The Illinois Department of Revenue's BOA-4 Financial Information Statement for Individuals is a comprehensive document designed to gather detailed financial information from an individual. This form covers various sections ranging from personal and employment details to an in-depth analysis of assets, liabilities, monthly income, and expenses. Filling out the Illinois Boa 4 form accurately is crucial for those required to submit their financial information to the state, whether for tax purposes, setting up payment plans, or other financial assessments. For a hassle-free process, click the button below to fill out the form.
The Illinois Department of Revenue's BOA-4 Financial Information Statement for Individuals is a detailed document designed to gather comprehensive financial information from individuals. It is divided into various sections, each aimed at collecting different types of data such as personal and employment details, financial accounts, assets, liabilities, and monthly income and expenses. The form is structured to extract information about an individual’s marital status, employment history, all types of accounts including savings, loans, and retirement accounts, real property, insurance policies, and even details on securities like stocks and bonds. Furthermore, it delves into more sensitive financial matters, such as pending bankruptcy or other proceedings, and it requires a detailed analysis of the individual's assets and liabilities, alongside a thorough report on monthly income and living expenses. This comprehensive approach ensures a clear financial portrait of the individual, which is crucial for the Illinois Department of Revenue to process the form properly. The requirement to sign the document under penalties of perjury emphasizes the importance of the accuracy and completeness of the information provided. This form plays a pivotal role in financial assessments and is a necessary step for individuals in certain financial situations in Illinois.
Illinois Department of Revenue
BOA-4 Financial Information Statement for Individuals
Section 1: Tell us about yourself and your employment
Part A: Your information
1
Marital status
single
married
separated
If married, complete your spouse’s information in Part B.
2
Your name ___________________________________________ 11
Filing status
married filing jointly
3 Street address ________________________________________
head of household
married filing separately
____________________________________________________ 12
Average monthly take-home pay $___________________________
City
State
ZIP
13
Amounts withheld from your paycheck (e.g., savings, bonds,
4
Home phone (____)____________________________________
deferred amounts, car payments, etc.) $______________________
5
Social Security number
___ ___ ___- ___ ___- ___ ___ ___ ___
______________________________________________________
6
Unemployed
yes
no If “yes,” how long. _______________ 14
Dates paid _____________________________________________
7
Current or former employer’s name ________________________ 15
Length of employment ____________________________________
8
Address _____________________________________________ 16
Date of birth
___ ___/___ ___/___ ___ ___ ___
____________________________________________________ 17
Name and address of next of kin (other than spouse)
Name ________________________________________________
9
Work phone (_____)____________________________________
Street address _________________________________________
10
Occupation___________________________________________
Part B: Your spouse’s information
18
Spouse’s name _______________________________________ 25
Work phone(_____)______________________________________
19
Address (if different)____________________________________ 26
Occupation ____________________________________________
____________________________________________________ 27
28
20
Home phone (if different)(_____)__________________________
21
___ ___ ___-___ ___-___ ___ ___ ___
22
no If “yes,” how long._______________ 29
23
Current or former employer’s name ________________________ 30
24
Address _____________________________________________ 31
Date of birth ___ ___/___ ___/___ ___ ___ ___
____________________________________________________
Section 2: Complete the following financial information
Note: Attach additional sheets in the same format for any of the following parts if necessary.
Part A: Your bank accounts (include savings and loans, credit unions, IRA and retirement plans, and certificates of deposit)
A
B
C
D
E
Type of
Account
Name of institution
Address
account
number
Balance
32
______________________
_______________________________________
___________
____________
33______________________
34
35
36
37______________________
38
Add Lines 32 through 37, Column E, and write the total here and on Part G, Line 56, Column B.
BOA-4 (R-4/01)
Page 1 of 4
Part B: Your charge cards or credit lines from your banks, credit unions, and savings and loans
Type of account
Current
or card
Name and address of financial institution
balance
39
_________________
_______________________________________________________________________
40
41
42
43
44
Add Lines 39 through 43, Column C, and write the total here and on Part G, Line 57, Column C.
44 ___________
Part C: Real property you own
Brief description
How property
of property
is titled
Physical address
County
45
_____________________________
__________________
46
47
Part D: Your life and health insurance policies
Policy
Face
Available
Insurance company
Type
amount
loan value
48
__________________________________________________
49
50
Add Lines 48 and 49, Column E, and write the total here and on Part G, Line 60, Column B.
50 ___________
Part E: Your securities (e.g., stocks, bonds, annuities, mutual funds, money market funds, government securities, notes, personal, etc.)
Quantity or
of security
Location
Owner of record
denomination
Present value
51
______________________________
_________________________
52
53
Add Lines 51 and 52, Column E, and write the total here and on Part G, Line 61, Column B.
53 ___________
Part F: Miscellaneous information
54a Are foreclosure, bankruptcy, receivership, or assignment for benefit of creditors proceedings pending? b What is the bankruptcy number? ______________________
Yes
No
c What date was the bankruptcy filed? ___ ___/___ ___/___ ___ ___ ___
If closed, what was the date? ___ ___/___ ___/___ ___ ___ ___
Month
Day
Year
Page 2 of 4
Part G: Analyze your assets and liabilities
Note: Write amounts in all unshaded areas that apply
Fair market
Description
value
55
Cash
56
Total bank accounts
from Section 2, Part A,
Line 38
57Total charge cards balance from Section 2, Part B,
Line 44
58Vehicles (model, year)
a ___________________
b ___________________
c ___________________
59
Real property listed
in Section 2,
Part C, (Line 45)
(Line 46)
(Line 47)
60
Total cash or loan value
of insurance from
Section 2, Part D,
Line 50
61
Total securities from
Section 2, Part E,
Line 53
62
Other assets (specify)
Liabilities
balance due
Equity
(Column B minus
Column C)
Monthly payment amount
F
Pledgee or obligee
___________________
G
Date of
final
payment
a___________________
b___________________
c___________________
63 Other liabilities not covered above (e.g., judgments, charities, tuition)
64 Federal taxes owed
65 State taxes owed a Illinois individual
income tax
b Illinois business income tax
c Other state taxes
66Total
Page 3 of 4
Part H: Analyze your monthly income and expenses
Income
Source
Gross
Net
67
Your wages or salary
68
Your spouse’s
wages or salary
69
Interest or dividends
70
Business income
71
Rental income
72
Your pension
73
Your spouse’s pension
74
Child support
75
Alimony
76Other (specify)
________________ ___________________ ___________________
________________
77 Add Lines 67 through 76, Column C.
This amount is your total net income.
____________________
Necessary monthly living expenses
Expense
Amount
78Rent (not included
in Part G, Line 59)
79
Groceries
(number of people____)
80
Installment pmts. from
Part G, Line 66, Col. E
81
Utilities
a
gas
b
water
c
electric
d
telephone
82
Transportation
83
Insurance
life
(monthly
health
premiums) c
home
car
84Medical (not covered
in Line 83b above)
85
Estimated tax payments
86
Court-ordered payments
87Other (specify)
__________________ ___________________
88Add Lines 78 through 87. This amount is your
total expenses.
89 Subtract Line 88 from Line 77. This amount is your net income after expenses.
89 ___________________
Part I: Complete any additional asset or income information
90Write any additional information you have about your assets or income that was not included in any of the preceding parts. Be sure to include a statement regarding the prospect of any increase in the value of your assets or your present income.
_____________________________________________________________________________________________________________
Section 3: Sign below
Under penalties of perjury, I state that I have examined this statement of assets, liabilities, and other information and, to the best of my knowledge, it is true, correct, and complete.
______________________________________________/___/_____ ______________________________________________/___/_____
Petitioner’s signature (not representative)
Date
Spouse’s signature
Page 4 of 4
This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this information is REQUIRED. Failure to provide information
could result in this form not being processed. This form has been approved by the Forms Management Center.
IL-492-3683
Filling out the Illinois BOA-4 form is a systematic process that requires attention to detail. It is designed to provide a comprehensive overview of an individual's financial information, including assets, liabilities, income, and expenses. To ensure accuracy and completeness, it is crucial to gather all relevant financial documents before beginning the task. Following the step-by-step guide below will help in completing the form correctly.
In Part I, provide any additional asset or income information not covered in previous sections, focusing on the prospect of any increase in future assets or income.
Completing the Illinois BOA-4 form meticulously is vital to ensure all financial details are accurately represented. Double-check each section for completeness and accuracy before submission to prevent any delays or issues. This detailed information helps in assessing financial stands and positions accurately.
What is the Illinois BOA-4 form used for?
The Illinois BOA-4 form, also known as the Financial Information Statement for Individuals, is a document utilized by the Illinois Department of Revenue. It is designed to gather detailed financial information from an individual. This includes personal and employment details, financial assets like bank accounts and real estate, liabilities, income, and expenses. It helps the department assess an individual’s financial situation, which can be critical for various purposes, including tax resolution processes or when determining eligibility for payment plans or other tax-related relief programs.
How do I complete the spouse’s information section if we are separated?
If you are separated from your spouse but not legally divorced, you still need to complete the spouse’s information section on the form. This part requires you to fill out details about your spouse's employment, income, and financial resources. If you are unsure of your spouse’s exact financial details, provide as much information as you currently know and specify that you are separated in the section that asks for your marital status.
What to do if I have more financial accounts than the spaces provided in Section 2, Part A?
If you have more financial accounts than the spaces available in Section 2, Part A of the BOA-4 form, you should attach additional sheets mirroring the format of Part A to list these accounts. Ensure every account is clearly detailed following the same structure, including the type of account, name of institution, address, account number, and balance. Make sure to indicate that these additional sheets are a continuation of Part A on each page.
How do I report income from sources other than employment in Part H?
Part H of the BOA-4 form is designated for reporting your monthly income. Income sources outside of traditional employment should be listed under the "Other" section (Lines 76 and 77). Such income might include dividends, interest payments, rental income, pension, child support, alimony, or any other sources. You need to specify the source alongside the gross and net amounts received from each, ensuring a comprehensive overview of your total net income.
Can I leave any sections blank if they do not apply to me?
Yes, you can leave sections blank on the BOA-4 form if they do not apply to your situation. However, it’s important to review each part carefully and ensure that you’re not overlooking any information that could be relevant to your financial picture. When a section is intentionally left blank because it does not apply, consider writing “N/A” (not applicable) as a clear indication that you have reviewed the section and determined it does not pertain to your circumstances.
What happens if I don’t know the exact figures to report?
If you’re unsure of the exact figures to report on your BOA-4 form, provide the best estimate you can and note that it is an estimate. It's crucial to give the most accurate information possible, but when exact numbers aren’t available, estimated amounts can be used temporarily. Be aware that significantly inaccurate information might lead to the need for clarification or correction in the future, which could delay processing.
Is it mandatory to sign the BOA-4 form?
Yes, signing the BOA-4 form is mandatory. The declaration at the end of the form requires your signature to verify that, to the best of your knowledge, the information provided is true, correct, and complete. Signing the document under penalties of perjury means you are legally attesting to the accuracy of the information within the form. Your spouse must also sign the form if they have been included in any part of the document.
What should I do once I’ve completed the BOA-4 form?
After completing the BOB-4 form, you should double-check all entries to ensure accuracy and completeness. Attach any additional required documents or sheets if you’ve exceeded the space provided in any section. Once fully completed and reviewed, submit the form to the Illinois Department of Revenue following the instructions provided with the form. Make sure to keep a copy for your records and note the submission date in case you need to reference it in future communications.
Filling out the Illinois Department of Revenue BOA-4, a Financial Information Statement for Individuals, requires careful attention to detail. However, errors can occur, compromising the accuracy of the disclosure. Below are some common mistakes to avoid when completing this form:
Avoiding these mistakes is crucial for providing a precise and truthful representation of your financial situation. Take your time, review each section carefully, and ensure all information is current and complete before submission.
The Illinois BOA-4 form, serving as a comprehensive financial information statement for individuals, often necessitates the inclusion of additional documents to provide a complete overview of one's financial health. These supplemental forms and documents play a pivotal role in creating a truthful and accurate depiction of an individual's financial situation, as required under various circumstances such as resolving tax issues or legal matters. Here is an overview of eight such documents commonly used alongside the Illinois BOA-4 form:
Each document plays a critical role in painting a complete financial portrait, as required by the Illinois Department of Revenue or other requesting bodies. When gathered and presented with the Illinois BOA-4 form, these documents collectively bolster the credibility and precision of the financial information being declared. It is crucial for individuals to meticulously prepare and review these documents to ensure compliance and accuracy in their financial disclosures.
The Illinois BoA 4 form, required by the Department of Revenue, demands comprehensive financial information from individuals, closely resembling the detailed financial inquiries seen in Chapter 7 bankruptcy paperwork. When filing for Chapter 7 bankruptcy, individuals must disclose their assets, liabilities, current income, expenditures, and financial transactions over the past two years. This disclosure mirrors the Illinois BoA 4's requirement for detailed financial statements including bank accounts, charge cards, real property, and monthly income and expenses. While the contexts differ—tax matters versus bankruptcy—the depth of financial scrutiny and the necessity of transparency are common threads that bind these documents.
Another document similar to the Illinois BoA 4 form is the IRS Form 433-A, Collection Information Statement for Wage Earners and Self-Employed Individuals. This form also requires taxpayers to reveal in-depth financial data, akin to the BoA 4. It covers the individual’s employment and business information, asset details such as real estate and vehicles, bank accounts, credit card accounts, and living expenses. Both forms serve to assess the individual's financial position to determine their capability to pay debts—tax obligations for the 433-A and various liabilities for the BOA-4. The similar structure in both documents emphasizes a comprehensive analysis of an individual’s financial standing, albeit for differing end goals.
Filling out the Illinois BOA-4 form requires careful attention to detail and accuracy. For those navigating this process, here's a handy guide highlighting essential dos and don'ts.
Do:
Don't:
Filling out the Illinois BOA-4 form carefully and accurately can greatly assist in presenting a clear and accurate picture of your financial situation to the appropriate authorities. Taking the time to double-check your information before submission can save you time and potential issues down the line.
Understanding the Illinois Department of Revenue BOA-4 Financial Information Statement for Individuals can be tricky. There are several misconceptions that people have about this form. Here are ten common ones:
Sorting fact from fiction when filling out the BOA-4 form ensures that individuals provide accurate and comprehensive financial information, which is crucial for any purposes the form may serve.
Filling out and using the Illinois Board of Appeals (BOA) Form 4 can seem intricate at first glance, yet it is a crucial step for individuals who need to provide detailed financial information to the Illinois Department of Revenue. Here are five key takeaways to help navigate this process with ease:
In essence, the Illinois BOA Form 4 is a vital document for individuals required to disclose their financial information to the state. It is a comprehensive tool that covers various aspects of an individual's financial life, from earnings and assets to liabilities and monthly expenses. Handling it with accuracy and transparency is crucial for a truthful representation of one’s financial situation.
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