The Md 433 A form, formally titled the "Collection Information Statement for Individuals," is a comprehensive financial disclosure form used by the State of Maryland. It requires individuals to provide detailed information about their income, assets, liabilities, and overall financial condition. This form is crucial for those in particular financial situations requiring state review, such as tax resolution matters. Ready to complete your Md 433 A form? Find clarity on your financial standing and begin the process by clicking the button below.
Navigating through financial obligations, especially when it involves interacting with state authorities, can be a complex process, requiring individuals to furnish detailed information about their current financial situation. The MD 433-A form, issued by the State of Maryland's Comptroller, serves as a collection information statement for individuals. This crucial form, updated in July 2000, seeks comprehensive details from Maryland residents regarding their employment, personal, and financial information to ensure a thorough understanding of their economic circumstances. It mandates the disclosure of various types of information, including taxpayer identification, marital status, employment details, next of kin, and an expansive section on financial details that cover bank accounts, charge cards, real property, life insurance, securities, and any other assets or liabilities. The form also explores possible future changes in financial condition and requires a detailed monthly income and expense analysis. Designed to be filled out with accuracy, it allows for additional sheets if the provided space is insufficient. Completing this form is a step toward transparency in financial dealings with the state, aiming to facilitate processes like tax collection, debt resolution, or any financial assessment the Comptroller's office deems necessary. The certification section at the end underscores the seriousness of the information provided, requiring signatures under the penalty of perjury, thereby emphasizing the form's importance in the financial governance of the state.
Form MD 433-A
(Rev. July 2022)
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 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
Payday: ___________ (Mon-Sun)
Sole proprietor
Partner
6 Spouse’s employer or business
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. 7-2022)
Page 2
Section III (continued) General Financial Information
14 Charge cards and lines of credit from banks, credit unions, and savings and loans.
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
c
17
Life Insurance (Name and Company)
Policy Number
Type
Face Amount
Available Loan Value
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
c Repossessions
d Recent sale or other transfer of
assets for less than full value
e Anticipated increase
f Participant or beneficiary
in income
to trust, estate, profit sharing, etc.
(Rev. 7-2022)
Page 3
Section IV
Assets and Liabilities
Equity
Amount of
Name and Address of
Date
Date of
Description
Market
in
Lien/Note Holder/Lender
Pledged
Final
Asset
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 #)
25 Real property
(from Section III,
item 16)
26 Other assets
d
e
27 Bank revolving credit (from item 14)
28 Other liabilities
(including bank
loans, judgements
notes, and
charge accounts
not entered in
item 13)
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
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:
Explain any difference between Item 53 and the installment payment amount:
Name of Originator
Filling out the MD 433 A form is a necessary step for individuals in Maryland undergoing certain financial procedures with the state's Comptroller. By providing a complete and accurate picture of your financial status, you are facilitating a smoother process. The guidelines below are designed to help you complete this form diligently and correctly.
Once you have completed the form, review it carefully to ensure all information is accurate and nothing has been overlooked. Submitting complete and accurate information is crucial to the efficient handling of your financial matters with the State of Maryland. Should you have any further questions or require clarification on specific items, it’s advisable to seek assistance directly from the Comptroller of Maryland’s office or consult a professional.
The MD 433-A form, introduced by the State of Maryland, serves as a Collection Information Statement for Individuals. Its primary purpose is to comprehensively gather financial information from an individual, which includes personal, employment, and financial details. This document is crucial for the Comptroller of Maryland to assess an individual's financial situation, particularly in scenarios where tax liabilities or other financial obligations to the state are concerned.
This form is typically required for individuals who have outstanding tax liabilities or need to arrange a payment plan with the State of Maryland. Furthermore, it may be requested from individuals undergoing financial assessments by the state for reasons related to tax collection or relief programs.
In the employment information section, individuals are required to provide details about their current employment or business, including the length of employment, business phone number, occupation, number of exemptions claimed on the W-4 form, and pay period frequency. If applicable, similar information must be provided for a spouse's employment.
The form instructs individuals to write “N/A” (not applicable) in any block that does not apply to their situation, ensuring that all parts of the form are correctly addressed and no sections are left blank inadvertently.
Yes, there are instances where providing additional information is necessary. If the space provided on the form is insufficient, individuals are encouraged to attach a separate sheet detailing the necessary information. This could involve elaborating on financial accounts, dependent information, or explaining aspects of their financial condition not fully covered by the form's questions.
Financial accounts, including savings, checking, IRAs, certificates of deposit, and retirement accounts, should be reported in Section III under General Financial Information. The individual must provide the name of the institution, address, type of account, account number, and current balance for each account listed.
When reporting life insurance policies, the form requires the name of the insurance company, the policy number, type of insurance (whole or term), face amount, and available loan value, if applicable. This data helps assess the individual's financial assets accurately.
Real property must be detailed in the form by providing a brief description, type of ownership, physical address, and specifying the county in which each property is located. This section is crucial for evaluating an individual's assets and liabilities related to real estate holdings.
Yes, there are sections and notes intended solely for the use of the Comptroller of Maryland. These include financial verification/analysis data, the monthly income and expense analysis for Comptroller’s use only, and any additional comments or explanations regarding differences in reported and assessed financial information.
The certification requires the signatures of the individual and, if filing jointly, the spouse. It affirms under the penalties of perjury that the information provided in the form is, to the best of the signatory's knowledge, true, correct, and complete. The date of signing must also be included alongside the signatures, underscoring the responsibility and legal obligation to provide accurate and honest information.
Filling out the Maryland Form MD 433-A, a Collection Information Statement for Individuals, is a crucial step in managing your taxes in the state of Maryland. However, individuals often stumble over several common errors during this process. Here, we highlight four such mistakes that could potentially complicate your tax situation or delay processing. By paying attention to these areas, you can ensure accuracy and completeness in your submission.
Not Completing All Required Sections: A frequent error is leaving fields blank that should either have information entered or be marked with “N/A” (not applicable) if the section does not apply. The form clearly instructs to fill in all blocks except shaded areas, emphasizing the importance of acknowledging every section to indicate thorough review and completion.
Underestimating Assets and Liabilities: Properly reporting all assets and liabilities in Section III and IV is vital for an accurate financial declaration. Individuals often mistakenly underreport or omit certain assets, such as retirement accounts or secondary income sources, and liabilities, including loans or credit card debts, potentially leading to discrepancies that could raise flags with the Maryland Comptroller's Office.
Inaccurate Personal Information: Details such as the correct spelling of names, Social Security numbers for both taxpayer and spouse if filing jointly, and current contact information are foundational yet frequently entered incorrectly. This basic information is crucial for identity verification and correspondence, and mistakes here can lead to processing delays or issues with your tax record.
Omission of Additional Information or Comments: The form provides a specific section for additional information or comments, intended for explaining any out-of-the-ordinary financial situations (e.g., recent sale or transfer of assets, participation in income to trust, or changes in employment status). Neglecting to provide context where necessary can lead to misunderstandings or requests for further clarification, stalling the evaluation process.
Understanding these common pitfalls and approaching Form MD 433-A with diligent attention to detail can help streamline your interactions with the Maryland Comptroller's Office, ensuring that your financial status is accurately represented and processed efficiently.
When handling financial or tax-related matters in Maryland, especially when completing the Form MD 433-A, it's quite common to also use other forms and documents to provide a comprehensive view of an individual's or household's financial situation. Understanding what these additional forms are and their purpose can streamline the completion process and ensure accurate reporting. Below is a list of documents often used alongside Form MD 433-A, briefly explained.
Accurately completing the MD 433-A form involves gathering pertinent information about one's financial standing. The forms and documents listed here are instrumental in offering a full financial disclosure. Whether dealing with income details, property ownership, or debts and investments, these documents ensure that individuals can provide the comprehensive information required by the Maryland Comptroller's Office. Keeping these documents organized and readily accessible will simplify the process of filling out the MD 433-A and any related paperwork.
The MD 433 A form is similar to other comprehensive financial information forms used by governmental and financial institutions to assess an individual's financial situation. These forms can include those for loan applications, financial aid, or tax relief programs. This similarity lies primarily in the detailed information required about personal finances, employment, assets, liabilities, and monthly income and expenses. Understanding these resemblances helps individuals better prepare for completing the MD 433 A form by knowing what kind of information they need to gather.
The IRS Form 433-A: Like the MD 433 A form, the Internal Revenue Service (IRS) Form 433-A is used to collect financial information from individuals to determine their ability to pay a tax debt. Both forms require detailed income, expense, asset, and liability information. They are designed to give the tax authorities a clear picture of an individual's financial standing. This includes similar sections on employment information, bank accounts, real and personal property, and monthly living expenses. However, the IRS Form 433-A is used at the federal level, while the MD 433 A form applies to the Maryland Comptroller's needs.
Loan Application Forms: Many loan application forms, like those for mortgages, personal loans, or credit lines, also share similarities with the MD 433 A form. These applications often require comprehensive financial details to evaluate the applicant's repayment ability. Key similarities include the requirement to list assets, liabilities, monthly income, and expenses. Both types of documents often ask for information regarding real estate owned, other outstanding debts, and employment details. The main difference lies in their purpose: loan applications for borrowing versus tax or financial assessment for the MD 433 A form.
Financial Aid Forms, such as the Free Application for Federal Student Aid (FAFSA): The FAFSA, and similar documents, also have areas of overlap with the MD 433 A form. They collect financial information from individuals or families to determine eligibility for financial aid. This includes detailed questions about income, investments, and savings. Both the FAFSA and the MD 433 A form aim to assess the financial state of an individual or household, though for different end goals: one for aid and scholarships, the other for tax-related financial status assessment.
Filling out the Maryland Form MD 433-A, a Collection Information Statement for Individuals, requires attention to detail and thoroughness. Here are five key practices to follow and avoid for a smooth submission process.
Do:
Don't:
Many people have misconceptions about the Form MD 433-A, a detailed document required by the Comptroller of Maryland. Here, we aim to clarify these misunderstandings to help individuals accurately complete their forms.
Understanding these common misconceptions about the Form MD 433-A can dramatically simplify the process of completing it, ensuring accurate and timely submission to the Comptroller of Maryland.
Understanding the MD 433-A form, issued by the State of Maryland, is crucial for individuals dealing with collection information statements. This form serves as a comprehensive declaration of an individual's financial status, including assets, liabilities, income, and expenses. Here are five key takeaways to consider when filling out and using the MD 433-A form:
In conclusion, the MD 433-A form is a vital document for those navigating financial declarations within Maryland. A clear and thorough approach, underscored by honesty and attention to detail, facilitates smoother interactions with state financial agencies, ensuring that all parties have an accurate understanding of an individual's financial capabilities and needs.
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