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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 identification number (FEIN)
   ___ ___ ___ - ___ ___ - ___ ___ ___ ___                                                                     ___ ___ ___ ___ - ___ ___ ___ ___
   Your spouse’s Social Security number                                                                        Illinois account ID
   __________________________________________________
   Your first name and middle initial                           Last name                                      Legal business name: ________________________________
   _________________________________________________________________                                           Doing-business-as (DBA), assumed, or trade name, if different 
   Your spouse’s first 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 first 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 financial 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 financial institution for the routing number (for savings accounts).
    Account number ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
    Check this box to authorize ACH debit payments from this account. 

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 financial condition and I may be required to pay a higher amount than the payment plan 
described above; (3) IDOR has the discretion to file 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, file 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 officer (if officer, 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-10/20)             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
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                    See instructions on next page.

CPP-1 back (R-10/20)

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 file this form?                                                                                American Express. The credit card 
                                         How must I make my 
You should file 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 
financial 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?
financial condition.                                                                                      Please fax your completed form to us 
                                         How must I make my first  
                                                                                                          at 217 785-2635 or mail it to 
When is this form due?                   payment or extra payments?
                                                                                                            INSTALLMENT CONTRACT UNIT
There is no specific due date. We        To make your first payment or if you                               ILLINOIS DEPARTMENT OF REVENUE
recommend that you file 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 financial 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 file 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 finds 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-10/20)  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 identification               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 financial 
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 file 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 identified 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 financial 
                                                                                    payment, file 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 
                                            Check the box to authorize the Illinois 
If you have both individual income tax                                              immediately, and IDOR may take 
                                            Department of Revenue to utilize the 
and other tax debt, submit a separate                                               enforcement action, including levy  
                                            ACH debit method of payment from 
Form CPP-1 for the individual income                                                of your bank account or wages. 
                                            this account. 
tax liability.
If you are requesting an installment 
payment plan for more than one type         Step 4: Read the statement 
of tax other than individual income         and sign the form
tax (i.e., sales, withholding, excise,      You (or in the case of a business, 
or business income tax), you may            the person responsible for remitting 
combine the tax types on your Form          payments) must sign the statement. If 
CPP-1. Write the type of tax beside the     you do not, processing of your request 
line provided or list the tax types and     will be delayed and we may take 
periods on a separate sheet of paper        collection action to collect the unpaid 
and attach it to this form.                 debt.
Line 2  Write the amount of your good       We will contact you if we do not 
faith down payment (which is due with       approve the installment payment plan 
your completed Form CPP-1). You             as you request or if we need additional 
must make this payment using MyTax          information from you. 
Illinois or “Pay by Phone” payment 
method or by mailing us a check or          By signing the application, you 
guaranteed remittance. Please make          agree to the following: 
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-10/20)