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Modesto California Form 433-A: What You Should Know

When completing this section, be sure to specify the name on the account and also note the names of the last four (4) adult names on the  account. Do not provide the name of the deceased person. In addition, the name on the account should match the last 4  surnames on the IRS information return (see below). Form 433 New 1/93. The original and three (3) copies of this form are to be Completed with all available information at the time the registered  person or joint account holder requests the Form as a proof of ownership (for example, sales  tax invoice). The following information should also be noted and  listed in the “Required information” section of the form: • Information that is required on the  Form: Name (full legal name), marital status (married or not married), address,  date of birth. Name (full legal name), marital status (married or not married), address, date of  birth. • Date of birth on the Form: • In the case of a married person with a joint account, the date of  birth of each spouse who is a qualifying person (see below). • In the case of a child under 21 whose marriage may be incorporated, the date of birth of each co-owner (see below). How to prepare your name, marital status, address and date of birth on a  Form 433 A (OIC) • The “Required information” section below gives you all the required information for all three adults on your account, which includes: • Date of birth for any co-owner • The name and address (with street address and ZIP Code) of each of your parent(s). • The number of credit hours you have for any person who is (1) not your spouse or (2) a qualifying person, i.e. a spouse of, parent of, grandparent of, child of you or someone else not listed here.

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