Form 668-A - Notice Of Levy Page 4
Download a blank fillable Form 668-A - Notice Of Levy in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 668-A - Notice Of Levy with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6PLEASE REMOVE THIS PAGE BEFORE COMPLETING IT.
SECTION 1.— Levy Acknowledgment
Signature of person responding
Printed name of person responding
Your telephone number
(
)
Date and time this levy received
SECTION 2.— Levy Results
(Check all applicable boxes.)
Check attached in the amount of $
No funds
No account
No record
SECTION 3.— Other Information
(Please complete this section only if you are NOT sending us the total
amount the taxpayer owes.)
Taxpayer's latest address, if different
from the one on this levy
.
Taxpayer's telephone number (
)
Name and address of taxpayer's
employer, if different from addressee
Next date you will owe funds to the taxpayer
Other information you believe may help us:
668-A(c)(DO)
Form
(Rev. 7-2002)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial