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IRSOther IRS Forms (4000–6999)

Official form guide

Form 433A: 433-A

Form 433‑A is the IRS Collection Information Statement for wage earners and self‑employed individuals. It is used when the IRS asks a taxpayer to disclose financial details to set up a payment plan or an Offer in Compromise.

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Form Overview

IRS Form 433A - 433-A

Form 433‑A is the IRS Collection Information Statement for wage earners and self‑employed individuals. It is used when the IRS asks a taxpayer to disclose financial details to set up a payment plan or an Offer in Compromise.

The form captures monthly income, living expenses, assets (bank accounts, real estate, vehicles) and liabilities.

Risk Radar

Scan points
  • 1A single mis‑typed dollar amount can cause the IRS to reject your payment‑plan request.
  • 2Leaving a required field blank
  • 3Mismatched totals between income and expense sections
  • 4Omitting a bank account or vehicle
  • 5Using outdated asset valuations

Plain English

Think of Form 433‑A as a detailed budget sheet the IRS asks for when you need a payment arrangement. You list income, expenses, assets and debts so the agency can see what you can realistically afford to pay.

Submission Date

  • Filing date: 2022-08-05 22:10:07
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

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Glossary Terms

financialpaymentlivingincomeoffer

Hover a term to preview the meaning.

What this form is for

  • Use when the IRS asks for a Collection Information Statement for an individual.
  • Do not use for business entities; they require Form 433‑B.
  • If you are filing an Offer in Compromise, also complete Form 433‑A as supporting documentation.

Form selector

Use this form or another form?

Business collection case

Captures corporate assets and liabilities

✓ Verify entity type first

Form 433‑B

Installment agreement request without IRS request

Simple payment‑plan request

✓ May not need full 433‑A

Form 9465

Bankruptcy filing

Subset of info for court

✓ Check bankruptcy court requirements

Form 433‑A (Bankruptcy)

Deadline or filing window

The IRS notice that requests Form 433‑A usually specifies a 30‑day response window. If the notice does not give a date, treat the request as urgent and submit within two weeks to avoid automatic denial of your payment‑plan request. Extensions are rarely granted without a written request.

  • —Monthly net income | Sum of wages, self‑employment profit, other income – taxes withheld | Net Income | Verify all sources are included

Checklist

What you need before filling it out

1

Income section

Recent pay stubs or 1099‑MISC · Employer portal or accounting software

⚠ Forgetting a side‑gig income✕ High
2

Expense section

Rent/mortgage statements, utility bills · Lease agreements, utility company statements

⚠ Using outdated rent amount✕ Medium
3

Asset section

Bank statements, vehicle titles · Online banking, DMV records

⚠ Missing a small savings account✕ Low
4

Liability section

Credit card statements, loan statements · Monthly statements

⚠ Omitting a personal loan✕ Medium

Before you submit

  1. 1All required fields completed
  2. 2Totals in income, expense, asset, and liability sections balance
  3. 3Signature and date present
  4. 4Social Security Number matches IRS records
  5. 5Attachments (pay stubs, statements) are legible
  6. 6Form is the 2024 edition
  7. 7Mailing address matches the notice
  8. 8PDF file size under IRS upload limit (if filing online)
  9. 9Copy retained for personal records
  10. 10Cover letter referencing the IRS notice number

How to file this form

  1. 1Read the IRS notice to confirm the request for Form 433‑A.
  2. 2Download the latest 2024 PDF from IRS.gov.
  3. 3Collect income, expense, asset and liability documents.
  4. 4Enter data into each section, using the calculator field for net income.
  5. 5Review totals and sign the form.
  6. 6Mail to the address on the notice or upload via your IRS Online Account.
  7. 7Save a scanned copy of the submitted form and all supporting documents.

Known limitations

  1. 1Form does not calculate eligibility for an Offer in Compromise; a separate analysis is required.
  2. 2IRS may request additional documentation beyond what is listed on the form.
  3. 3The form assumes U.S. residency; non‑resident taxpayers use a different statement.
  4. 4Values are self‑reported; the IRS can audit and adjust figures.

Field map

Compact field-by-field guide

6 fields

General Info

2 items

Taxpayer Name and TIN

Full legal name and taxpayer identification number (SSN or EIN).

Requiredtext
Address

Current mailing address.

Requiredtext

Details

2 items

Required Information

Complete all applicable sections of this form according to the official IRS instructions.

Requiredtext
Amount (if applicable)

Enter the relevant dollar amount if this form involves tax calculation.

amount

Certification

1 items

Certification Statement

Read and acknowledge any certifications required by this form.

Requiredcheckbox

Signatures

1 items

Signature

Sign and date. Unsigned forms cannot be processed.

Requiredsignature
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Current form status
IRS

Form 433‑A is active for the 2024 tax year and remains the standard statement for individual collection cases. No newer replacement has been published as of the latest IRS notice.

What changed or needs a fresh check

  • Edition date: Look for the “2024” revision on the top of the form.
  • Fee: No filing fee for Form 433‑A.
  • Mailing address: Use the address printed on the IRS notice you received.
  • Signature line: Must be signed by the taxpayer or authorized representative.
  • PDF version: Ensure you download the latest PDF from IRS.gov.

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Quick Facts

Taxpayers who owe personal income tax and are negotiating a payment plan or settlement submit this form.
The form captures monthly income, living expenses, assets (bank accounts, real estate, vehicles) and liabilities.
It is filed after the IRS issues a notice requesting a Collection Information Statement; there is no fixed calendar deadline, but the IRS usually expects a response within 30 days.
Submit the completed form to the IRS address listed in the notice, or upload it through the IRS Online Account if you have one.
Errors can lead to a denied payment plan, a higher required payment, or additional penalties.
Gather recent pay stubs, bank statements, mortgage or rent records, and a list of personal property. Fill each section on the paper form or PDF, double‑check totals, sign and date, then mail or upload as instructed. Keep a copy for your records.

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After you file

  1. 1Confirm receipt by checking your IRS Online Account or waiting for a confirmation letter.
  2. 2Track any follow‑up requests for additional documentation.
  3. 3Keep the original form and all attachments for at least three years.
  4. 4Monitor your payment‑plan balance and due dates.
  5. 5If the IRS rejects the form, review the rejection notice and correct the identified errors.
  6. 6Update the form if your financial situation changes significantly.

Sources

  • SRCIRS.gov Form 433‑A pageshows purpose and who files it
  • SRCIRS Notice instructionsspecify 30‑day response window
  • SRCIRS Publication 594explains collection information statements
  • SRCForm headerdisplays 2024 edition date
  • SRCIRS Online Account guidementions upload option
  • SRCNot found in provided source: exact mailing address for 2024 notices
  • SRCNot found in provided source: fee amount (confirmed as none)
  • SRCNot found in provided source: calculator field example (inferred from form layout)

Common confusion points

Income vs. net income

Taxpayers often list gross wages instead of net after taxes

→ Verify net amount on pay stub

Asset valuation

Some think market value is required, but IRS accepts current fair market value

→ Use recent appraisal or online estimate

Self‑employment profit

May be confused with gross receipts

→ Use Schedule C net profit line

Expense categories

Rent vs. mortgage interest can be mixed up

→ Follow IRS instructions for each line

Signature requirement

Some think electronic signature is acceptable for mailed forms

→ Use a handwritten signature unless filing online

Workflow map

Related forms and next steps

5 signals

Before

Receive IRS notice requesting 433‑A

Current

433A

After

IRS reviews and issues payment‑plan approval or denial

Often used with

Form 9465 (Installment Agreement) when setting up a payment planForm 656 (Offer in Compromise) as supporting financial statement

⚠ If something goes wrong

  • File a revised Form 433‑A with corrected data

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Copyright & Licensing - US Government Forms

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Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
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