Form 433a - Collection Information Statement For Individuals - West Virginia State Tax Department Page 3

Download a blank fillable Form 433a - Collection Information Statement For Individuals - West Virginia State Tax Department 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 433a - Collection Information Statement For Individuals - West Virginia State Tax Department 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

Section IV.
Asset and Liabilities
Current
Current
Equity in
Amt. of
Name and Address of
Date
Date of
Description
Market
Amount
Asset
Mo.
Lien / Note Holder /
Pledged
Final
Value
Owed
Payment
Obligee / Lender
Pymt
2 0. Cash
21. Bank Accounts
0.00
(from
Item 13)
0.00
22. Securities
(from Item 18)
23. Cash or loan value of
0.00
insurance
24. Vehicles (model, year,
license, tag#)
a.
b.
c.
a.
25. Real
Property (From
b.
Section III, Item
16)
c.
26. Other assets
a.
b.
c.
d
e.
27. Bank revolving credit
0.00
0.00
(from item 14)
28. Other liabilities (i.e. bank loans, judgments, notes and charge accounts not entered in Item 13)
a.
b.
c.
d.
e.
f.
g.
29. State taxes owed (prior
year)
$
$
0.00
0.00
Totals
30.

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 4