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Home > Individuals > Audits and Collections > Payment Plans > Payment Plan CD-5
Payment Plan Agreement Request CD-5
Scroll down to the CD-5 form, on this page
Instructions for Form CD-5
Use Form CD-5 to request a monthly installment plan if you cannot pay the full amount you owe on a personal income tax notice we have sent you. Payment plan requests using this form cannot exceed 12 months.
Do not submit this form if you are currently in bankruptcy, have unfiled personal income tax returns that are past due, have a pending offer in compromise with the department or have unpaid personal income tax liabilities for previous years.
Because of the expense of interest and penalties associated with a longer payment plan, you are encouraged to consider less costly alternatives. If you choose this plan, you are urged to make your payments as large as possible to lower those fees. Be aware that a tax lien will be filed against you regardless of whether you are making payments. This action is taken to protect the interests of the State of West Virginia. Tax liens are a matter of public record and may be recorded by private credit reporting agencies that calculate credit scores.
If your payment plan is approved, you will receive a formal payment agreement and a statement of account each month showing the full balance due. Your payment will be due by the fifteenth of each month.
How the Installment Agreement Works
By entering into this installment agreement, you are agreeing to pay your total tax liability in timely monthly installments over the course of 12 months instead of paying the total amount of tax due in full. You also are agreeing not to accrue additional tax debt during the period of the payment plan. You will continue to receive automatically generated billing notices for the total amount of personal income tax due. Please continue to remit at least your monthly payment amount due using either your payment plan voucher or the billing voucher.
If you do not make your payments on a timely basis or you accrue additional tax debt, enforcement actions will be taken including the filing of a tax lien, wage garnishment, or bank levies to collect the total amount you owe.
Payment plans cost you substantially in interest and fees. We encourage you to avoid future tax liabilities by examining your withholding or estimated tax payments to ensure that sufficient taxes are being withheld from your income to meet your tax obligations.
12-Month Personal Income Tax Installment Agreement Request Form
West Virginia State Tax Department Compliance Division Application For 12-Month Personal Income Tax Installment Agreement Plan
Taxpayer Information
First Name:
Middle Initial:
Last Name:
Did your address change since you last filed? Yes No If you choose 'Yes', this page will return with space for you to provide your updated address information.
Daytime Phone Number:
Enter your daytime phone number as 10 numbers, no spaces, no dashes, no parenthesis.
Home Phone Number:
If you provide your home phone number, enter it as ten numbers, no spaces, no dashes, no parenthesis.
e-mail:
Enter your e-mail address, so that we may communicate with you electronically.
Return Information
Please enter at least one of the following (Social Security Number, Account Number, Letter ID):
Social Security Number:
Enter your social security number as 9 numbers, no spaces, no dashes.
Account Number:
Enter your account number as the 8 numbers shown on the bill or notice you received.
Letter ID:
Enter your letter ID as the 10 numbers shown on the bill or notice you received.
Is this a joint return? Yes No If you choose 'Yes', this page will return with space for you to provide your spouse' information.
Requested Installment Payment Plan
Total Amount You Owe:
Optional. Enter your total amount owed, as shown on the bill or notice you received.
Use the drop-down list below to enter the total number of months you are requesting for the installment payment agreement. Remember: You cannot exceed twelve months. Your first installment payment will be due the 15th of the month following submission of this form.
Payment Plan Term, in Months: 0 1 2 3 4 5 6 7 8 9 10 11 12
Select a term, in months, for your installment payment plan.
Submit Your Request
By submitting this payment installment form, you are agreeing that your balance due is correct; that you will continue to file state tax return(s) and pay any additional state tax due in a timely manner during the term of agreement; and that you will make timely monthly payments until your tax liability, including interest and penalties, is paid in full.
Tax Information and Assistance: (304) 558-3333 or (800) 982-8297
Copyright 2023 State of West Virginia. All Rights Reserved.
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