Form Dtf-4.2 - Compromise Of Spousal Share Of Liability On Joint Tax Return Page 2

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Page 2 of 6 DTF-4.2 (2/08)
9
Enter the names and addresses of all banks or other financial institutions where you have done business during the past
three years.
Name and address
Name and address
10 Enter your most recent financial information in the columns below. Enter the fair market value of each asset you own directly
or indirectly. Also list your interests in partnerships, S corporations, LLCs, estates, trusts, and other property rights,
including contingent interests and remainders.
Assets
Fair market value
Cash
Cash surrender value of insurance
Real estate
Furniture and fixtures
Automobiles and trucks
Recreational vehicles
Stocks, bonds, and other securities
Jewelry
Business equipment
Individual retirement accounts, 401(k)s, etc.
Other assets
(list below)
Total assets
$
11 Enter the amount owed on the following applicable liabilities.
Liabilities
Amount
Mortgage(s)
Real estate taxes owed
Judgments
Federal income tax owed
Loans from relatives
Loans from others
Credit card debt
Other liabilities
(list below)
Total liabilities
$
12 Real estate
(attach copy of indenture, mortgage, and deed for each)
Fair market
Balance due
Overdue taxes,
Address(es) and description(s) of real property
Cost
value
on mortgage
penalties, interest
Totals
$
$
$
$

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