Offer in Compromise Withdrawal

• Legal Form Number: 14773
• Year: 2026
• Issuer: Treasury Department
• Section: Treasury Department

Catalog Number 68986V www.irs.gov Form 14773 (Rev. 12-2017)

Form 14773

(December 2017)

Department of the Treasury - Internal Revenue Service

Offer in Compromise Withdrawal

Offer number Taxpayer Identification Number (last 4 digits)

To whom it may concern:

I hereby withdraw my Offer in Compromise (OIC) dated . I understand that by withdrawing this OIC, I waive

my appeal rights.

Signature Name (printed) Date

Please complete this section if you submitted a deposit with the OIC. (This does not include the non-refundable

application fee you paid.) (If you need additional space, attach a separate sheet.)

Amount of Deposit $

Check one

I wish to have my OIC deposit refunded to me.

I consent to the application against my outstanding tax liability, as shown below, of the above amount deposited on

my OIC.

Taxpayer ID Number (last 4 digits) Type of Tax Period Amount to be Applied

Sign here to acknowledge application of deposit Date