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Form 3561 Installment Agreement Financial Statement

Form 3561 Installment Agreement Financial Statement.pdf

Form Instructions

INSTRUCTIONS: CALIFORNIA INSTALLMENT AGREEMENT FINANCIAL STATEMENT (Form FTB 3561)

If applying for an installment agreement for a payment plan related to California state tax, you will be required to submit a financial statement if you owe more than $10,000 or need more than 36 months to complete payment. This purpose of this form FTB 3561 is to verify you have a financial hardship justifying your request. The form is found on the website of the California Franchise Tax Board.

California Installment Agreement Financial Statement FTB 3561 Step 1: At the top of the first page, enter all information requested about you, any spouse with whom you file taxes jointly, and all dependants.

California Installment Agreement Financial Statement FTB 3561 Step 2: The next section requires you to give information about your employment, including the name, address and contact information of your workplace. Your spouse, if any, must provide the same information.

California Installment Agreement Financial Statement FTB 3561 Step 3: The next section requires you to provide information about all bank accounts you have, including the name and address of the institution where they are held, the type of account, its number and the current balance.

California Installment Agreement Financial Statement FTB 3561 Step 4: The next section requires you to detail all real property owned, including its address and county, the date of purchase, the current value, the balance owed on the mortgage, and the name of the lender associated with the mortgage.

California Installment Agreement Financial Statement FTB 3561 Step 5: The next section requires you to detail all motor vehicles owned, including their year, make, license number, date of purchase, current value, the balance left on any loan taken to finance the purchase, and the date on which your loan will be paid off.

California Installment Agreement Financial Statement FTB 3561 Step 6: The next section requires you to detail any life insurance policies you have, while the last on the page requires you to detail miscellaneous assets.

California Installment Agreement Financial Statement FTB 3561 Step 7: The second page requires you to detail all monthly income and expenses.

California Installment Agreement Financial Statement FTB 3561 Step 8: On the third page, note any changes in your income and/or health you expect. If you have filed for bankruptcy, give the case information. Both spouses, if applicable, should sign and date the form.

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