Form 433-A: Collection Information Statement

What is Form 433-A?

Form 433-A is the IRS Collection Information Statement for Wage Earners and Self-Employed Individuals. It provides a detailed snapshot of your financial situation, including income, expenses, assets, and liabilities.

When is it Required?

You'll need Form 433-A when applying for:

• Offer in Compromise (OIC)
• Currently Not Collectible (CNC) status
• Partial Payment Installment Agreement
• Any situation where the IRS needs to verify your ability to pay

Information You'll Need

Personal Information

• Name, address, Social Security number
• Marital status and dependents
• Employer information

Income (Last 3 months)

• Wages, salaries, and tips
• Self-employment income
• Social Security, pensions, disability
• Child support, alimony
• Rental income

Monthly Expenses

• Housing (rent/mortgage, property taxes, insurance)
• Utilities (electric, gas, water, phone, internet)
• Transportation (car payment, insurance, gas, maintenance)
• Health insurance and out-of-pocket medical
• Food and personal care
• Child care and dependent expenses

Assets

• Bank accounts (checking, savings)
• Investments (stocks, bonds, retirement accounts)
• Real estate (primary home, rental properties)
• Vehicles
• Business assets
• Personal property (jewelry, collectibles)

Liabilities

• Credit card balances
• Mortgages and home equity loans
• Auto loans
• Student loans
• Other debts

Tips for Completing Form 433-A

• Be Accurate: The IRS will verify information - incorrect data can delay or deny your request
• Use Allowable Expenses: The IRS has standard allowances for certain expenses - don't underestimate
• Document Everything: Include bank statements, pay stubs, bills, and receipts
• Explain Unusual Circumstances: Use Section 8 to explain special situations
• Keep Copies: Maintain copies of all forms and supporting documents

Common Mistakes to Avoid

• Forgetting to sign and date the form
• Omitting account numbers or financial details
• Not including required supporting documentation
• Underestimating legitimate expenses
• Failing to update information if circumstances change

Ready to Complete Form 433-A?

Use our dashboard tools to gather your information and complete the form accurately.