS DEPARTMENT OF REVENUE 
recommend that you fle this form when    would like to make payments in                                    PO BOX 19035 
you receive a bill or notice which you   addition to your regular installment                              SPRINGFIELD IL  62794-9035  
are unable to pay because of a fnancial  payments, you may use one of the 
hardship. Once you receive the bill or   following options.                                                Where do I get help? 
notice, you should complete and return 
                                         • MyTax Illinois — This is the                                    •  Visit our website at tax.illinois.gov 
this form within 10 days. Note: Even 
                                           Department’s online account                                     •  Call our Installment Contract Unit at 
when you enter into an installment 
                                           management system. You may use                                  217 785-8556 
payment plan, you continue to accrue 
                                           MyTax Illinois to make electronic 
interest and applicable penalties and                                                                      •  Write to 
                                           payments as well as fle returns for 
fees on the delinquent tax you owe.                                                                        INSTALLMENT CONTRACT UNIT 
                                           most taxes. Go to mytax.illinois.gov.                           ILLINOIS DEPARTMENT OF REVENUE 
When will my installment                 • “Pay by Phone”  — Call                                          PO BOX 19035 
payment plan request be                    1 866-490-2061 to make a payment                                SPRINGFIELD IL  62794-9035 
approved?                                  from your checking or savings 
Approval of your request for an            account. You will need your 
installment payment plan will depend       Taxpayer ID, bank routing number, 
upon the completeness of the               and bank account number. 
information you provide on this form.    • Mail — You may mail your 
If additional information is needed to     remittance to 
process your request, we will contact 
                                           INSTALLMENT CONTRACT UNIT 
you.                                       ILLINOIS DEPARTMENT OF REVENUE 
If our review fnds that you                PO BOX 19035 
•  can pay in full, then we will require   SPRINGFIELD IL  62794-9035 
you to do so.                            • Credit card (This payment method 
•  qualify for an installment payment      is only available for Individual 
plan, we will send you a letter of         Income Tax liability.)  — You 

CPP-1 Instructions Front (R-06/23)  Printed by the authority of the state of Illinois — Web only, One copy 

Step-by-step                Instructions      Information Statement for Individuals,    and that this authorization remains 
                                              or Form EG-13-B, Financial and Other      in effect until the debt is paid or you 
Step 1: Debtor identifcation                  Information Statement for Businesses,     notify IDOR in writing to cancel; 
Line A Complete all lines. If you have        and submit it with Form CPP-1. Both       (2) IDOR may request additional 
a spouse who is also liable, complete         of these forms are available on our       information about your fnancial 
the lines about your spouse.                  website at tax.illinois.gov.              condition and you may be required 
                                                                                        to pay a higher amount than the 
Line B If business debt, complete             Line 4  For your regular installment      payment plan described on this 
all lines to identify the business or         plan payments, write the date             form; 
organization.                                 payments will begin and the amount 
                                                                                        (3) IDOR has the discretion to fle a 
                                              of each payment. Please make the 
                                                                                        lien at any time, including, but not 
                                              payment amount as large as possible 
                                                                                        limited to, when IDOR determines 
Step 2: Describe your debt                    to reduce additional interest accrual. 
                                                                                        there is a risk of non-payment; 
and installment payment plan                  Interest accrues on the tax until paid. 
request                                                                                 (4) IDOR may contact you about this 
                                              Line 5 Check one box to tell us           payment plan at any address 
Line 1   Identify all tax periods (i.e.,      how frequently you will make your         and phone number listed in 
month, quarter, or year) for which            installment plan payments as identifed    Step 1 (this includes electronic 
the liability exists. For individual or       on Line 4.                                communication by email or text); 
business income tax liabilities, write                                                  and 
the tax year covered by the return.                                                     (5) if you do not remit the scheduled 
                                              Step 3: Provide your fnancial 
                                                                                        payment, fle all required returns, 
  If you need additional space, write     the institution and account                   and pay all taxes when due, 
tax period beside the line provided or        information                               IDOR may cancel the installment 
list the tax periods on a separate sheet  of 
                                                                                        payment plan, the entire unpaid 
paper and attach it to this form.             Complete all lines about your account 
                                                                                        balance will become due 
                                              to authorize  the Illinois Department of 
If you have both individual income tax                                                  immediately, and IDOR may take 
                                              Revenue to   utilize the ACH debit 
and other tax debt, submit a separate                                                   enforcement action, including levy 
                                              method      ofpayment from  this account. 
Form CPP-1 for the individual income                                                    of your bank account or wages. 
tax liability. 
If you are requesting an installment          Step 4: Read the statement 
payment plan for more than one type           and sign the form 
of tax other than individual income           You (or in the case of a business, 
tax (i.e., sales, withholding, excise,        the person responsible for remitting 
or business income tax), you may              payments) must sign the statement. If 
combine the tax types on your Form            you do not, processing of your request 
CPP-1. Write the type of tax beside the       will be delayed and we may take 
line provided or list the tax types and       collection action to collect the unpaid 
periods on a separate sheet of     paper      debt. 
and attach it to this form.  
                                              We will contact you if we do not 
Line 2   Write the amount of your good        approve the installment payment plan 
faith down payment (which is due with         as you request or if we need additional 
your completed Form CPP-1). You               information from you. 
must make this payment using MyTax 
Illinois or “Pay by Phone” payment            By signing the application, you 
method or by mailing us a check or            agree to the following: 
guaranteed remittance. Please make 
your down payment amount as large             (1) the Illinois Department of Revenue 
as possible to reduce additional              (IDOR) is authorized to use the 
interest accrual. Interest accrues on         information on this form to make 
the tax until paid.                           withdrawals (ACH debits) at the 
                                              frequency you selected in Line 5 
Line 3  Write the amount of debt              and from the account listed on 
to be included in your installment            Line 6 in accordance with the 
payment plan. If your unpaid                  Department of Revenue Law of the 
liability is over $10,000, complete           Civil Administrative Code of Illinois 
Form EG-13-I, Financial and Other             and all applicable Illinois tax acts, 
CPP-1 Instructions Back  (R-06/23)