A771 2026

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  1. Click ‘Get Form’ to open the a771 document in the editor.
  2. Begin with Part A: Proposed Payment Plan. Enter your desired payment amount, select the frequency (Monthly, Bi-weekly, Weekly), and specify the first payment date.
  3. In Part B: Your Information, fill in your name, date of birth, mailing address, SSN, phone number, city, state, and zip code. Don’t forget to list your dependents' names and ages.
  4. Complete details about your employment in the same section by providing your employer's name, phone number, job title/position, gross income, and net income.
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Tablets USP 4 mg tablets are supplied as a green, round tablet scored on one side and debossed A over 771 on the other side.
The pill with imprint A 771 (Green, Round, 6mm) has been identified as 4 mg and is used for Adrenal Insufficiency, Addisons Disease, Adrenogenital Syndrome, Adrenocortical Insufficiency, and Allergic Rhinitis. It belongs to the drug class glucocorticoids and is not a controlled substance.
The 0.5 mg tablets are yellow, approximately 7.93 mm, round, biconvex tablet debossed with 0.5 on one side and score on the other side. The 1 mg tablets are light green, approximately 7.93 mm, round, biconvex tablet debossed with 1 on one side and score on the other side.
The pill with imprint 771 (White, Round, 0mm) has been identified as Acetaminophen 325 mg and is used for Sciatica, Muscle Pain, Chronic Pain, Back Pain, and Headache.
Request a payment plan by doing one of the following: Submit request online through My Tax Account. Register or log in to My Tax Account. Add access to your accounts and request a payment plan by selecting Manage My Collection. Mail, fax, or email the Payment Plan Request form.
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Tablets USP 4 mg tablets are supplied as a green, round tablet scored on one side and debossed A over 771 on the other side. Store at 20 to 25C (68 to 77F) [see USP Controlled Room Temperature].

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