CUT OUT AND RETURN THE VOUCHER IMMEDIATELY BELOW IF YOU ONLY HAVE AN INQUIRY. DO ~OT USE IF YOU ARE MAKING A PAYMENT.

Transcription

1 ~1~ l"r" S lrcpanmeut "I" the Treasury ~tfh'?j1 " " Inrcrnat /{Cn'III1C Serv lce PO BOX 17 MEMPHIS TN , AT '111' "11",11111, "1' ~:...:. r ~ PROHEAL HI RURAL HEALTH SERVICES INC CUT OUT AND RETURN THE VOUCHER IMMEDIATELY BELOW IF YOU ONLY HAVE AN INQUIRY. DO ~OT USE IF YOU ARE MAKING A PAYMENT. CUT OUT AND RETURN THE VOUCHER AT THE BOTTOM OF THIS PAGE IF YOU ARE MAKING A PAYMENT, EVEN IF YOU ALSO HAVE AN INQUIRY. The IRS address must appear 1n the window BODCD-TE Use for inqu1r1es only Letter Number: Letter Date Tax Period LTR3217C INTERNAL REVENUE SERVICE PO BOX 17 MEMPHIS TN ,,"1111,," ,,""111 11, * * PS PROH ((- C1"'\'TheIRS addr~ss must appear in the window BODCD-TE Use for payments Letter Number: Letter Date Tax Period LTR3217C INTERNAL REVENUE SERVICE CINCINNATI OH ,,1,1,1,1.1,,1,1"1,1,.11,"",11,1,1,11,"1,,1, Illil * * PROHEALTH RURAL HEALTH SERVICES INe PS PROH

2 ~<ii\\ IRS Department of the Treasury ilt!l,"j{/ Internal Revenue Service PO BOX 17 MEMPHIS TN In reply refer to: BODC: TE Taxpayer Identification Number: Form(s) and Tax Period(s): June Sep. Dec. Mar. 30, 30, 31, 31, June 30, Sep. 30, Dec. 31, Mar. 31, Dec. 31, Dec. 31, 2008 Dear Taxpayer: Thank you for making arrangements to resolve your account. We've accepted your offer for an Installment Agreement. The agreement covers the tax period(s) shown above. Please make your first payment of $2, by Sep. 19, Thereafter, send us that amount by the 19th of each month, until you've paid the full amount you owe. You may want to pay down your account balance by paying more than required by your Installment Agreement as penalty and interest charges continue to accumulate until your account is paid in full. Please make your check payable to the United States Department of the Treasury and write on it your name, address, social security or employer identification number. Include with your payment a daytime telephone number where we can call you, the tax year you are paying, and the tax form number you filed for that year. We'll send you a monthly statement with a payment stub and return envelope shortly before each payment is due. The statement will show the total amount remaining on your account, as well as your monthly payment amount. If you don't receive the statement at least ten days before your first payment due date, make your payment and return the last page of this letter with your payment. We charge a $105 User Fee to cover the cost of providing an

3 Installment Agreement. Although your approved Installment Agreement payment may be for less than $105, your first payment should be for at least $105 to cover the fee. The Installment Agreement User Fee may be reduced for individuals whose income falls at or below levels based on IRS Installment Agreement Low Income Guidelines, Our initial review djd not qualify you for the reduced fee, however, if you believe you qualify for a one time reduction to your Installment Agreement User Fee you may complete and submit Form for consideration. The form is available at or you may call Please mail your application to IRS, PO Box , Stop 5050, Kansas City, MO To determine whether you qualify, compare your total income before any losses or adjustments, to the chart below. IRS Installment Agreement Low Income Guidelines Size of 48 Contiguous States Family Unit and D.C. j\laska Hawaii 1 $27,075 $33,825 $31,150 2 $36,425 ${.5,525 $41,900 3 $45,775 $57,225 $52,650 4 $55,125 $68,925 $63,400 5 $64,475 $80,625 $74,150 6 $73,825 $92,325 $84,900 7 $83,175 $104,025 $95,650 8 $92,525 $115,725 $106,400 For each additional person, add $9,350 $1l,700 $10,750 Source: Based on 2010 US Dept of Health & Human Services Poverty Guidelines, Federal Register, Vol. 75, No. 148, August 3, 2010, PP If you have already paid the User Fee of $105.00, and your request for a reduced fee is approved, we will apply $62.00 to the tax you owe. Once your request is considered, you will be notified by mail. You need to meet all of the conditions of the Installment Agreement. When someone doesn't meet the terms of their Installment Agreement, we cancel it. We then begin to act to collect the full amount of the tax liability. In addition, canceled Installment Agreements that

4 we later reinstate require the payment of a $45 reinstatement fee We've based your specific Installment Agreement on your current financial condition. We may revise or cancel it if your ability to pay changes. The other conditions of this agreement are: 1. You will pay all federal taxes that become due during the term of this agreement. 2. You will file all federal and state tax returns that become due during the term of this agreement on time. 3. You will make all Installment Agreement payments on time. 4. You will pay all 5. You will provide one. 6. We will continue is paid in full. interest for not Installment Agreement processing fees. a current financial statement when we request to charge penalty and interest until your account The total amount you owe includes penalty and paying the tax that was due, in full, by April We will apply all installment payments to the oldest tax assessment first, then to penalties, and then to interest. 8. We will apply any tax refund we owe you to your account, until it is paid in full. We will not consider the refund as a monthly payment. 9. We may cancel this agreement if you do not meet its terms or fail to pay any future taxes. We also may cancel the agreement if we find that the collection of the tax is in jeopardy. We would then act to collect the entire amount you owe. 10. We may file a federal tax lien to protect the interest of the federal government. The federal income tax is a pay-as-you-go tax. You must pay the tax as you earn or receive income during the year. There are three ways to do this: 1. WITHHOLDING - If you're an employee, your employer will withhold income tax from your salary. Tax is also withheld from other types

5 of income including pensions, bonuses, commissions, and gambling winnings. In each case, the amount withheld is paid to the United States Treasury in your name. If too little tax is being withheld from your wages, you should give your employer a new Form W-4, Employee's Withholding Allowance Certificate, to change the amount of withholding. 2. ESTIMATED TAX PAYMENTS - If you don't pay your tax through withholding, or don't pay enough, you might have to pay estimated tax. People who are in business for themselves generally will have to pay their tax this way. Note: People who are in business for themselves will generally have to pay self-employment tax as well as income tax. If you need more information about changing your Form W-4 or making estimated tax payments, please let us know. Publication 505, Tax Withholding and Estimated Tax, explains both of these methods in detail. You can get Form W-4 or Publication 505 by calling TAX-FORM ( ) or visiting our web site at 3. FEDERAL TAX DEPOSITS - If you have employees, you may be required to make Federal Tax Deposits for employment taxes. As an employer, you must withhold Federal income tax, social security and Medicare taxes, and Federal Unemployment Tax Act (FUTA) taxes. Employers required to make deposits must deposit electronically. You can deposit electronically via the Electronic Federal Tax Payment System (EFTPS). If you need more information ~bout making Federal Tax Deposits, please let us know. Publication 15, Circular E, Employers Tax Guide, and Publication 15-A, Employer's Supplemental Tax Guide, explain in detail an employer's responsibility. You can get Publication 15 and 15-A by calling TAX-FORM ( ) or visiting our web site at We've provided a general explanation of the possible penalties and/or interest included in the current balance due on your account. If you would like a specific explanation of how the amounts were computed on your account, please contact us at the toll-free number shown in this letter and we will send you a detailed computation. ** Paying Late -- IRC Section 6651(d) **

6 Initially, the penalty is 1/2Y. of the unpaid tax for each month or part of a month the tax isn't paid. If we issue a Notice of Intent to Levy and the balance due isn't paid within 10 days from the date of the notice, the penalty increases to 1% a month. The penalty can't be more than 25Y. of the tax paid late. ** Filing and Paying Late -- IRC Section 6651 ** We charge a 5% combined penalty of 4 1/2% for filing late and 1/2% for paying late when a return is filed late and the tax is not paid by the due date of the return. The combined penalty is 5Y. of the unpaid tax for each month or part of a month the return is late, but not more than 5 months, which would total 25Y. (22 1/2% late filing and 2 1/2Y. late paying). In addition to the 22 1/2% late filing penalty for the first 5 months a return is late, we continue to charge the 1/2Y. late paying penalty for each month or part of a month for as long as the tax is unpaid, but not for more than 25Y.. The maximum penalty we can charge is 47 1/2% (22 1/2% late filing plus 25% late paying). ** Partnership Late Filing -- IRC Section 6698(b) ** The penalty is $85.00 for each partner, for each late month (including part of a month), for up to 12 months (effective for returns required to be filed after 12/20/2007). For returns required to be filed after 12/31/2008, the penalty amount is $ The Hokie Act adds $1.00 to the penalty amount for returns with a taxable year beginning in ** Interest -- IRC Section 6601 ** We charge interest when tax is not paid on time. We figure interest from the due date of the return (regardless of extensions) to the date we receive full payment or the date of the notice. Electronic Payment Options: Visit for information on paying your taxes electronically, including by credit or debit card. If you don't have

7 access to the internet, call EFTPS Customer Service at (individual) or (business). Please call us at the IRS telephone number listed in your local directory or with any questions you may have. You also can write to us at the address shown on the top of the first page of this letter. Whenever you wl'it e, please include a copy of this letter. Please also include your telephone number with the hours we can reach you. Keep a copy of this letter for your records. Telephone Number ( ) Hours _ Sincerely yours, Felisha S. Tipton Operations Mgr., CSCO Enclosure(s): Copy of this letter Envelope

8 Letter Number: 3217C Taxpayer Identification Number: Tax Form: 990 Tax Period Ending: Dec. 31, 2008 PAYMENT ON INSTALLMENT AGREEMENT or EXTENSION OF TIME TO PAY If you don't receive your monthly statement at least ten days before your first payment due date of Sep. 19, 2012, please return this page with your payment of $2, in the enclosed envelope. Make your check or money order payable to the United States Treasury and clearly print your name, social security or employer identification number, and the tax year. Include with your payment a daytime telephone number where we can call you, the tax year you are paying, and the tax form number you filed for that year.

9 Letter Number: 3217C Taxpayer Identification Number: Tax Form: 990 Tax Period Ending: Dec. 31, 2008 PAYMENT ON INSTALLMENT AGREEMENT or EXTENSION OF TIME TO PAY If you don't receive your monthly statement at least ten days before your first payment due date of Sep. 19, 2012, please return this page with your payment of $2, in the enclosed envelope. Make your check or money order payable to the United States Treasury and clearly print your name, social security or employer identification number, and the tax year. Include with your payment a daytime telephone number where we can call you, the tax year you are paying, and the tax form number you filed for that year.

10 ~~ IRS Department of the Treas.ur), \/tfb"1jj ' Internal Revenue SCI'\'I('f PO BOX 17 MEMPHIS TN In reply refer to: BODC: TE '29129 Taxpayer Identification Number: Form(s) and Tax Period(s) : 941 June 30, Sep. 30, Dec. 31, Mar. 31, June 30, Sep. 30, Dec. 31, Mar. 31, Dec. 31, Dec. 31, 2008 Dear Taxpayer: Thank you for making arrangements to resolve your account. We've accepted your offer for an Installment Agreement. The agreement covers the tax period(s) shown above. Please make your first payment of $2, by Sep. 19, Thereafter, send us that amount by the 19th of each month, until you've paid the full amount you owe. You may want to pay down your account balance by paying more than required by your Installment Agreement as penalty and interest charges continue to accumulate until your account is paid in full. Please make your check payable to the United States Department of the Treasury and write on it your name, address, social security or employer identification number. Include with your payment a daytime telephone number where we can call you, the tax year you are paying, and the tax form number you filed for that year. We'll send you a monthly statement with a payment stub and return envelope shortly before each payment is due. The statement will show the total amount remaining on your account, as well as your monthly payment amount. If you don't receive the statement at least ten days before your first payment due date, make your payment and return the last page of this letter with your payment. We charge a $105 User Fee to cover the cost of providing an

11 Installment Agreement. Although your approved Installment Agreement payment may be for less than $105, your first payment should be for at least $105 to cover the fee. The Installment Agreement User Fee may be reduced for individuals whose illcome falls at or below levels based on IRS Installment Agreement Low Income Guidelines. Our initial review did not qualify you for the reduce~ fee, however, if you believe you qualify for a one time reduction to your Installment Agreement User Fee you may complete and submit Form for consideration. The form is available at or you may call Please mail your application to IRS, PO Box , stop 5050, Kansas City, MO To determine whether you qualify, compare your total income before any losses or adjustments, to the chart below. IRS Installment Agreement Low Income Guidelines Size of ~8 Contiguous States Family Unit and D.C. Alaska Hawaii 1 $27,075 $33,825 $31,150 2 $36,425 $45,525 $41,900 3 $(15,775 $57,225 $52,650 4 $55,125 $68,925 $63,400 5 $64,475 $80,625 $74,150 6 $73,825 $92,325 $84,900 7 $83,175 $104,025 $95,650 8 $92,525 $115,725 $106,400 For each additional person, add $9,350 $11,700 $10,750 Source: Based on 2010 US Dept of Health & Human Services Poverty Guidelines, Federal Register, Vol. 75, No. 148, August 3, 2010, pp {,5629 If you have already paid the User Fee of $105.00, and your request for a reduced fee is approved, we will apply $62.00 to the tax you owe. Once your request is considered, you will be notified by mail. You need to meet all of the conditions of the Installment Agreement. When someone doesn't meet the terms of their Installment Agreement, we cancel it. We then begin to act to collect the full amount of the tax liability. In addition, canceled Installment Agreements that

12 we later reinstate require the payment of a $45 reinstatement fee We've based your specific Installment Agreement on your current financial condition. We may revise or cancel it if your ability to pay changes. The other conditions of this agreement are: 1. You will pay all federal taxes that become due during the term of this agreement. 2. You will file all federal and state tax returns that become due during the term of this agreement on time. 3. You will make all Installment Agreement payments on time. 4. You will pay all 5. You will provide one. 6. We will continue is paid in full. interest for not Installment Agreement processing fees. a current financial statement when we request to charge penalty and interest until YOur account The total amount you owe includes penalty and paying the tax that was due, in full, by April We will apply all installment payments to the oldest tax assessment first, then to penalties, and then to interest. 8. We will apply any tax refund we owe you to your account, until it is paid in full. We will not consider the refund as a monthly payment. 9. We may cancel this agreement if you do not meet its terms or fail to pay any future taxes. We also may cancel the agreement if we find that the collection of the tax is in jeopardy. We would then act to collect the entire amount you owe. 10. We may file a federal tax lien to protect the interest of the federal government. The federal income tax is a pay-as-you-go tax. You must pay the tax as you earn or receive income during the year. There are three ways to do this: 1. WITHHOLDING - If you're an employee, your employer will withhold income tax from your salary. Tax is also withheld from other types

13 of income including pensions, bonuses, commissions, and gambling winnings. In each case, the amount withheld is paid to the United States Treasury in your name. If too little tax is being withheld from your wages, you should give your employer a new Form W-4, Employee's Withholding Allowance Certificate, to change the amount of withholding. 2. ESTIMATED TAX PAYMENTS - If you don't pay your tax through withholding, or don't pay enough, you might have to pay estimated tax. People who are in business for themselves generally will have to pay their tax this way. Note: People who are in business for themselves will generally have to pay self~employment tax as well as income tax. If you need more information about changing your Form W-4 or making estimated tax payments, please let us know. Publication 505, Tax Withholding and Estimated Tax, explains both of these methods in detail. You can get Form W-4 or Publication 505 by calling TAX-FORM ( ) or visiting our web site at 3. FEDERAL TAX DEPOSITS - If you have employees, you may be required to make Federal Tax Deposits for employment taxes. As an employer, you must withhold Federal income tax, social security and Medicare taxes, and Federal Unemployment Tax Act (FUTA) taxes. Employers required to make deposits must deposit electronically. You can deposit electronically via the Electronic Federal Tax Payment System (EFTPS). If you need more information about making Federal Tax Deposits, please let us know. Publication 15, Circular E, Employers Tax Guide, and Publication 15-A, Employer's Supplemental Tax Guide, explain in detail an employer's responsibility. You can get Publication 15 and 15-A by calling TAX-FORM ( ) or visiting our web site at We've provided a general explanation of the possible penalties and/or interest included in the current balance due on your account. If you would like a specific explanation of how the amounts were computed on your account, please contact us at the toll-free number shown in this letter and we will send you a detailed computation. ** Paying Late -- IRC Section 6651Cd) **

14 Initially, the penalty is 1/2% of the unpaid tax for each month or part of a month the tax isn't paid. If we issue a Notice of Intent to Levy and the balance due isn't paid within 10 days from the date of the notice, the penalty increases to 1% a month. The penalty can't be more than 25% of the tax paid late. ** Filing and Paying Late -- IRC Section 6651 ** We charge a 5% combined penalty of 4 1/2% for filing late and 1/2% for paying late when a return is filed late and the tax is not paid by the due date of the return. The combined penalty is 5% of the unpaid tax for each month or part of a month the return is late, but not more than 5 months, which would total 25% (22 1/2% late filing and 2 1/2% late paying). In addition to the 22 1/2% late filing penalty for the first 5 months a return is late, we continue to charge the 1/2% late paying penalty for each month or part of a month for as long as the tax is unpaid, but not for more than 25%. The maximum penalty we can charge is 47 1/2% (22 1/2% late filing plus 25% late paying). ** Partnership Late Filing -- IRC Section 6698(b) ** The penalty is $85.00 for each partner, for each late month (including part of a month), for up to 12 months (effective for returns required to be filed after 12/20/2007). For returns required to be filed after 12/31/2008, the penalty amount is $ The Hokie Act adds $1.00 to the penalty amount for returns with a taxable year beginning in ** Interest -- IRC Section 6601 ** We charge interest when tax is not paid on time. We figure interest from the due date of the return (regardless of extensions) to the date we receive full payment or the date of the notice. Electronic Payment Options: Visit for information on paying your taxes electronically, including by credit or debit card. If you don't have

15 PROHEAL TH RURAL ilealhi SERVICES INC access to the internet, call EFTPS Customer Service at (individual) or (business). Please call us at the IRS telephone number listed in your local directory or with any questions you may have. You also can write to us at the address shown on the top of the first page of this letter. Whenever you write, please include a copy of this letter. Please also include your telephone number with the hours we can reach you. Keep a copy of this letter for your records. Telephone Number ( ) Hour s _ Sincerely yours, Felisha S. Tipton Operations Mgr., CSCO Enclosure(s): Copy of this letter Envelope

16 Letter Number: 3217C Taxpayer Identification Number: Tax Form: 990 Tax Period Ending: Dec. 31, 2008 PAYMENT ON INSTALLMENT AGREEMENT or EXTENSION OF TIME TO PAY If you don't receive your monthly statement at least ten days before your first payment due date of Sep. 19, 2012, please return this page with your payment of $2, in the enclosed envelope. Make your check or money order payable to the United States Treasury and clearly print your name, social security or employer identification number, and the tax year. Include with your payment a daytime telephone number where we can call you, the tax year you are paying, and the tax form number you filed for that year.