Purpose of form: The information and proposal submitted on this form by an employer will be used by the TWC Tax Department to determine the propriety of accepting the employer's proposal to liquidate a tax debt over an extended time period. If approved by the Commission, this document will formalize the agreement between the parties.
If the employer fails to comply with the terms of the agreement or fails to submit quarterly wage reports and pay the taxes due on those reports before they are past-due, the agreement is immediately cancelled and payment of the debt in full is due immediately. Enforcement of statutory collection remedies such as notice of state tax lien, civil lawsuit, and asset seizure will commence.
IMPORTANT: The Texas Workforce Commission, by its acceptance of this proposal, is not deprived
of statutory collection remedies.
KEEP A COPY OF THIS FORM FOR YOUR FILE.
- Enter the TWC Account Number for which this proposal
is submitted.
- All underlined fields are to be completed. Enter the total amount of debt due from the employer,
and then enter the details of the proposal to pay the debt by installments. An acceptable payment
proposal is one with a down-payment of 15 percent of the total due and which pays off the debt within
12 months of the agreement.
- The installment payment proposal must be signed by an Owner, Officer, Partner,
or Individual with power of attorney for the business.
- The down payment must be mailed in with the completed payment proposal.
You will be notified when the TWC has processed this proposal.
If you have any questions, contact the nearest Texas Workforce Commission Tax Office for assistance.
Please
e-mail questions or comments to