The IRS 433-F form, also known as the Collection Information Statement, is a tool used by the Internal Revenue Service to collect financial information from individuals who need to arrange payment plans or settle tax debts. This comprehensive document is crucial for individuals seeking to understand their financial standing and negotiate terms with the IRS effectively. For those ready to take the first step towards resolving their tax issues, simply click the button below to begin filling out your form.
When individuals find themselves facing financial difficulties with the Internal Revenue Service (IRS), the 433-F form emerges as a critical document. This form, essentially a financial statement, allows people to express their financial situation in detail to the IRS. Its primary role is to provide the IRS with the necessary information to assess an individual’s ability to pay back taxes. From income and expenses to assets and liabilities, the 433-F covers a broad spectrum of financial data. This extensive documentation process seeks to strike a balance between what taxpayers can afford to pay and their outstanding tax obligations. By completing this form with accuracy and thoroughness, individuals open the door to potential payment plans or settlements with the IRS, making it a pivotal step in resolving tax debts. The process of filling out the 433-F can seem daunting at first glance; however, understanding its components and their importance can significantly alleviate this challenge, setting a clear path toward financial resolution with the IRS.
Form 433-F
(February 2019)
Department of the Treasury - Internal Revenue Service
Collection Information Statement
Name(s) and Address
Your Social Security Number or Individual Taxpayer Identification Number
Your Spouse’s Social Security Number or Individual Taxpayer Identification Number
If address provided above is different than last return filed,
Your telephone numbers
Spouse’s telephone numbers
please check here
Home:
County of Residence
Work:
Cell:
Enter the number of people in the household who can be claimed on this year’s tax return including you and your spouse. Under 65
65 and Over
If you or your spouse are self employed or have self employment income, provide the following information:
Name of Business
Business EIN
Type of Business
Number of Employees (not counting owner)
A. ACCOUNTS / LINES OF CREDIT
PERSONAL BANK ACCOUNTS Include checking, online, mobile (e.g., PayPal), savings accounts, money market accounts. (Use additional sheets if necessary.)
Name and Address of Institution
Account Number
Type of Account
Current
Balance/Value
Check if
Business Account
INVESTMENTS Include Certificates of Deposit, Trusts, Individual Retirement Accounts (IRAs), Keogh Plans, Simplified Employee Pensions, 401(k) Plans, Profit Sharing Plans, Mutual Funds, Stocks, Bonds, Commodities (Silver, Gold, etc.), and other investments. If applicable, include business accounts. (Use additional sheets if necessary.)
VIRTUAL CURRENCY (CRYPTOCURRENCY) List all virtual currency you own or in which you have a financial interest (e.g., Bitcoin, Ethereum, Litecoin, Ripple, etc.). (Use additional sheets if necessary.)
Type of Virtual Currency
Name of Virtual Currency Wallet,
Exchange or Digital Currency
Exchange (DCE)
Email Address Used to Set-up
With the Virtual Currency
Exchange or DCE
Location(s) of Virtual Currency (Mobile Wallet, Online, and/or External Hardware storage)
Virtual Currency
Amount and Value in US dollars as of today (e.g., 10 Bitcoins $64,600 USD)
B. REAL ESTATE Include home, vacation property, timeshares, vacant land and other real estate. (Use additional sheets if necessary.)
Description/Location/County
Monthly Payment(s)
Financing
Current Value
Balance Owed
Equity
Year Purchased
Purchase Price
Primary Residence
Other
Year Refinanced
Refinance Amount
C. OTHER ASSETS Include cars, boats, recreational vehicles, whole life policies, etc. Include make, model and year of vehicles and name of Life Insurance company in Description. If applicable, include business assets such as tools, equipment, inventory, etc. (Use additional sheets if necessary.)
Description
Monthly Payment Year Purchased Final Payment (mo/yr) Current Value
/
D. CREDIT CARDS (Visa, MasterCard, American Express, Department Stores, etc.)
Type
Credit Limit
Minimum Monthly Payment
TURN PAGE TO CONTINUE
Catalog Number 62053J
www.irs.gov
Form 433-F (Rev. 2-2019)
Page 2 of 4
E. BUSINESS INFORMATION Complete E1 for Accounts Receivable owed to you or your business. (Use additional sheets if necessary.) Complete E2 if you or your business accepts credit card payments. Include virtual currency wallet, exchange or digital currency exchange.
E1. Accounts Receivable owed to you or your business
Name
Address
Amount Owed
List total amount owed from additional sheets
Total amount of accounts receivable available to pay to IRS now
E2. Name of individual or business on account
Credit Card
(Visa, Master Card, etc.)
Issuing Bank Name and Address
Merchant Account Number
F. EMPLOYMENT INFORMATION If you have more than one employer, include the information on another sheet of paper. (If attaching a copy of current pay stub, you do not need to complete this section.)
Your current Employer (name and address)
How often are you paid (check one)
Weekly
Biweekly
Semi-monthly
Monthly
Gross per pay period
Taxes per pay period (Fed)
(State)
(Local)
How long at current employer
Spouse’s current Employer (name and address)
G. NON-WAGE HOUSEHOLD INCOME List monthly amounts. For Self-Employment and Rental Income, list the monthly amount received after expenses or taxes and attach a copy of your current year profit and loss statement.
Alimony Income
Child Support Income
Net Self Employment Income
Net Rental Income
Unemployment Income
Pension Income
Interest/Dividends Income
Social Security Income
Other:
H. MONTHLY NECESSARY LIVING EXPENSES List monthly amounts. (For expenses paid other than monthly, see instructions.)
1. Food / Personal Care See instructions. If you do not spend more than
4. Medical
Actual Monthly
IRS Allowed
the standard allowable amount for your family size, fill in the Total amount
Health Insurance
Expenses
only.
Out of Pocket Health Care
Food
Total
Housekeeping Supplies
Clothing and Clothing Services
5. Other
Personal Care Products & Services
Miscellaneous
Child / Dependent Care
Estimated Tax Payments
2. Transportation
Term Life Insurance
Retirement (Employer Required)
Gas / Insurance / Licenses /
Retirement (Voluntary)
Parking / Maintenance etc.
Union Dues
Public Transportation
Delinquent State & Local Taxes
(minimum payment)
3. Housing & Utilities
Student Loans (minimum
payment)
Rent
Court Ordered Child Support
Electric, Oil/Gas, Water/Trash
Court Ordered Alimony
Telephone/Cell/Cable/Internet
Other Court Ordered Payments
Real Estate Taxes and Insurance
Other (specify)
(if not included in B above)
Maintenance and Repairs
Under penalty of perjury, I declare to the best of my knowledge and belief this statement of assets, liabilities and other information is true, correct and complete.
Your signature
Spouse’s signature
Date
Page 3 of 4
Instructions for Form 433-F, Collection Information Statement
What is the purpose of Form 433F?
Form 433-F is used to obtain current financial information necessary for determining how a wage earner or self-employed individual can satisfy an outstanding tax liability.
Note: You may be able to establish an Online Payment Agreement on the IRS web site. To apply online, go to https://www.irs.gov, click on “I need to pay my taxes,” and select “Installment Agreement” under the heading “What if I can't pay now?”
If you are requesting an Installment Agreement, you should submit Form 9465, Installment Agreement Request, along with Form 433-F. (A large down payment may streamline the installment agreement process, pay your balance faster and reduce the amount of penalties and interest.
Please retain a copy of your completed form and supporting documentation. After we review your completed form, we may contact you for additional information. For example, we may ask you to send supporting documentation of your current income or substantiation of your stated expenditures.
If any section on this form is too small for the information you need to supply, please use a separate sheet.
Section A – Accounts / Lines of Credit
List all accounts, even if they currently have no balance. However, do not enter bank loans in this section. Include business accounts, if applicable. If you are entering information for a stock or bond, etc. and a question does not apply, enter N/A.
Section B – Real Estate
List all real estate you own or are purchasing including your home. Include insurance and taxes if they are included in your monthly payment. The county/description is needed if different than the address and county you listed above. To determine equity, subtract the amount owed for each piece of real estate from its current market value.
Section C – Other Assets
List all cars, boats and recreational vehicles with their make, model and year. If a vehicle is leased, write “lease” in the “year purchased” column. List whole life insurance policies with the name of the insurance company. List other assets with a description such as “paintings”, “coin collection”, or “antiques”. If applicable, include business assets, such as tools, equipment, inventory, and intangible assets such as domain names, patents, copyrights, etc. To determine equity, subtract the amount owed from its current market value. If you are entering information for an asset and a question does not apply, enter N/A.
Section D – Credit Cards
List all credit cards and lines of credit, even if there is no balance owed.
Section E – Business Information
Complete this section if you or your spouse are self-employed, or have self-employment income. This includes self-employment income from online sales.
E1: List all Accounts Receivable owed to you or your business. Include federal, state and local grants and contracts.
E2: Complete if you or your business accepts credit card payments (e.g., Visa, MasterCard, etc.) and/or virtual currency wallet, exchange or digital currency exchange.
Section F – Employment Information
Complete this section if you or your spouse are wage earners.
If attaching a copy of current pay stub, you do not need to complete this section.
Section G – Non-Wage Household Income
List all non-wage income received monthly.
Net Self-Employment Income is the amount you or your
spouse earns after you pay ordinary and necessary monthly business expenses. This figure should relate to the yearly net profit from Schedule C on your Form 1040 or your current year profit and loss statement. Please attach a copy of Schedule C or your current year profit and loss statement. If net income is a loss, enter “0”.
Net Rental Income is the amount you earn after you pay ordinary and necessary monthly rental expenses. This figure should relate to the amount reported on Schedule E of your Form 1040.
Do not include depreciation expenses. Depreciation is a non-cash expense. Only cash expenses are used to determine ability to pay).
If net rental income is a loss, enter “0”.
Other Income includes distributions from partnerships and subchapter S corporations reported on Schedule K-1, and from limited liability companies reported on Form 1040, Schedule C, D or E. It also includes agricultural subsidies, gambling income, oil credits, and rent subsidies. Enter total distributions from IRAs if not included under Pension Income.
Section H – Monthly Necessary Living Expenses
Enter monthly amounts for expenses. For any expenses not paid monthly, convert as follows:
If a bill is paid …
Calculate the monthly
amount by …
Quarterly
Dividing by 3
Multiplying by 4.3
Biweekly (every two
Multiplying by 2.17
weeks)
Semimonthly (twice
Multiplying by 2
each month)
Page 4 of 4
For expenses claimed in boxes 1 and 4, you should provide the IRS allowable standards, or the actual amount you pay if the amount exceeds the IRS allowable standards. IRS allowable standards can be found by accessing https://www.irs.gov/ businesses/small-businesses-self-employed/collection-financial- standards.
Substantiation may be required for any expenses over the standard once the financial analysis is completed.
The amount claimed for Miscellaneous cannot exceed the standard amount for the number of people in your family. The miscellaneous allowance is for expenses incurred that are not included in any other allowable living expense items. Examples are credit card payments, bank fees and charges, reading material and school supplies.
If you do not have access to the IRS web site, itemize your actual expenses and we will ask you for additional proof, if required. Documentation may include pay statements, bank and investment statements, loan statements and bills for recurring expenses, etc.
Housing and Utilities – Includes expenses for your primary residence. You should only list amounts for utilities, taxes and insurance that are not included in your mortgage or rent payments.
Rent – Do not enter mortgage payment here. Mortgage payment is listed in Section B.
Transportation – Include the total of maintenance, repairs, insurance, fuel, registrations, licenses, inspections, parking, and tolls for one month.
Public Transportation – Include the total you spend for public transportation if you do not own a vehicle or if you have public transportation costs in addition to vehicle expenses.
Medical – You are allowed expenses for health insurance and out-of-pocket health care costs.
Health insurance – Enter the monthly amount you pay for yourself or your family.
Out-of-Pocket health care expenses – are costs not
covered by health insurance, and include:
•Medical services
•Prescription drugs
•Dental expenses
•Medical supplies, including eyeglasses and contact lenses. Medical procedures of a purely cosmetic nature, such as plastic surgery or elective dental work are generally not allowed.
Child / Dependent Care – Enter the monthly amount you pay for the care of dependents that can be claimed on your Form 1040.
Estimated Tax Payments – Calculate the monthly
amount you pay for estimated taxes by dividing the quarterly amount due on your Form 1040ES by 3.
Life Insurance – Enter the amount you pay for term life insurance only. Whole life insurance has cash value and should be listed in Section C.
Delinquent State & Local Taxes – Enter the minimum
amount you are required to pay monthly. Be prepared to provide a copy of the statement showing the amount you owe and if applicable, any agreement you have for monthly payments.
Student Loans – Minimum payments on student loans for the taxpayer’s post-secondary education may be allowed if they are guaranteed by the federal government. Be prepared to provide proof of loan balance and payments.
Court Ordered Payments – For any court ordered
payments, be prepared to submit a copy of the court order portion showing the amount you are ordered to pay, the signatures, and proof you are making the payments. Acceptable forms of proof are copies of cancelled checks or copies of bank or pay statements.
Other Expenses not listed above – We may allow
other expenses in certain circumstances. For example, if the expenses are necessary for the health and welfare of the taxpayer or family, or for the production of income. Specify the expense and list the minimum monthly payment you are billed.
Filling out the IRS 433-F form can feel overwhelming at first glance, but it's a crucial step in ensuring that you accurately communicate your financial situation to the Internal Revenue Service. This form is typically used for those who are setting up a payment plan or proving financial hardship. By providing detailed information about your income, expenses, and liabilities, you're allowing the IRS to work with you in finding an appropriate solution. The process of completing the form is straightforward if you take it one step at a time, ensuring accuracy in every detail you provide. Follow these steps to accurately complete the IRS 433-F form.
With the submission of your IRS 433-F form, you've taken a significant step towards addressing your tax situation. The IRS will review the information provided to understand your financial standing and make determinations regarding your payment plan or need for other forms of relief. Remember, transparency and accuracy in completing this form are essential. If your financial situation changes after submitting the form, it's important to inform the IRS to adjust your plan or agreement accordingly. The goal is to establish a feasible solution that considers your current financial capabilities.
What is the IRS 433-F form used for?
The IRS 433-F form, known as the Collection Information Statement, is used by individuals to provide their financial information to the Internal Revenue Service (IRS). This includes details about their income, expenses, and assets. The purpose of the form is to help the IRS understand the taxpayer's financial situation to determine a suitable payment plan or settlement for outstanding taxes. It is often required when setting up an installment agreement or negotiating an offer in compromise.
Who needs to fill out the IRS 433-F form?
Not every taxpayer will be required to complete the IRS 433-F form. It is primarily requested by the IRS from those who owe taxes and are seeking to arrange a payment plan or reduce their tax liability but cannot pay their debt in full immediately. If you're facing financial hardship and cannot settle your tax debt, the IRS may ask you to provide your financial information through this form. It's crucial to provide accurate and complete information to secure a feasible payment solution.
How can I obtain an IRS 433-F form?
The IRS 433-F form is accessible through the IRS website. Taxpayers can download and print the form for completion. Alternatively, individuals may also request a physical copy by contacting the IRS directly by phone or mail. The IRS also provides the form to taxpayers during personal interactions, such as IRS office visits or audits when deemed necessary by an IRS officer.
What information is required on the IRS 433-F form?
When completing the IRS 433-F form, individuals are required to provide comprehensive details regarding their financial status. This includes personal information, employment data, bank account balances, investment information, available credit, life insurance, real and personal property details, monthly income, and living expenses. Each category must be filled out thoroughly, as this information will influence the IRS's decision-making regarding payment plans or settlements. Omitting or inaccurately reporting information can result in penalties or the rejection of submitted plans.
What should I do if I cannot pay the full amount of my tax debt?
If you find yourself unable to pay the full amount of your tax debt, it's important to contact the IRS as soon as possible to discuss your situation. Submitting a completed IRS 433-F form is a critical step in this process, as it provides the IRS with the necessary information to assess your financial situation. Based on the furnished details, the IRS may offer you an installment agreement, temporarily delay collection, or even settle for less than the full amount owed if you qualify for an offer in compromise. Engaging with the IRS proactively and honestly can lead to manageable solutions that can help alleviate financial stress.
Filling out the IRS 433-F form, also known as the Collection Information Statement, is a step that requires careful attention. This document helps the IRS assess an individual's financial situation for setting up payment plans or compromise agreements. However, many people make errors that can have significant consequences. Here are seven common mistakes to be cautious of:
Not providing complete information: Every section of the form should be filled out thoroughly. Leaving sections blank or partially completed can lead to delays or a denial of your payment plan request.
Failing to account for all income sources: It's critical to include all income streams, not just your primary job. This includes part-time jobs, freelance work, and any other income sources. Underreporting income can lead to accusations of fraud.
Underestimating expenses: Many people underreport their monthly expenses, either intentionally or by mistake. It's imperative to include all living expenses to accurately depict your financial situation. Neglecting to do so may result in an unaffordable payment plan.
Not listing all assets and liabilities: The form requires a detailed accounting of your assets (property, vehicles, savings) and liabilities (mortgages, loans, credit card debt). Inaccuracies or omissions can affect the IRS's determination of your ability to pay.
Overlooking the importance of documentation: The IRS may require documentation to support the figures reported on the form. Failing to provide necessary documentation can halt the process.
Using outdated information: Financial situations can change frequently. Therefore, it's important to use the most current and accurate information available to you at the time you fill out the form.
Attempting to hide information: Attempting to be less than forthcoming with the IRS is a grave mistake. It's essential to be honest and complete in your disclosures to avoid potential legal consequences.
Avoiding these mistakes can help streamline the process and lead to a more favorable outcome with the IRS. It's also beneficial to seek advice from a tax professional if you have any doubts or questions while completing the form.
The IRS Form 433-F, Collection Information Statement, is a tool used by the Internal Revenue Service to collect financial information from individuals. This form helps determine how these individuals can fulfill their tax obligations. When submitting the IRS 433-F, it's often necessary to include additional forms and documents to provide a complete picture of one's financial situation. These additional materials ensure that the IRS has all the relevant details to make informed decisions regarding payment plans or settlements.
Accurately completing and submitting the IRS Form 433-F along with these supporting documents is a critical step in addressing tax liabilities. This process demonstrates to the IRS the taxpayer's current financial situation, facilitating a more straightforward negotiation of payment plans or offering in compromise settlements. It's always recommended to consult with a tax professional or advisor to ensure compliance and accuracy in the submission process.
IRS 433-A (OIC) - This form is used for individuals who want to settle their tax debt for less than the full amount they owe through an Offer in Compromise (OIC). Like the 433-F, the 433-A (OIC) collects detailed information about your financial situation, including income, expenses, and assets, to determine your ability to pay. The main difference is that the 433-A (OIC) is specifically for the OIC program, while the 433-F is more generally used for payment agreements or determining collection potential.
IRS 433-B (OIC) - Similar to the 433-A (OIC) but designed for businesses, the 433-B (OIC) form collects financial data from businesses that are offering to settle their tax debts. It includes sections for detailing business assets, liabilities, income, and expenses. The 433-F can also be used by self-employed individuals as a means to provide their business information, making these forms closely related in purpose and content.
IRS 9465 (Installment Agreement Request) - This form is used to request a monthly payment plan if you cannot pay the full amount of taxes you owe. While the 9465 itself doesn’t require the detailed financial data of the 433-F, it often must be accompanied by the 433-F to provide the IRS with enough information to establish an appropriate payment amount. Essentially, the 9465 tells the IRS you want to make payments, and the 433-F shows them how much you can afford.
Form 656 (Offer in Compromise) - This is the form you use to apply for an Offer in Compromise, a program that allows you to settle your tax debt for less than the amount you owe. While Form 656 is the application itself, it's frequently submitted alongside Form 433-A (OIC) or 433-B (OIC), depending on whether it's an individual or business applying. While not the same as the 433-F, they are part of the same process of negotiating tax debts based on an analysis of the debtor's financial situation.
Form 1040 (U.S. Individual Income Tax Return) - While primarily known as the standard form for filing annual income tax returns, the Form 1040 details your annual income, tax deductions, and credits, which can be crucial background information when filling out the 433-F for a payment plan or OIC. Information from a completed 1040 forms the foundation for understanding your financial situation, making it simpler to accurately complete the 433-F and properly report your ability to pay tax debts.
The IRS Form 433-F, a Collection Information Statement, is used by individuals to provide their financial information to the Internal Revenue Service (IRS). This information helps in setting up payment plans or resolving tax liabilities through various programs. When filling out this form, certain practices should be followed to ensure the process aids in resolving your tax matter effectively. Below are things you should and shouldn’t do while filling out the IRS 433-F form.
What you should do:
Provide accurate and complete information: Ensure every detail you provide about your finances, including income, expenses, and assets, is accurate. This will help the IRS understand your situation better and make appropriate decisions regarding your tax liabilities.
Gather necessary documents beforehand: Before filling out the form, collect all relevant financial documents such as pay stubs, bank statements, bills, and any other information about your assets and liabilities. This preparation makes the process smoother and ensures accuracy.
Review IRS guidelines: Understanding the instructions and guidelines provided by the IRS for filling out Form 433-F can be very helpful. It ensures that you fill out the form correctly and in accordance with what is expected by the IRS.
Consider seeking professional advice: If you find the form complicated or your financial situation is complex, consider getting help from a tax professional. They can provide valuable guidance and ensure that the form is filled out properly, maximizing your chances of a favorable outcome.
What you shouldn't do:
Omit information: Leaving out details about your income, expenses, or debts can result in an incomplete picture of your financial situation, potentially leading to unfavorable decisions regarding your case.
Estimate values: Guessing or providing approximate values of your assets, income, or liabilities can lead to inaccuracies on your form. It’s important to provide precise numbers based on your financial documents.
Ignore deadlines: Once you're in communication with the IRS regarding your tax liabilities, they may set deadlines for submitting Form 433-F. Missing these deadlines can result in penalties or complicate your situation further.
Fail to follow up: After submitting the form, stay proactive in your communication with the IRS. If there are any requests for additional information or clarification, address them promptly to keep the process moving forward.
The IRS 433-F form, often surrounded by myths and misconceptions, serves as a crucial tool for individuals and businesses alike in providing the Internal Revenue Service (IRS) with detailed financial information. This information aids in establishing payment plans or settlements for outstanding taxes. Let's clear up some common misunderstandings about this form.
The IRS 433-F form, also known as the Collection Information Statement, is used by the IRS to collect financial information from individuals who need to set up a payment plan or resolve other tax issues. Understanding how to fill out and use this form correctly can significantly affect your tax resolution process. Here are eight key takeaways to guide you:
By following these guidelines, taxpayers can more accurately and confidently complete the IRS 433-F form, potentially leading to a more favorable resolution with the IRS. Remember, if you find the process overwhelming, consider seeking help from a tax professional who can provide guidance based on your specific situation.
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