Form 433-D Installment Agreement
1-800-829-8374 (Individual – Self-Employed/Business Owners), or 1-800-829-0922 (Individuals – Wage Earners) Or write (City, State, and ZIP Code) Kinds of taxes (form numbers) Tax periods. Amount owed as of$ I / We agree to pay the federal taxes shown above, PLUS PENALTIES AND INTEREST PROVIDED BY LAW, as follows $ on ................
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