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COVID-19 - Level 1 If you've been affected by COVID-19, we may be able to help. Find out more

Complete this form to support a proposal to pay using instalments, or if you've been asked to complete one as part of a hardship application.

You need to send us this form as soon as you can.

Gather your information

You'll need:

  • your IRD number
  • details of your income after tax has been deducted
  • details of your expenses
  • details of any assets or liabilities.

Sign the form and send it to us

Inland Revenue
PO Box 39090
Wellington Mail Centre
Lower Hutt 5045

What happens next

We'll assess your situation and let you know your options.

You can still make payments to your account while we do this.

If you're in New Zealand, we'll start by using the Household Expenditure Guide - AD164 to get an idea of living costs in your region.