Proposed Restitution Order
The defendant must make restitution to the following victim(s) in the amount(s) listed below.
|Tax Year(s) or Period(s) and Items (describe in detail)||Amount to be credited to tax||Interest Under the Internal Revenue Code Due Through _________*|
|*This interest figure has been calculated by the IRS under 26 U.S.C. 6601 and/or 6621, as of the anticipated date of sentencing. This interest figure does not include any interest that may accrue under 18 U.S.C. 3612.|
|| Total Restitution ordered: $_____________
||Restitution amount ordered pursuant to plea agreement $_______________
||The defendant must pay interest on restitution and on a fine of more than $2,500, unless the restitution or fine is paid in full before the fifteenth day after the date of the judgment, pursuant to 18 U.S.C. § 3612(f). All of the payment options on the Restitution Order and payment schedule may be subject to penalties for delinquency and default, pursuant to 18 U.S.C. 3612(g).
||The court determined that the defendant does not have the ability to pay interest that might accrue under 18 U.S.C. 3612 and it is ordered that:
[ ] the interest requirement is waived for the [ ] fine [ ] restitution
[ ] the interest requirement for the [ ] fine [ ] restitution is modified as follows:
A [ ] Lump sum payment of $ ____________ due immediately, balance due (if any)
B [ ] Payment to begin immediately (may be combined with [ ] C or [ ] E below); or
C [ ] Payment in equal ___________ (e.g., weekly, monthly, quarterly) installments of $ ________ over a period of ______________ (e.g. months or years), to commence _____________ (e.g. 30 or 60 days) after the date of this judgment; or
D [ ] Payment in equal _____________ (e.g., weekly, monthly, quarterly) installments of $______ over a period of ______________ (e.g. months or years), to commence _____________ (e.g., 30 or 60 days) after release from imprisonment to a term of supervision; or
E [ ] Special instructions regarding the payment of restitution:
Unless the court has expressly ordered otherwise, if this judgment imposes imprisonment, payment of restitution is due and payable immediately and, if necessary, during imprisonment through participation in BOP's Inmate Financial Responsibility Program. The BOP is directed to deduct from the defendant's resources the maximum amount permitted under 28 C.F.R. 545.11.
Upon release, the defendant shall make monthly payments of not less than $ [ ]. This monthly amount may be adjusted in accordance with 18 U.S.C. 3664(k). The defendant is obligated to report to the Government and the Court any material change in [ his/her ] economic circumstances, pursuant to 18 U.S.C. 3664(k).
Defendant shall make all restitution payments, except those payments made through the Federal Bureau of Prisons, to:
IRS - RACS
[ judge's signature-if appropriate in your district ]
FN 1. In cases involving employment taxes, be sure to include the tax period, type of tax, and the name of the applicable individual or entity. Examples of the type of tax include § 3101 Employee FICA, § 3111 Employer FICA, § 3401 ITW, and § 3301 FUTA. Here is a sample:
|Tax Period||Type of Tax||Name of Individual/ Entity on Applicable Return (if different than defendant's)||Amount of Tax|
|Ex: 12/2010, 03/2011||Ex: § 3101 Employee FICA||Ex: John Doe, X Corporation|
|FN 2. Prosecutors should check to see if the judges in their district sign restitution orders separately from the rest of the judgment. If so, make the appropriate changes to the restitution order form.|