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Form Collection Information Statement for Wage Earners …

form 433-A Collection Information Statement for Wage (Rev. December 2012). Department of the Treasury Earners and Self-Employed Individuals Internal Revenue Service Wage Earners Complete Sections 1, 2, 3, 4, and 5 including the signature line on page 4. Answer all questions or write N/A if the question is not applicable. Self-Employed Individuals Complete Sections 1, 3, 4, 5, 6 and 7 and the signature line on page 4. Answer all questions or write N/A if the question is not applicable. For Additional Information , refer to Publication 1854, "How To Prepare a Collection Information Statement .". Include attachments if additional space is needed to respond completely to any question.

Catalog Number 20312N. www.irs.gov Form . 433-A (Rev. 5-2020) Form . 433-A (May 2020) Department of the Treasury Internal Revenue Service. …

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