The IRS 433-F form, also known as the Collection Information Statement, is a document used by the Internal Revenue Service to collect financial information from individuals who need to set up a payment plan or resolve a tax debt. This form plays a crucial role in determining an individual's ability to pay, allowing the IRS to assess their financial situation accurately. For those facing tax obligations they are unable to pay in full, clicking the button below to fill out the IRS 433-F form can be the first step towards finding a manageable solution.
When faced with outstanding tax debt, the pathway to resolution can seem daunting for many taxpayers. A key tool in this journey is the IRS 433-F form, a crucial document used by the Internal Revenue Service to assess an individual's financial situation and determine feasible payment plans. This form allows taxpayers to provide detailed information about their income, expenses, and assets, giving the IRS a comprehensive view of their financial health. By accurately completing the 433-F form, individuals can work with the IRS to establish manageable installment agreements or negotiate other payment options that can mitigate the burden of tax debt. Understanding each section of this form is essential, as it directly influences the terms of payment arrangements offered by the IRS. With its significant role in the tax resolution process, the 433-F form exemplifies the importance of transparency and honesty in disclosing financial circumstances to ensure a fair and workable solution is reached.
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 is a critical step for individuals who need to provide the IRS with information about their financial situation, often for the purpose of setting up a payment plan or settling tax debts. This form requires a detailed account of one's income, expenses, assets, and debts. Approaching this task with careful attention to detail will ensure that the information presented to the IRS is accurate and complete, helping to facilitate a smoother interaction with tax authorities. Below are the steps to guide you through completing the IRS 433-F form.
Once the IRS receives and processes your Form 433-F, they will use the information to determine your ability to pay and may propose a payment plan or other arrangements suitable to your financial situation. It's crucial to respond promptly to any correspondence from the IRS and to adhere to the terms of any agreed payment plan. This proactive approach can help manage and resolve tax debts more effectively.
The IRS 433-F form, also known as the Collection Information Statement, is used by the IRS to collect financial information from individuals to determine how they can fulfill their tax liabilities. This form helps the IRS assess an individual's ability to pay by evaluating their monthly income and expenses, as well as their assets and liabilities.
This form is typically requested from individuals who owe taxes and are unable to make immediate payment in full. Filling out the form is a crucial step for those who are seeking to arrange a payment plan or compromise with the IRS to resolve their tax debt. It's also required in cases where the IRS needs to verify financial hardship.
Completing the IRS 433-F requires detailed financial information, including:
Once completed, the IRS 433-F form can be submitted to the IRS in a few different ways depending on the individual's situation. The form can be mailed to the address provided by the IRS, faxed if instructions for faxing are provided, or submitted during a meeting with an IRS representative. It is important to ensure that all information is accurate and complete before submission to avoid delays in processing.
After submission, the IRS will review the information provided on Form 433-F to evaluate your financial situation and determine an appropriate payment plan, offer in compromise, or other resolution to your tax liabilities. The review process can take some time, during which the IRS may also request additional documentation to support the information on your form. Once a decision is made, the IRS will contact you with the details of your payment plan or the resolution proposal. It is crucial to respond promptly and continue to comply with all tax obligations during this period.
Filling out the IRS 433-F form, known as the Collection Information Statement, is an intricate process that requires detailed financial information. This form assists the Internal Revenue Service (IRS) in determining an individual’s ability to pay outstanding tax liabilities. Mistakes during this process can lead to significant delays, misunderstandings with the IRS, or even an unfavorable repayment plan. Below are nine common mistakes people make when completing this form:
Not verifying personal information: Taxpayers often overlook the importance of ensuring that all personal information, including their name, address, and Social Security number, is accurate and current. Inaccuracies in this section can lead to processing delays or misapplied submissions.
Leaving sections incomplete: Every section of the form that applies should be filled out completely. Omissions can result in the IRS lacking critical information needed to make an informed decision regarding the payment plan.
Underestimating expenses: Many individuals fail to report all of their allowable living expenses, which can lead to a less favorable payment arrangement, as the IRS assumes a greater ability to pay than actually exists.
Overstating expenses: Conversely, overstating living expenses can raise red flags with the IRS, potentially leading to a detailed review or audit. Accurate representation of expenses is crucial.
Not including all sources of income: It is vital to report all income sources, as failure to do so can be considered fraudulent. This includes wages, business income, rental income, and any other form of earnings.
Miscalculating asset values: Incorrectly valuing assets, whether intentionally or accidentally, can affect the outcome of the repayment plan. This includes real estate, vehicles, and personal property.
Ignoring tax debts from previous years: Taxpayers sometimes omit older tax debts, either because they are under negotiation or for other reasons. However, including all tax liabilities is necessary for an accurate assessment.
Failure to consider future income changes: If a taxpayer expects significant changes in their financial situation, this should be communicated to the IRS. Substantial upcoming modifications can affect the payment arrangement suitability.
Attempting to fill out the form without understanding its requirements: The IRS 433-F form is complex, and proceeding without a clear understanding of the questions or required documentation often leads to errors. Seeking advice or clarification is advised for those unsure about any aspect of the form.
Avoiding these mistakes can greatly affect the outcome of one's dealings with the IRS. It ensures that the process is smoother, potentially leading to more favorable repayment terms that accurately reflect the taxpayer's financial situation. If there is any uncertainty, consulting with a tax professional is strongly recommended.
When someone is working with the IRS 433-F form, which is used to collect information about an individual's financial status to establish a payment plan or settle tax debt, several other documents may often need to be completed or submitted alongside it. These documents are important because they provide a more comprehensive view of a person's financial situation, helping the IRS make informed decisions regarding payment plans or settlement options.
Collecting and preparing these documents in advance can significantly ease the process of completing the IRS 433-F form. Each of these documents plays a pivotal role in painting a complete and accurate picture of a person's financial capabilities and obligations, ensuring that any arrangement made with the IRS is fair and achievable based on the individual’s unique financial situation.
IRS 433-A: This document, much like the IRS 433-F, is used to collect financial information from individuals, but it is specifically tailored for those who are self-employed or own a sole proprietorship. Both forms serve the essential purpose of determining the taxpayer's ability to pay outstanding tax debts, making them fundamentally similar in their objectives and the type of information they request.
IRS 433-B: Similar to the 433-F form, the 433-B is designed for businesses rather than individuals. It collects financial information to help the IRS determine how a business can settle its tax liabilities. The similarity lies in their purpose to assess financial situations and work out a feasible payment plan or settlement for taxes owed.
Form 9465: This form is used to request a monthly installment plan if you can’t pay the full amount you owe shown on your tax return. While Form 9465 sets up the payment plan, IRS 433-F provides the financial information necessary to determine what that payment plan will look like. They are often used in conjunction, highlighting their synergistic roles in resolving tax debts.
Form 656: Known as an offer in compromise, Form 656 allows taxpayers to settle their tax debt for less than the full amount owed. The IRS 433-F is often a prerequisite for Form 656, as it offers a detailed account of the taxpayer's financial situation, thereby demonstrating their inability to pay the full debt. This relationship underscores their similarity in facilitating tax debt resolution.
Form 1040: Although primarily a tax return form, IRS Form 1040 may require additional information from IRS 433-F when there are discrepancies or when a taxpayer is setting up a payment plan. Both forms are integral to the tax filing and resolution process, with the 433-F supplementing the 1040 by providing a fuller picture of the taxpayer's financial ability.
Bankruptcy Forms (Chapter 7 & 13): When filing for bankruptcy, individuals must disclose their financial status comprehensively. The IRS 433-F shares a similar purpose, as it also aims to paint a complete picture of one’s financial situation to evaluate the ability to pay debts, including taxes. The overlap in financial disclosure makes these documents comparable in their utilization.
Financial Statement for Businesses: Just as the IRS 433-F collects financial information from individuals and sole proprietors, a standard business financial statement gathers detailed financial information about a company. Both types of documents are used to assess financial health and operating capacity, making them inherently similar in their functions and objectives.
Credit Application: When applying for credit, individuals must often provide detailed financial information similar to that required on the IRS 433-F form. Both documents assess financial stability and the ability to meet financial obligations, thus serving comparable purposes from the perspective of evaluating financial health and responsibility.
Filling out the IRS 433-F form, also known as the Collection Information Statement, is an important step in resolving your tax obligations and setting up a payment plan with the Internal Revenue Service (IRS). Paying attention to the details and providing accurate information can significantly impact the outcome of your request. Below are eight key dos and don'ts to keep in mind when completing this form.
The IRS 433-F form, often required for setting up payment plans or resolving tax debt issues, is surrounded by misconceptions. Understanding these can provide clarity and ease the stress associated with tax obligations.
Only individuals can use the 433-F form: This statement is incorrect. The IRS 433-F form is not solely for individual use; businesses facing difficulty in paying their taxes can also use this form to communicate their financial situation to the IRS.
Completing the 433-F form will automatically lead to an Offer in Compromise approval: While the 433-F form is a step in the process, it is not a guarantee of an Offer in Compromise. The IRS evaluates each situation based on comprehensive criteria including ability to pay, income, expenses, and asset equity.
Only those with a business can file the 433-F form: This is a misconception. Both individuals and business owners can file this form. Its purpose is to help the IRS understand the filer's financial situation, whether personal or business-related.
Information provided in the 433-F form doesn't affect future tax years: The information you provide can affect future dealings with the IRS. For instance, it can influence your eligibility for future payment plans or settlements.
Filing a 433-F form means you don't have to pay taxes: This is untrue. Submitting this form is part of the process to find a manageable way to fulfill your tax obligations, not to exempt you from paying taxes.
The 433-F form is only for disclosing financial hardships: While financial hardship is a significant reason for submitting this form, it's also used to provide a comprehensive snapshot of your financial situation, which includes income, assets, expenses, and liabilities, not just hardships.
Submitting the 433-F form will halt all IRS collection activities: Although submitting the form can lead to a temporary pause in collection activities (like levies or garnishments) while the IRS reviews your situation, it is not a permanent solution to stop collection efforts.
You need a tax professional to fill out the 433-F form: While seeking assistance from a tax professional can be beneficial, especially in complex cases, individuals can complete and submit the form on their own. The IRS provides instructions and resources to help filers.
The 433-F form is the same as the 433-A or 433-B forms: Although similar in purpose, the 433-F form is distinct from the 433-A (OIC) and 433-B (OIC) forms, which are used specifically for Offers in Compromise for individuals and businesses, respectively. The 433-F serves a broader purpose and is often used in initial contacts with the IRS regarding payment agreements.
Understanding these misconceptions can provide a clearer view of the IRS 433-F form and its role in managing tax obligations. This knowledge can lead to more informed decisions and potentially smoother interactions with the IRS.
The IRS 433-F form, known as the Collection Information Statement, plays a crucial role in negotiations with the IRS regarding payment plans and resolving outstanding tax liabilities. Accurate and thoughtful completion of this form can significantly impact an individual's or business's financial dealings with the IRS. Below are key takeaways to consider when filling out and utilizing the IRS 433-F form:
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