IRS Form 433-A: Collection Information Statement for Wage Earners and Self-Employed Individuals
Form 433-A is a detailed financial statement for wage earners and self-employed people who owe the IRS. It lists income, expenses, assets and debts in more depth than Form 433-F. A separate version, Form 433-A (OIC), goes with an offer in compromise.
What this form is for
It gives the IRS a full financial picture for collection decisions, including business details for self-employed people.
When people usually use it
It is often requested by an IRS collection employee, or used with larger balances and more involved payment arrangements.
What to have ready
- Pay stubs and business income records
- Bank, retirement and investment statements
- Monthly expense records and loan balances
Notices that mention it
- IRS Notice CP504: Notice of intent to levy
- IRS Letter LT11: Final notice of intent to levy
- IRS Notice CP90: Intent to levy and right to a hearing
Related forms
- Form 433-F: Collection Information Statement
- Form 9465: Installment Agreement Request
- Form 656: Offer in Compromise
Read the IRS page
IRS.gov page for Form 433-A (opens in a new tab). The IRS page is the final word on this form.
Frequently asked questions
What is IRS Form 433-A?
Form 433-A is a detailed financial statement for wage earners and self-employed people who owe the IRS. It lists income, expenses, assets and debts in more depth than Form 433-F. A separate version, Form 433-A (OIC), goes with an offer in compromise.
Where do I get Form 433-A?
Get it from IRS.gov. The IRS page for Form 433-A, https://www.irs.gov/pub/irs-pdf/f433a.pdf, has the latest revision, the instructions and any recent changes.
Do I need to file Form 433-A?
That depends on your own facts. The instructions on IRS.gov explain who uses Form 433-A, and any IRS letter you got may say what it needs from you. This is not tax advice.
What should I have ready for Form 433-A?
Gather: pay stubs and business income records; bank, retirement and investment statements; monthly expense records and loan balances. The instructions on IRS.gov list everything the form asks for.
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