IRS · United States

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Form 433-F: Collection Information Statement

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JustFill is not affiliated with IRS. This is an independent third-party tool to help you complete Form 433-F. Always download the current blank form from the official source and verify your completed copy before signing or submitting. Official Form 433-F from IRS

Quick answer

Form 433-F (Rev. 7-2024), Collection Information Statement, is the financial statement the IRS requests when you owe tax and cannot pay in full. It lists your accounts, assets, debts, income and monthly expenses so the IRS can see what you can pay, or find you currently not collectible. Attach it to Form 9465 if you owe over $50,000 or offer less than the balance divided by 72; otherwise send it to the address or fax on your IRS notice. JustFill makes the blank IRS PDF fillable so you can type your figures; the first clean completed download is included at no charge.

Form
Form 433-F
Issued by
IRS
Country
United States
Free allowance
Watermarked preview (hand-filled PDFs up to 1 page)
Official edition
Rev. 7-2024 (July 2024), Catalog Number 62053J
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What is Form 433-F?

Form 433-F is the shorter Collection Information Statement the IRS (and its Automated Collection System) uses to evaluate a taxpayer's ability to pay a tax debt. Its sections A–H cover bank and investment accounts, digital assets such as cryptocurrency, real estate, vehicles and other assets, credit cards, business receivables, employment, non-wage income and monthly living expenses. The expense table has an "Actual" and an "IRS Allowed" column: for food/personal care and medical you enter the IRS Collection Financial Standards (currently effective June 29, 2026) unless you pay more and can prove it, and housing and transportation are limited to the local standard or what you actually spend, whichever is less. The IRS compares your income to those allowed expenses to set an installment amount or determine that you are currently not collectible. Because the numbers determine your monthly payment, clarity counts. JustFill lets you complete the 433-F online so every income, expense and asset figure is legible before you send it.

Download the Form 433-F form PDF — free

The official Form 433-F (Rev. 7-2024) PDF, with its instructions on pages 3–4, is free at irs.gov/pub/irs-pdf/f433f.pdf. If the IRS asked you for one, open the blank in JustFill to type your accounts, income and expenses cleanly, then download it and send it the way your notice or Form 9465 directs — the first clean completed download is included at no charge.

Get the official Form 433-F PDF from IRS

Who fills out Form 433-F?

  • Taxpayers attaching it to Form 9465 because they owe more than $50,000, or propose a monthly payment below line 10 (the balance divided by 72) that they cannot raise
  • People applying for currently-not-collectible (hardship) status
  • Taxpayers responding to an IRS Automated Collection System request
  • Tax professionals preparing a collection statement on a client's behalf
  • Taxpayers with an existing installment agreement whose CP522 notice asks for updated finances — the IRS takes the completed 433-F figures over the phone

Field-by-field breakdown

What each section of Form 433-F asks for. JustFill’s AI will detect these fields automatically when you upload the PDF — review the breakdown below so you know what to enter.

Personal & contact information

Name, address, SSN or ITIN for you and your spouse, phone numbers, county of residence, how many household members can be claimed on this year's return (under 65 and 65 and over), and, if self-employed, the business name, EIN, type and number of employees.

Bank & investment accounts

Section A: every checking, savings, online or mobile (PayPal-type) account and every investment (CDs, IRAs, 401(k)s, stocks, bonds, mutual funds), even at a zero balance, with institution, account number, type and current balance. Digital assets need the wallet or exchange, the email used to open it, where they are held and today's U.S.-dollar value. Bank loans do not go here.

Real estate & assets

Sections B and C: each property (primary residence or other) with monthly payment, purchase and refinance years and amounts, current value, balance owed and equity; then vehicles (make, model, year — write "lease" if leased), boats, whole-life policies and business assets. Equity is current market value minus what you owe.

Income

Section F asks for employer, pay frequency, gross pay and tax withheld per pay period for you and your spouse — or skip it and attach a current pay stub. Section G lists monthly non-wage income: net self-employment (attach Schedule C or a current profit-and-loss statement), net rental, alimony, child support, unemployment, pension, Social Security, interest and dividends.

Monthly living expenses

Section H: food/personal care, transportation, housing and utilities, medical, and other (child care, estimated taxes, term life, required and voluntary retirement, union dues, delinquent state taxes, student loans, court-ordered payments). Convert bills you do not pay monthly: weekly × 4.3, biweekly × 2.17, semimonthly × 2, quarterly ÷ 3. Rent goes here; a mortgage payment belongs in Section B.

Credit cards & business information

Section D lists every credit card and line of credit, even with no balance, with its limit, balance owed and minimum monthly payment. Section E, for the self-employed, lists accounts receivable owed to you and any merchant accounts that take card or digital-asset payments.

Signature and supporting documents

You (and your spouse) sign under penalty of perjury and date the form. Keep a copy plus your paperwork: the IRS may ask for pay statements, bank and investment statements, loan statements, court orders and bills to substantiate any figure, and it must see proof for any expense above the standard.

Common mistakes to avoid

  • 1Understating or omitting income, which the IRS may catch against wage and 1099 records and reject the statement.
  • 2Claiming more than the IRS Collection Financial Standards for food/personal care or medical without being able to substantiate it — the IRS allows the standard unless you prove the higher actual amount, and the miscellaneous line can never exceed the standard for your family size.
  • 3Leaving lines blank instead of listing zero-balance accounts and cards or writing N/A — the instructions ask for every account and credit line even with no balance, and gaps bring a request for more information.
  • 4Entering the mortgage under rent in Section H, or a bank loan under accounts in Section A — the mortgage belongs with the property in Section B, and loans appear as the balance owed on the asset they financed.
  • 5Using an old copy — the current form is Rev. 7-2024 (July 2024); the Rev. 2-2019 version still circulating on other sites has no digital-asset section.

Form 433-F example — what a filled-out form looks like

A fictional single renter in Columbus, Ohio, owes about $31,000 for tax years 2023 and 2024. Form 9465 line 10 (the balance divided by 72) comes to $431 a month, but they can only offer $250, so Form 9465 tells them to check the box on line 11b and attach Form 433-F.

Header — household and self-employment

1 person under 65 · County: Franklin · address box unchecked · business lines: N/A

Count only people who can be claimed on this year's return. Tick the address box only if you have moved since your last return; the business lines are for the self-employed.

Section A — personal bank accounts

Sample Community Bank, 100 Main St, Columbus OH — checking ••••4321, $1,240 · savings ••••8765, $0

List every account even at a zero balance. Bank loans do not go in this section; they show up as the balance owed on the asset they financed.

Section A — investments and digital assets

Employer 401(k) — $18,500 · digital assets: N/A

Retirement plans count as investments. Write N/A rather than leaving the crypto table blank, so the IRS does not come back to ask.

Sections B and G — real estate, non-wage income

N/A (renting; no rental, pension, unemployment or other income)

Blank lines look like omissions and trigger follow-up requests; N/A shows the section was considered.

Section C — vehicle

2019 Honda Civic — payment $310/mo — purchased 2021 — final payment 05/2028 — value $14,000 — owed $6,200 — equity $7,800

Give make, model and year; equity is current market value minus the loan balance. Write "lease" in the year-purchased column for a leased car.

Section D — credit cards

Visa — limit $5,000 — balance $3,100 — minimum payment $95

Every card and line of credit, even with nothing owed. Card payments are not a separate allowed expense; they fall under the miscellaneous allowance.

Section F — employment

Sample Logistics LLC — biweekly — gross $2,150 per pay period — withheld: federal $245, state $70, local $50 — 3 years

Or skip this section entirely and attach a current pay stub, which the instructions allow.

Section H, box 3 — housing and utilities

Rent $1,150 · electric, gas, water $160 · phone and internet $95 · total $1,405

Rent goes here; a mortgage payment belongs with the property in Section B. Only list utilities and taxes that are not already inside the rent.

Section H, box 2 — transportation

Gas, insurance, licence, maintenance $380 · public transportation $0 · total $380

Operating costs only; the $310 car payment is already in Section C. The IRS allows the local standard or the actual amount, whichever is less.

Section H, boxes 1 and 4 — food/personal care and medical

Food/personal care: Total line only, the one-person national standard from the IRS Collection Financial Standards · medical: health insurance $0 (deducted from pay), out-of-pocket $45

If you do not spend more than the standard for your family size, the form says to fill in the Total only. Claim more than the standard only if you can prove it.

These values are made up. They are here to show what belongs on each line, not to be copied — every name, number, and address on your own Form 433-F has to be your own.

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Related forms

IRS

Form 433-A

Form 433-A: Collection Information Statement for Wage Earners and Self-Employed Individuals

IRS

Form 433-D

Form 433-D: Installment Agreement

Internal Revenue Service (IRS), U.S. Department of the Treasury

Form 1040

Form 1040, U.S. Individual Income Tax Return

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Frequently asked questions

Form 433-F (Rev. 7-2024) is the two-page statement the IRS collection phone and notice units use and the one Form 9465 tells you to attach. Form 433-A (Rev. 6-2026) is the eight-page version a revenue officer or an Offer in Compromise requires; 433-B is the business version. Form 433-D is not a financial statement at all — it is the installment agreement you sign once a plan is approved. JustFill can fill any of them, but send only the one the IRS asked for.
Yes. Upload the official PDF to JustFill — the AI detects each field across sections A–H, you type your figures, and the first clean completed download is included at no charge. The IRS has no online version of the 433-F itself; if you owe $50,000 or less you can usually skip it altogether by applying for a payment plan at IRS.gov/OPA.
The IRS subtracts your allowed living expenses from your income to decide how much you can pay each month, whether a payment below Form 9465 line 10 is acceptable, or whether you are currently not collectible (hardship). It also looks at equity in accounts, property and vehicles, and may ask for proof of any figure after reviewing the form.
Attach a current pay stub if you skip Section F, and Schedule C or a current profit-and-loss statement if you have self-employment income. Be ready to provide court orders and proof of payment for child support or alimony, loan statements, and bills for any expense above the IRS standard. Keep a copy of everything; the IRS may ask for more after it reviews the form.
The form has no address of its own. If an IRS notice or caller asked for it, use the address or fax number printed on that notice, or the phone number it gives (a CP522, for example, asks you to call 800-831-0273 with the completed form in front of you). If you are sending it with Form 9465 after you have filed your return, mail both to the Form 9465 address for your state — Memphis, Ogden or Philadelphia for U.S. addresses, Austin for foreign, U.S. territory and APO/FPO addresses. If Form 9465 goes in with your tax return, the 433-F goes with the return.
The "IRS Allowed" column uses the Collection Financial Standards (irs.gov, effective June 29, 2026): national standards for food, clothing and personal care and for out-of-pocket health care, and local standards for housing and utilities and for transportation. For food/personal care and medical you enter the standard for your family size unless you pay more and can prove it; for housing and transportation the IRS allows the local standard or what you actually spend, whichever is less. The miscellaneous allowance can never exceed the standard.
Form 9465 requires it when you owe more than $50,000, or when the payment you propose on line 11a (or 11b) is below line 10 — the balance divided by 72 — and you cannot raise it. For a balance between $25,000 and $50,000 with a payment at or above line 10, you avoid the 433-F by choosing direct debit (line 13) or payroll deduction (line 14). The IRS also asks for it when you request currently-not-collectible (hardship) status or when a CP522 review of an existing agreement needs updated finances. Balances of $50,000 or less can usually get a plan online without it.

Official source: Form 433-F on IRS’s website

Edition checked: Rev. 7-2024 (July 2024), Catalog Number 62053J. Verified against the official source on · Verified in our Government Forms Fillability Study.

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