How to Fill Out Form 433-A: A 2026 Guide With a Worked Example

To fill out Form 433-A, use the June 2026 revision, complete Sections 1 through 5 if you earn wages (Sections 1, 3, 4, 5, 6 and 7 if you are self-employed), answer every line or write N/A, and sign under penalties of perjury. The IRS then compares your monthly income with its Collection Financial Standards to work out what you can pay.

This guide covers how to fill out Form 433-A section by section, when the IRS asks for it, the documents to have ready and how a revenue officer turns your figures into a monthly payment, with figures as of October 2026.

What Form 433-A Is and Which Version to Use

Form 433-A is the Collection Information Statement for Wage Earners and Self-Employed Individuals. The current version is Form 433-A (Rev. 6-2026), an eight-page form in seven sections. Download the current PDF rather than reusing an older copy.

The IRS companion guide, Publication 1854, says the form "is used to obtain current financial information necessary for determining how a wage earner or self-employed individual can satisfy an outstanding tax liability." It lists the people who may need to complete it, including individuals who owe income tax on Form 1040, individuals who may be responsible for a Trust Fund Recovery Penalty, single-member LLC owners whose company is disregarded, and self-employed individuals.

Several IRS forms share the 433 number, and they are not interchangeable:

The Internal Revenue Manual chapter on financial analysis, IRM 5.15.1, says revenue officers may use the shorter Form 433-F for individuals who owe only individual (IMF) liabilities "with an aggregate balance of assessments less than $250,000," and adds that "Form 433-F cannot be used for Offer-in-Compromise cases." If you are preparing an offer, the 433-A (OIC) and its own worksheet apply, and our guide to the offer in compromise process covers that route.

When the IRS Asks for a Collection Information Statement

Many balances never reach this form. According to the IRS payment plans page, an individual may apply online for a long-term plan if "You owe $50,000 or less in combined tax, penalties and interest, and filed all required returns." When a taxpayer cannot meet the minimum online payment, the same page says the IRS will give directions for completing Form 433-H, Form 433-F or Form 433-B.

Form 433-A usually appears once a revenue officer is assigned, for example when the balance is above the online limit, the taxpayer is self-employed, or the taxpayer asks for currently not collectible status. If you are asking for a payment plan on paper, our walkthrough of Form 9465 and installment agreement requests explains the request itself, and this statement supports it.

If you have received a final notice of intent to levy, the deadline to request a hearing runs separately from any financial review. Our guide to Form 12153 and Collection Due Process hearings explains how to preserve that right while you prepare the statement.

How to Fill Out Form 433-A, Section by Section

The form's own instructions say wage earners complete Sections 1, 2, 3, 4 and 5, self-employed individuals complete Sections 1, 3, 4, 5, 6 and 7, and both must "Answer all questions or write N/A if the question is not applicable." Self-employed filers should finish Sections 6 and 7 first, because the business net income feeds into Section 5.

Section 1: Personal information

Enter names, address, marital status and Social Security numbers or ITINs. Line 2c lists everyone else in the household, including whether each person contributes to household income. Line 3 asks about outside business interests, including any stake in an LLC, LLP, corporation or partnership, with your ownership percentage.

Section 2: Employment for wage earners

List each employer, your time there, your occupation and your pay period.

Section 3: Other financial information

This section asks about lawsuits, anticipated increases or decreases in income, bankruptcy filings, trusts, safe deposit boxes and asset transfers. Line 11 asks whether, in the past 10 years, you transferred any asset with a fair market value above $10,000 for less than its full value.

The June 2026 revision also asks about ties outside your current finances. Line 8a asks whether you hold a US passport, line 8b whether you lived outside the US for six months or longer in the past 10 years, and line 8c whether you hold dual citizenship. Line 9a asks whether you are currently incarcerated.

Section 4: Personal assets, foreign and domestic

Report cash on hand and every bank account, including mobile accounts such as PayPal and payroll cards; Publication 1854 says to list accounts "even if there is currently no balance." The section then covers investments including IRAs and 401(k) plans, available credit, life insurance, real estate, vehicles, other personal assets and digital assets, including who has access to your private keys.

Enter assets at current fair market value. IRM 5.15.1 explains that the IRS may then apply a quick sale value (QSV) when it works out your equity, and states: "Generally, the QSV is calculated at 80% of FMV."

Section 5: Monthly income and expenses

Lines 21 to 35 capture gross monthly income from every source. The form's footnotes convert pay to a monthly figure: multiply weekly gross pay by 4.3, biweekly pay by 2.17, and semimonthly pay by 2. Enter gross wages before withholding.

Lines 36 to 49 are living expenses, from food and housing through secured debts, delinquent state or local taxes and other expenses, with the total on line 50. Line 51 is the net difference. An "IRS use only" column records the allowable amount for each line.

Publication 1854's item numbers run one behind the June 2026 form in places (it calls food and clothing item 35, while the form puts it on line 36), so match each instruction to the line label, not the number.

Sections 6 and 7: Self-employed only

Line 52 asks whether the business is a sole proprietorship filing Schedule C. If it is an LLC, partnership or corporation, the owner also completes Form 433-B for the entity. Section 6 lists business accounts, payment processors (including digital currency exchanges), receivables and business assets. Section 7 is the business income and expense statement, and its lines "should reconcile with business Profit and Loss Statement." If net business income is a loss, the form says to enter zero on line 24, never a negative number.

Signing the form

The certification is made under penalties of perjury. For joint liabilities, Publication 1854 says both spouses must sign. If a CPA, enrolled agent or attorney will deal with the revenue officer for you, file a power of attorney first; our guide to Form 8821 and Form 2848 explains the difference between the two authorizations.

Documents to Gather Before You Submit

The form itself warns that after review "you may be asked to provide verification," and names "previously filed income tax returns, pay statements, self-employment records, bank and investment statements, loan statements, bills or statements for recurring expenses." IRM 5.15.1 gives revenue officers a documentation chart. Based on those two sources, a complete package usually includes:

• Wage statements for the prior three months, or a statement with year-to-date figures.
• For self-employed taxpayers, proof of gross income (invoices, receivables, commission statements) for the prior three months and a current profit and loss statement.
• Bank statements for the last three to six months; the IRM recommends "a minimum of six months of statements be secured for business taxpayers."
• Cancelled checks and credit card statements for the last three months.
• Current investment and retirement account statements, and loan statements showing payments and balances.
• Bills for recurring expenses, plus court orders for support payments.
• Proof of any expense you claim above the standard amount.

The IRM also tells revenue officers not to "make a blanket request for information," so requests should fit your case.

How the IRS Turns Form 433-A Into a Monthly Payment

IRM 5.15.1 defines net disposable income as "the difference between gross income and allowable living expenses." Allowable expenses must meet the necessary expense test, meaning they provide for the health and welfare of the taxpayer and family or for the production of income.

The Collection Financial Standards set the caps, and the current set states: "These Standards are effective on June 29, 2026, for purposes of federal tax administration only." Two different rules apply:

• National Standards (food, clothing and other items; out-of-pocket health care). The IRM says taxpayers are allowed these amounts "without questioning the amounts they actually spend." Per Publication 1854, the monthly food, clothing and miscellaneous allowance is $867 for one person, $1,558 for two, $1,857 for three and $2,176 for four, plus $397 for each additional person. Out-of-pocket health care is $90 per person under 65 and $163 per person 65 or older.
• Local Standards (housing and utilities; transportation). The IRS page says "the taxpayer is allowed the amount actually spent, or the local standard, whichever is less." Housing caps are set by county. The transportation standards allow ownership costs of up to $703 a month for one car and $1,406 for two, and $220 a month for public transportation; operating costs vary by region and metro area.

Items such as health insurance, current year taxes, court-ordered payments and child care fall under other necessary expenses, which the IRM says "meet the necessary expense test and normally are allowed," provided the amount is reasonable. For child care, "Only reasonable amounts are allowed." If a standard is too low for a specific household, the IRM directs revenue officers to allow a deviation when the taxpayer provides reasonable substantiation. The IRM also notes that when three months of expenses do not reflect the year, "additional months, up to one year, may be reviewed."

Worked example: monthly ability to pay (illustrative)

The household below is hypothetical. The $1,900 housing cap is made up for an imagined county and is not an IRS figure; the other standards are June 29, 2026 IRS amounts. Check your own county on the IRS housing table. The household has two adults and one child, all under 65, living in a Midwest county outside the metro areas the IRS lists separately, with one financed car. The taxpayer earns $3,400 every two weeks and the spouse earns $1,500 a month.

Gross monthly income is $3,400 x 2.17 = $7,378, plus $1,500, for a total of $8,878.

By the family's own budget, $8,878 minus $7,720 leaves $1,158 a month. The IRS calculation gives $8,878 minus $7,400, or $1,478 a month. The $320 gap comes from the $550 of housing above the made-up cap and the $47 of operating costs above the regional standard, partly offset by the higher national standard amounts ($157 for food and clothing and $120 for health care) that the IRS allows without receipts.

Running this calculation before you sign shows roughly what the revenue officer will propose and which expenses need documents to support a deviation.

Common Mistakes When You Fill Out Form 433-A

• Leaving lines blank. The form asks for an answer or N/A on every line, and blanks invite a follow-up request.
• Using an old revision. An older copy may not match the current questions or line numbers.
• Leaving out accounts with a zero balance, retirement accounts or digital assets. Each has its own line, and the form is signed under penalties of perjury.
• Netting withholding out of wages. Lines 21 and 22 take gross wages; taxes go on line 46.
• Guessing at self-employment income. Reconcile Section 7 to your profit and loss statement and attach an explanation if this year differs from prior years.
• Claiming expenses above the standards without proof. Anything above a cap is treated as available to pay unless you document why it is necessary.

If the balance includes penalties you believe should be removed, a separate request using Form 843 for penalty abatement can reduce what the 433-A has to cover. If a joint balance really belongs to a former spouse, look at innocent spouse relief under Form 8857 before agreeing to pay it. For help choosing who should represent you, see our comparison of a CPA, an EA and a tax attorney.

Frequently Asked Questions

How do I fill out Form 433-A if I am self-employed? Complete Sections 1, 3, 4, 5, 6 and 7, and finish Sections 6 and 7 before Section 5. Your monthly net business income from Section 7 goes on line 24, and Section 7 should reconcile with your profit and loss statement.

Is Form 433-A the same as Form 433-F? No. Form 433-F (Rev. 7-2024) is the shorter statement used by the Automated Collection System and IRS campuses, while revenue officers generally use the fuller Form 433-A (Rev. 6-2026).

Do I need Form 433-A for a payment plan under $50,000? Often not. An individual who owes $50,000 or less in combined tax, penalties and interest and has filed all required returns may apply for a long-term payment plan online, per the IRS payment plans page.

Which Collection Financial Standards apply in October 2026? The set effective June 29, 2026. National Standards are allowed in full regardless of actual spending, while housing, utilities and transportation are allowed at the lesser of actual spending or the local standard.

How many months of bank statements should I attach? IRM 5.15.1 lists three to six months and recommends at least six for business taxpayers. A revenue officer can ask for more.

Next Step

Madras Accountancy supports US CPA firms and their clients with accounting and tax work, including the financial workpapers behind IRS collection cases, such as organized bank statement summaries and income and expense schedules for a Collection Information Statement. To discuss a case or ongoing support, contact our team.