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Department of Taxation and Finance

Offer in Compromise DTF-4(5/23)
For liabilities not fixed and final, and subject to administrative review

Use Form DTF-4.1 instead if you do not have 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 (if different from above, or if a PO Box number) Entity type(s)

Individual
Business address
Partnership
Name of taxpayer’s representative (attach power of attorney; see instructions) Telephone number
( ) 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;
attach Form DTF-5, Statement of Financial Condition

3. Total amount offered (must be more than $0) ...................................................................................... $
Is the sum offered in compromise borrowed money? .............................................................................................. Yes No
If Yes, list the name and address of the lender, and any collateral 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, your payment will be applied to the amount you owe.

4. Liabilities and payments
(Attach additional pages if needed, and submit copies of all notices)
Total payments
Assessment I.D. Type of tax or liability Liability period Amount due to date

5. Provide the facts and reasons supporting the grounds for acceptance of this offer (see instructions)

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Page 2 of 4 DTF-4 (5/23)
 6. Conditions – Read this section in its entirety                         under the Tax Law and compounded from the date of 
      prior to signing this form                                           default; or (c) disregard the amount of the offer and apply 
                                                                           all amounts previously deposited under the offer against 
6A.   It is agreed (a) that the Commissioner of Taxation and               the amount of the liability sought to be compromised, 
      Finance (the Commissioner) shall keep all payments,                  immediately and without further notice file a warrant 
      sums collected, and other credits made to the liabilities            thereon and proceed to collect the balance of the 
      asserted for the periods covered by this offer, and                  original liability. The taxpayer(s) agrees that any pending 
      (b) that the Commissioner shall keep any and all                     conciliation conference or proceedings before the 
      amounts to which taxpayers may be entitled under the                 Division of Tax Appeals, or any right thereto, pursuant 
      Tax Law, including, but not limited to, overpayments of              to Tax Law §§ 170, 171, and Article 40 thereof, and the 
      any tax or other liability, offsets, credits, or funds payable       regulations adopted pursuant thereto, on the liability 
      to the taxpayers that are available to New York State                compromised, are finally and irrevocably concluded or 
      (for example, lottery offsets and unclaimed funds), for              waived, as the case may be.
      periods ending before, or within, or as of the end of the 
      calendar year in which this offer is accepted (and which         6D. It is understood that this offer will be considered and 
      are not in excess of the difference between the liability            acted upon in due course and does not relieve the 
      sought to be compromised and the amount offered).                    taxpayer(s) from the liability sought to be compromised, 
                                                                           unless and until the offer is accepted in writing by the 
6B.   Any payments made under the terms of this offer shall                Commissioner, and there has been full compliance with 
      be applied, unless otherwise agreed in writing, to the               the terms of the offer and any collateral agreements.
      liabilities of the taxpayer(s) in the order determined by 
      the Commissioner.                                                6E. Taxpayers waive the benefit of any statute of limitations 
                                                                           applicable to the assessment and collection of liabilities 
  6C. It is further agreed and consented to by the taxpayer(s)             sought to be compromised, and agree to the suspension 
      that upon notice of the acceptance of this offer, the                of the running of the statutory period of limitations on 
      taxpayer(s) shall have no right to contest in the Bureau             assessment and collection for the period during which 
      of Conciliation and Mediation Services, the Division                 this offer is pending, and for one year thereafter. For 
      of Tax Appeals, any court, or otherwise, at any time,                these purposes, the offer shall be deemed pending from 
      the amount of the liability sought to be compromised.                the date of acceptance of the waiver of the statutory 
      The Tax Department will not compromise any liability,                period of limitations by an authorized Tax Department 
      nor satisfy any warrant, until all obligations of each               official, until the date on which the offer is formally 
      taxpayer under the compromise agreement, or any                      accepted, rejected, or withdrawn in writing.
      collateral agreement, are completely performed and 
      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                defenses against the issuance of new assessment(s) for 
      interest due under its terms, or a default on any other              the compromised liability in the event any taxpayer fails 
      term that the taxpayer(s) may have agreed upon with the              to comply with the terms of the offer in compromise.
      Commissioner for acceptance of the deferred payments,              Taxpayers also agree to forfeit any current capital loss or 
                                                                     6G.
      New York State, at the option of the Commissioner or                 net operating loss credits taken on any future New York 
      an official designated by him or her, may (a) proceed                State return.
      immediately by suit to collect the entire unpaid balance 
      of the offer; or (b) proceed immediately by suit to collect    6H.   Taxpayers agree that during the five-year period, 
      as liquidated damages an amount equal to the liability               beginning with the date the Tax Department accepts 
      sought to be compromised, minus any payments already                 the offer, to comply with all provisions of the New York 
      received under the terms of the offer, with interest on              State Tax Law regarding filing tax returns and paying all 
      the unpaid balance at the annual rate(s) as established              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 § 171, subdivision eighteenth (a), the undersigned submits this offer to the Commissioner to compromise the liabilities 
described in paragraph 4 of this Form DTF-4.

Date                                                            Signature of taxpayer(s)

Date                                                            Signature of taxpayer(s)

Corporations: See instructions on page 4, Section 7.

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DTF-4 (5/23) Page 3 of 4
Instructions

Use the correct form documents. We recommend Form ET-14, Estate Tax Power
Use Form DTF-4, Offer in Compromise, For Liabilities Not Fixed of Attorney. If you use another power of attorney form, it must
and Final, and Subject to Administrative Review, to submit your include the same information as Form ET-14.
request to compromise liabilities, where you still have protest or
appeal rights. Specific instructions
You may submit Form DTF-4 if there is doubt as to liability, Section 1. Taxpayer information
or doubt as to collectibility of the full amount owed (including, Enter the full name and phone number of the taxpayer(s). If the
for individuals only, when full collection would cause undue
economic hardship). For an explanation of doubt as to liability taxpayer is a business, enter the name of the business or its
and doubt as to collectibility, see the instructions for Section 2. trade name (or both). If this is a joint income tax liability, both
spouses may submit one application and enter both names.
Use Form DTF-4.1, Offer in Compromise, For Fixed and Final However, for any other type of joint liability, such as a
Liabilities, where you do not have any protest or appeal rights. partnership, each must submit separate Forms DTF-4.
You do not have these rights if you:
Enter the taxpayer’s Social Security number, or, for a business,
• owe tax, interest, or penalties due to a math or clerical error the employer identification number.
on a return, a change the IRS made to your federal return, or
your failure to pay on time the tax that you reported due on Enter the taxpayer’s physical home address, mailing address if
your return; or different or a PO Box, and business address (if applicable).
• received a Statement of Proposed Audit Changes. Mark an Xin a box to indicate entity type(s). If Other, fill in the
Your liabilities are fixed and final, and may be established by a blank.
valid warrant. If the taxpayer has a representative, enter the name, phone
number, and address of the representative, and attach a
Considerations for using Form DTF-4 completed power of attorney.
You must be in compliance with all paying and filing
requirements for periods not included in your offer. This includes Section 2. Basis for compromise
estimated payments, tax deposits, and similar requirements. Mark an Xto indicate what the offer is based on.
Submitting Form DTF-4 does not automatically suspend pending • Doubt as to liability (you don’t agree with the amount the Tax
proceedings in the Bureau of Conciliation and Mediation Department claims you owe).
Services, nor does it suspend the time for you to take any action To support your claim, you must submit affidavits showing
about an assessment. the material facts of the case. You must also include certified
Also, submitting Form DTF-4 does not affect the interest and copies of the documents of record, if any; true copies of all
penalties that continue to accrue on your liabilities. Interest is other papers and documents referred to in any affidavit; and
due at the rate set by the Tax Law, from the date of the notice or a full list of the statutes, regulations, and case law you are
agreement until we receive full payment. relying on. You are responsible for completely presenting
all your facts and legal arguments. We may require you to
We may require a written collateral agreement or other security, provide additional documentation from third parties.
to protect the Tax Department’s interest. • Doubt as to collectibility (you have insufficient assets and
Generally, a taxpayer may make only one offer in compromise income to pay the full amount), or where collection in full
for a particular liability for a particular period. would cause undue economic hardship (individuals only).
For there to be doubt as to collectibility, you must show that
If we accept your offer you have been discharged in bankruptcy, you are insolvent,
If the Tax Department accepts your offer, and you satisfy all or (for individuals only) that collection in full would cause you
the terms of the offer (for example, you paid in full the offer and undue economic hardship.
complied with the terms of any collateral agreement), we will You are considered insolvent if all your liabilities (including
eliminate the remaining balance of your liabilities included in this your tax debt) exceed the fair market value of your assets.
offer. Undue economic hardship generally means that you are
unable to pay reasonable basic living expenses, which are
Taxpayer’s representative those providing for the health, welfare, and production of
If you have a representative, you must include a completed income for your family. We use Internal Revenue Service
power of attorney. We recommend Form POA-1, Power of (IRS) standards to help determine allowable living expenses.
Attorney, available at www.tax.ny.gov. If you use another power We also consider other factors, including the taxpayer’s age,
of attorney, it must include the same information as Form POA-1. employment status, and employment history; any inability to
earn income because of long-term illness, medical condition,
Estates or disability; and any obligation to dependents.
When Form DTF-4 is submitted by an estate fiduciary (executor All offers based on doubt as to collectibility or where collection
or administrator), the fiduciary must submit a copy of the in full would cause the taxpayer hardship, must include a
appropriate court appointment (for example, letters testamentary completed Form DTF-5, Statement of Financial Condition,
or letters of administration) or, if there is no court appointment, available at www.tax.ny.gov, including copies of:
appropriate documents as requested by the Tax Department. If • your last three federal income tax returns;
the offer in compromise will be handled by the fiduciary’s duly
authorized representative, and the representative will sign on • a credit report less than 30 days old; and
page 2 on behalf of the fiduciary, the fiduciary must also submit • your last 12 months of statements from your bank or
a completed power of attorney along with the appropriate financial institution.

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Page 4 of 4 DTF-4 (5/23)

Section 3. Amount offered Mail all documents to:
Enter the total amount you intend to offer. You must offer more NYS TAX DEPARTMENT
than $0, and you cannot include any amounts previously paid or CED OFFER IN COMPROMISE UNIT
collected against the liabilities. W A HARRIMAN CAMPUS
ALBANY NY 12227-5100
For an offer based on doubt as to liability, the amount acceptable
depends upon the degree of doubt found in your particular case. Private delivery services – If not using U.S. Mail, see
Publication 55, Designated Private Delivery Services.
For an offer based on doubt as to collectibility, the amount must
be a figure we realistically expect we could collect within a Privacy notification
reasonable period of time. It is based on the total value of assets See our website at www.tax.ny.gov or Publication 54, Privacy
and the amount we could expect to collect from anticipated Notification.
future income. Otherwise, the amount proposed must be justified
by information you submit. More information
Mark an X in the Yes box if all or part of the money you are These instructions are intended only as a guide for preparing
offering for the compromise is borrowed. If Yes, enter the name Form DTF-4. For an overview, see Publication 220, Offer in
and address of the source of the borrowed money, and include a Compromise Program. For specific details, see regulations
list of any collateral you have pledged to secure the loan. Title 20 NYCRR Part 5000, Compromises, available at
www.dos.state.ny.gov/state-register.
Section 4. Liabilities and payments For questions, call 518-591-5000. For forms and more
List all unpaid liabilities administered by the Tax Department information, see www.tax.ny.gov.
you wish to compromise. You may not submit an offer for a tax
year or period that has not been assessed. Include copies of Checklist
all notices that you list. You can view all your unpaid liabilities
Is Form DTF-4 the correct form for you?
on your Online Services account. If you do not have an Online
Services account, you can visit our website at www.tax.ny.gov If you have a representative, did you enter their name,
and create one. address and phone number? Did you include a completed
In the Type of tax or liability column, indicate whether the notice power of attorney?
is for income, sales, withholding, or some other tax or liability.
Did you enter an offer of more than $0?
If, for a particular liability, you are both personally liable and
jointly liable with another individual or separate entity such as If your offer includes borrowed money, did you enter the
a corporation, you must submit your own Form DTF-4. For joint lender’s name and address, and collateral, if any?
liabilities, if only one taxpayer’s offer is accepted and paid, the
Did you include copies of notices of unpaid liabilities?
remaining taxpayers remain liable for the outstanding balance of
the liability. An offer we accept forgives further payment only for
Did you include copies of all appropriate documents
the taxpayer whose offer was accepted. to support your offer? If you fail to submit all required
Section 5. Grounds for the offer statements and documents, we will not process your
Provide all the facts and reasons supporting the grounds for application.
acceptance of your offer. If needed, attach additional pages, and Did you sign and date the bottom of page 2?
copies of appropriate documents, to fully and completely explain
the details of your offer. For individuals only, if your offer is based If your offer is based on doubt as to collectibility or
on undue economic hardship, explain your situation and provide , did you include a completed Form DTF-5,
hardship
supporting documentation. including copies of:
Section 6. Conditions your last three federal income tax returns (if you are not
By submitting this application, you have read, understand, and required to file, include an explanation),
agree to the terms and conditions in this section.
a credit report less than 30 days old, and
Section 7. Signatures your last 12 months of statements from your
Sign and date. If you and your spouse seek to compromise a bank or financial institution?
joint income tax liability, both of you must sign.
Corporations: Enter the corporate name. An authorized
corporate signatory must sign. Print the signatory’s name and
title immediately below the signature.

Mailing your Form DTF-4
Along with your completed Form DTF-4, be sure to include
copies of all notices listed in Section 4, and all supporting
documents.
If your offer is based on doubt as to collectibility or hardship,
remember to include a completed Form DTF-5. Include copies
of your federal income tax returns for the last three years, copies
of the last 12 months of statements from your bank or financial
institution, and all other material required by Form DTF-5.

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