53 Form 3347 -- Investigation Report of Judgment Debtor

Investigation of Judgment Debtor		Submit in Triplicate
1. Name and Address of Judgment Debtor	2. Judgment Debtor's Age	5. Case Number
	3. Marital Status	6.Judgment Date
	4. Name of Spouse	7. Amount $
8. Dependents

Name	Relationship	Name	Relationship
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________

9. Present Business or Occupation	10. Name and Address of Business or Employer	11. Estimated Annual Income
12. If No Visible Means of Support, Give Opinion of Source of Livelihood
13. Description and Location of Assets Discovered (Include estimated value and amount realizable at forced sale) (Use reverse if needed)
14. Present Financial Condition (Attach statement if secured)
15. Future Prospects of Earnings or Property Acquisitions
16. Records Examined
17. Recommendations (Give reasons on reverse) [ ] Request execution of Judgment [ ] Reinvestigation next year [ ] Close	Revenue Officer (Signature)	Date

Reviewed by (Name and Title)	Date	Approved - Chief SPS	Date
Form 3347 (Rev. 2-79) Use and issue first "Rev. 12-73" Department of the Treasury - Internal Revenue Service