March 30th, 2005
FiledMarch 30th, 2005Issued under the authority of P.A. 122 of 1941, as amended.You must file this form if you wish to establish an installment agreement. Treasury Account Number(i) Name and Address (i )Type of EntityIndividual Sole ProprietorCorporation PartnershipOther, specify: _ Home Telephone Number Business Telephone Number