Employer and taxpayer blocks
The employer's name and address, contact person and telephone, then the taxpayer's name and address, SSN or EIN, and the spouse's last four digits.
2159
Payroll Deduction Agreement
Form 2159, Payroll Deduction Agreement, is an IRS installment agreement paid through an employer. The taxpayer agrees to have a set amount deducted from each wage or salary payment and paid by the employer to the IRS "until the total liability is paid in full." The employer signs to agree to withhold that amount and send it to the IRS on a set schedule.
The form comes in three copies: Part 1, the Acknowledgement Copy that goes back to the IRS; Part 2, the Employer's Copy; and Part 3, the Taxpayer's Copy. The back of Part 2 has instructions to the employer and the back of Part 3 has instructions to the taxpayer. Some fields may already be filled in by an IRS employee, and a section at the bottom is for IRS use only.
The front also lists the agreement terms and user fees. You can fill out the form free in your browser on this page and download the result without an account.

The employer's name and address, contact person and telephone, then the taxpayer's name and address, SSN or EIN, and the spouse's last four digits.
A statement agreeing to withhold the amount shown from each wage or salary payment, boxes for how often payments are sent (week, two weeks, month or other), the start date, and the employer's signature, title and date.
Kinds of taxes by form number, tax periods, the amount owed as of a date plus penalties and interest, how often the taxpayer is paid, the deduction amount and start date, and a table for scheduled increases or decreases.
The Debit Payments Self-Identifier box, the assistance numbers 1-800-829-3903 and 1-800-829-7650, and a space for the IRS campus address.
The terms of the agreement, including how payments and refunds are applied and when the IRS may modify or terminate it, and a section titled "Understanding user fees."
Lines for the taxpayer's and spouse's signatures, then an IRS-only area with the agreement locator number and the Notice of Federal Tax Lien boxes.
Enter the employer's name and address, your name (and your spouse's for a joint return) and current address, and your SSN or EIN. The instructions say to use the number that appears on the notice you received.
Check "I am unable to make debit payments" if it applies. The form says not checking the box indicates you are able but choosing not to make debit payments.
Enter the kinds of taxes by form number, the tax periods and the amount owed as of the date you spoke to the IRS.
Check how often you are paid, then enter the agreed deduction amount and the date it begins. Fill in increases or decreases only if you agreed to them with the IRS; otherwise the instructions say to leave them blank.
Sign and date, with your spouse if this is a joint liability, and give the form to your participating employer. If the form came by mail, give the employer a copy of the letter that came with it.
The employer marks the payment frequency, signs, and returns the parts requested on the letter, or Part 1 to the address in the "For assistance" box.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The employer returns the requested parts to the IRS address on the letter that came with the agreement, or to the address shown on the front of the form if there is no letter.
The employer instructions say to make each check payable to the "United States Treasury" and write the employee's name and Social Security number on it. Payments continue unless the IRS gives notice to stop.
The form lists a $178 user fee, reduced to $43 for low-income taxpayers at or below 250% of Federal poverty guidelines, and a $89 reinstatement fee. It points to Form 13844 for the reduced fee.
The terms say federal tax refunds are applied to the amount owed, all federal returns are filed and taxes paid on time, and the IRS may modify or terminate the agreement in the cases it lists.
The form lists 1-800-829-3903 for self-employed individuals, business owners and businesses, and 1-800-829-7650 for individual wage earners. With a letter, use the number on the letter.
13844
9 fields, 2 pages
433-D
168 fields, 4 pages
9465
66 fields, 2 pages
433F
214 fields, 4 pages
433-A
515 fields, 8 pages
The taxpayer instructions refer to the amount owed and the deduction "you agreed to have deducted from your pay when you spoke to IRS." The signature line also has a title box for a corporate officer or partner.
If the amount owed is for a joint return, the form asks for the last four digits of the spouse's Social Security number and the spouse's signature.
The employer instructions say the agreement "is subject to your approval." A participating employer enters a contact person, picks how often it sends payments, signs and returns the requested parts.
The taxpayer instructions say to fill in the details "if not already completed by an IRS employee." The IRS completes the additional terms and the box marked for IRS use only.
The Debit Payments Self-Identifier box lets a taxpayer state they are unable to make debit payments. The taxpayer instructions say fees for a low-income taxpayer who checks it are reimbursed upon completion of the agreement.
The taxpayer who owes the tax and that taxpayer's employer each complete a section. The IRS fills in its own section and may complete some taxpayer details.
The agency’s own page for Form 2159.
The IRS instructions for filling out and filing Form 2159.
The official blank form, to print or fill by hand.
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The taxpayer completes the taxpayer details and signs, the employer completes and signs its section, and the IRS completes its own section. Some taxpayer details may already be filled in by an IRS employee.
The employer instructions say the payroll deduction agreement "is subject to your approval." The employer agrees by completing and signing its section.
A $178 user fee, reduced to $43 for low-income taxpayers, and a $89 reinstatement fee if a terminated agreement is reinstated. Form 13844 covers the reduced fee.
The terms say the IRS will apply federal tax refunds or overpayments to the amount owed until it is fully paid.
Yes. The terms list cases such as missed payments, other federal tax debt not paid when due, financial information not provided when requested, or collection of the tax being in jeopardy.
No. The taxpayer instructions say the agreement will not affect any liability for backup withholding under Public Law 98-67.