DescriptionDepartment of the Treasury Internal Revenue Service Form 433-A OIC Rev. May 2012 Collection Information Statement for Wage Earners and Self-Employed Individuals Use this form if you are An individual who owes income tax on a Form 1040 U.S. Individual Income Tax Return partnership liability income. Spouse s Last Name Name Age Relationship Claimed as a dependent on your Form 1040 Contributes to household income Yes ...
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