Md 433 A Form PDF Details

Navigating the complexities of state tax obligations can often feel overwhelming, especially when faced with the need to provide detailed financial information to tax authorities. The State of Maryland's Form MD 433-A, revised in July 2000, serves as a comprehensive tool for this purpose, which taxpayers are required to fill out as part of the Collection Information Statement for Individuals. Designed to capture a broad spectrum of personal and financial details, this form requires taxpayers to meticulously report on their employment history, personal information including but not limited to marital status, Social Security numbers, and contact details, as well as a deep dive into their financial health. This includes accounts held, credit card debts, real estate and life insurance policies, among others. Furthermore, the form extends into an intricate examination of assets and liabilities, culminating in a monthly income and expense analysis section intended for use exclusively by the comptroller's office. Not only does it necessitate the disclosure of current income sources and living expenses, but it also ventures into the realm of future financial expectations and past fiscal events such as bankruptcy or asset transfer at undervalued prices. Completing the MD 433-A with accuracy and honesty is crucial, as it concludes with a certification under penalty of perjury to the truthfulness and completeness of the information provided. This process not only aids the Maryland Comptroller in assessing an individual's tax situation but also enforces a rigorous self-audit of one’s financial status, laying the groundwork for transparent and fair tax collection practices.

QuestionAnswer
Form NameMd 433 A Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other names433 form md a, 433 a form md, form md 433 a, md form 433a

Form Preview Example

Form MD 433-A

(Rev. July 2000)

State of Maryland Comptroller of Maryland

Collection Information Statement for Individuals

(If you need additional space, please attach a separate sheet)

Note: Complete all blocks, except shaded areas. Write “N/A” (not applicable) in those blocks that do not apply.

1 Taxpayer(s) name(s) and address

2 Home phone number

3 Marital status

( )

4a Taxpayer’s Social Security number

4b Spouse’s Social Security number

County ______________________

Section I

Employment Information

 

 

 

 

 

 

 

5 Taxpayer’s employer or business

a How long employed

b Business phone number

 

c Occupation

(name and address)

 

 

 

 

 

 

 

 

 

 

d Number of exemptions

e Pay period: ! Weekly

! Bi-weekly

f (Check appropriate box)

 

claimed on W-4

! Monthly

! ________

! Wage earner

 

 

 

 

! Sole proprietor

 

 

Payday: ___________ (Mon-Sun)

! Partner

 

 

 

 

 

6 Spouse’s employer or business

a How long employed

b Business phone number

 

c Occupation

(name and address)

 

 

 

 

 

 

 

 

 

 

d Number of exemptions

e Pay period: ! Weekly

! Bi-weekly

f (Check appropriate box)

 

claimed on W-4

! Monthly

! ________

! Wage earner

 

 

 

 

! Sole proprietor

 

 

Payday: ___________ (Mon-Sun)

! Partner

 

 

 

 

 

Section II

Personal Information

 

 

7 Name, address and telephone number of next of kin or other reference

8 Other names or aliases

9 Previous address(es)

10 Age and relationship of dependents living in your household (exclude yourself and spouse)

11Date of birth

aTaxpayer

bSpouse

12 Last filed income tax return (tax year)

a Number of exemptions claimed

b Adjusted gross income

Section III

General Financial Information

13 Bank accounts (include savings and loans, credit unions, IRA and retirement plans, certificates of deposit, etc.)

Name of Institution

Address

Type of Account

Account No.

Balance

Total (Enter in Item 21) ..................................................................................................................................................................................

Form MD 433-A (Rev. 7-2000)

Page 2

Section III (continued) General Financial Information

 

 

 

14 Charge cards and lines of credit from banks, credit unions, and savings and loans.

 

Type of Account

or Card

Name and Address of Financial institution

Monthly Payment

Credit Limit

Amount

Owed

Credit

Available

Total (Enter in Item 27) ..........................................................................................

15 Safe deposit boxes rented or accessed (List all locations, box numbers, and contents)

16 Real Property (Brief description and type of ownership)

 

Physical Address

 

 

 

 

 

 

a

 

 

 

 

 

 

County _________________________________

 

 

 

 

 

b

 

 

 

 

 

 

County _________________________________

 

 

 

 

 

c

 

 

 

 

 

 

County _________________________________

 

 

 

 

 

17 Life Insurance (Name and Company)

Policy Number

Type

Face Amount

Available Loan Value

 

 

 

 

 

 

 

! Whole

 

 

 

 

! Term

 

 

 

 

 

 

 

 

 

! Whole

 

 

 

 

! Term

 

 

 

 

 

 

 

 

 

! Whole

 

 

 

 

! Term

 

 

 

 

 

 

 

Total (Enter in Item 23)

18 Securities (stocks, bonds, mutual funds, money market funds, government securities, etc.):

Kind

Quantity or Denomination

Current

Value

Where Located

Owner

of Record

19 Other information relating to your financial condition. If you check the “Yes” box, please give dates and explain on page 4, Additional Information or Comments:

a Court proceedings

! Yes

! No

b Bankruptcies

! Yes

! No

 

 

 

 

 

 

c Repossessions

! Yes

! No

d Recent sale or other transfer of

! Yes

! No

 

 

 

assets for less than full value

 

 

 

 

 

 

 

 

e Anticipated increase

! Yes

! No

f Participant or beneficiary

! Yes

! No

in income

 

 

to trust, estate, profit sharing, etc.

 

 

 

 

 

 

 

 

Form MD 433-A (Rev. 7-2000)

 

 

 

 

 

 

Page 3

Section IV

 

 

 

Assets and Liabilities

 

 

 

Current

Current

Equity

Amount of

Name and Address of

Date

Date of

Description

Market

Amount

in

Monthly

Lien/Note Holder/Lender

Pledged

Final

 

Value

Owed

Asset

Payment

 

 

Payment

20Cash

21Bank accounts (from item 13)

22Securities (from item 18)

23Cash or loan value of insurance

24Vehicles leased or owned (model, year, license, tag #)

a

b

c

25 Real property

a

(from Section III,

 

item 16)

b

c

26 Other assets

a

 

 

b

 

 

c

 

 

d

 

 

e

 

 

27 Bank revolving credit (from item 14)

 

28 Other liabilities

a

 

(including bank

 

 

loans, judgements

b

 

notes, and

 

 

charge accounts

c

 

not entered in

 

 

item 13)

d

 

 

e

 

 

f

 

 

g

 

29 Federal taxes owed (prior years)

 

29 Totals

$

$

 

Comptroller of Maryland Use Only Below This Line

 

Financial Verification/Analysis

 

Date Information or

Date Property

Estimated Forced

Item

Encumbrance Verified

Inspected

Sale Equity

Personal Residence

Other real property

Vehicles

Other personal property

State employment (husband and wife)

Income tax return

Wage statements (husband and wife)

Sources of income/credit (D&B report)

Expenses

Other assets/liabilities

Form MD 433-A (Rev. 7-2000)

 

 

 

 

Page 4

Section V

Monthly Income and Expense Analysis

 

 

 

 

 

 

 

 

 

Total Income

 

 

Necessary Living Expenses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Comptroller’s use Only

Source

 

Gross

 

 

Claimed

Allowed

 

 

 

 

 

 

31 Wages/salaries (taxpayer)

$

42

National Standard Expenses (1)

$

$

32 Wages/salaries (spouse)

 

43

Housing and utilities (2)

 

 

33

Interest, dividends

 

44

Transportation (3)

 

 

34

Net business income

 

45

Health care

 

 

 

(from Form MD 433-B)

 

 

 

 

 

35

Rental income

 

 

46

Taxes (income and FICA)

 

 

36

Pension (taxpayer)

 

47

Court ordered payments

 

 

37

Pension (spouse)

 

48

Child/dependent care

 

 

38

Child support

 

 

49

Life insurance

 

 

39

Alimony

 

 

50

Secured or legally-perfected

 

 

 

 

 

 

 

debts (specify)

 

 

40

Other income

 

 

51 Other expenses (specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

41 Total income

$

52

Total Expenses

$

$

 

 

 

 

 

 

 

 

53

(Comptroller’s use only) Net

$

 

 

 

 

difference (income less necessary

 

 

 

 

 

living expenses)

 

 

 

 

 

 

 

 

Certification Under penalties of perjury, I declare that to the best of my knowledge and belief this statement of

assets, liabilities, and other information is true, correct, and complete.

54 Your signature

55 Spouse’s signature (if joint return filed)

56Date

Notes

1 Clothing and clothing services, food, housekeeping supplies, personal care products and services, and miscellaneous.

2 Rent or mortgage payment for the taxpayer’s principal residence. Add the average monthly payment for the following expenses if they are not included in the rent or mortgage payment: property taxes, homeowner’s or renter’s insurance, parking, necessary maintenance and repair, homeowner dues, condominium fees and utilities. Utilities include gas, electricity, water, fuel oil, coal, bottled gas, trash and garbage collection, wood and other fuels, septic cleaning, and telephone.

3 Lease or purchase payments, insurance, registration fees, normal maintenance, fuel, public transportation, parking, and tolls.

Additional information or comments:

Comptroller of Maryland Use Only Below This Line

Explain any difference between Item 53 and the installment payment amount:

Name of Originator

Date

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form md 433 completion process clarified (portion 1)

2. After this part is completed, you'll want to put in the essential particulars in Name address and telephone number, Other names or aliases, Previous addresses, Age and relationship of, Date, htrib fo, a Taxpayer, b Spouse, Last filed income, a Number of exemptions, b Adjusted gross income, raey xat nruter xat, demialc, III noitceS Bank accounts include, and noitamrofnI laicnaniF lareneG allowing you to move on further.

noitamrofnI laicnaniF lareneG, a Taxpayer, and htrib fo in form md 433

Many people often make some mistakes when completing noitamrofnI laicnaniF lareneG in this part. Make sure you double-check whatever you enter right here.

3. Throughout this step, check out Type of Account, draC ro, Name and Address of noitutitsni, Monthly tnemyaP, Credit timiL, Amount, Owed, Credit, Available, Total Enter in Item, Safe deposit boxes rented or, Real Property Brief description, Physical Address, County, and County. Each one of these will need to be completed with greatest accuracy.

Credit, Amount, and Credit timiL in form md 433

4. Filling in County, Life Insurance Name and Company, Policy Number, Type, Face Amount, Available Loan Value, Whole Whole, Term, Whole, Term, Whole, Term, Total Enter in Item, Securities stocks bonds mutual, and dniK is paramount in this step - make sure to take your time and take a close look at each field!

dniK, Whole, and Type of form md 433

5. The final point to submit this document is pivotal. Be sure to fill in the displayed form fields, and this includes e Anticipated increase, emocni ni, Yes, d Recent sale or other transfer of, f Participant or beneficiary cte, and Yes, prior to finalizing. Failing to accomplish that might generate an incomplete and probably invalid document!

form md 433 completion process clarified (step 5)

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