The IRS Form 433-A is typically requested by IRS Revenue Officers, Settlement Officers (in the context of a Collection Due Process Hearing), and other collections officers when evaluating the amount that may be collectible from a taxpayer, while also serving as a road-map for their future collections efforts such as liens and levies. As it is signed under penalty of perjury, great care should be taken to ensure it is completed accurately.

Click on the image above to download the PDF form.

This form was uploaded on 12/29/18. The IRS website should be checked for updates.

A revised version (May 2020) IRS Form 433-A can be found here.