Low-Income Taxpayer Clinic
Supporting Documents
Documents needed to support Offer in Compromise (Form 433A)
Section 2 – For self-employment or operation of a business (for past 3 months)
1. Proof of self-employment income for the past three months
a. Invoices
b. Commissions
c. Income statements
Section 3 – Employment information (for past 3 months)
1. Proof of gross earnings and deductions
a. Pay stubs
b. Earning statements
Section 4 – Other income information (for past 3 months)
1. Pension
2. Social Security
3. Child support
4. Alimony
5. Rental income
6. Any statements showing deductions for the past 3 months
Section 5 – Other income information (for past 3 months)
1. Bank statements
a. Checking
b. Savings
c. Money market
d. Brokerage account
2. 401K statements
3. Credit card statements
4. Life insurance that has a cash value
a. Term Life Insurance does not have a cash value
b. Statement that indicates policy holder, type and cash/loan value
Section 7 – Banking, Investment, Cash, Credit, and Life insurance
1. Current car loan statement showing monthly payment and current balance of loan for each car
2. Mortgage statements
a. Current statement showing monthly payment amount and current balance due for each
piece of real estate owned
Section 9 – Expenses and miscellanceous (for past 3 months)
1. Copy of last Form 1040 with all schedules
2. Utilities statements for past 3 months
a. Gas
b. Electric
c. Water, sewage, trash
d. Telephone both local and long distance
3. Proof of non-business transportation expenses
a. Car Insurance
b. Gas receipts
c. Public transportation costs (MARTA, taxi)
d. Registration costs
4. Proof of out-of-pocket healthcare expenses
a. Health Insurance premiums
b. Co-payments
5. Property taxes
a. Personal
b. Real estate
6. Court ordered expenses
a. Copies of any court order requiring payment
b. Proof of payments
1. Canceled checks
2. Money orders
3. Earning statements
