Transcription of Form 433-B (Rev. 2-2019)
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form 433-B (Rev. December 2012)Department of the Treasury Internal Revenue ServiceCollection Information Statement for No. 16649 PForm 433-B (Rev. 12-2012)Note: Complete all entry spaces with the current data available or "N/A" (not applicable). Failure to complete all entry spaces may result in rejection of your request or significant delay in account resolution. Include attachments if additional space is needed to respond completely to any 1: Business Information1aBusiness Name 1bBusiness Street AddressMailing AddressCityState ZIP1d1cBusiness Telephone()1eType of Business1fBusiness Website (web address)County2aEmployer Identification No.
Catalog Number 16649P. www.irs.gov Form . 433-B (Rev. 2-2019) Form . 433-B (February 2019) Department of the Treasury Internal Revenue …
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