Form Ador 20-1020 - Collection Information Statement For Business
ADVERTISEMENT
1
2
3
4Arizona Department of Revenue
1600 W Monroe - Phoenix AZ 85007-2650
Collection Information Statement for Business
Note: Complete all blocks, except shaded areas. Write "N/A" (not applicable) in those blocks that do not apply.
1. Name and address
2. Business phone number
3. (Check appropriate box)
Sole proprietor
Other (specify)
Partnership
Corporation
4. Name and title of person being interviewed
5. Employer Identification
6. Type of business
7. Information about owner, partners, officers, major shareholder, etc.
Total Shares or
Name and Title
Effective Date
Home Address
Phone Number
Social Security Number
Interest
Section I.
General Financial Information
Form
Tax Year ended
Net income before taxes
8. Latest filed income tax return
9. Bank accounts (List all types of accounts including payroll and general, savings, certificates of deposit, etc.)
Name of Institution
Address
Type of Account
Account Number
Balance
$
Total (Enter on line 17)
10. Bank credit available (Lines of credit, etc.)
Monthly
Name of Institution
Address
Credit Limit
Amount Owed
Credit Available
Payments
Totals (Enter on lines 24 or 25 as appropriate)
$
$
$
11. Location, box number, and contents of all safe deposit boxes rented or accessed
ADOR 20-1020 (10/01)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial