Blank IRS 433-D Template

The IRS 433-D form is a document used by taxpayers to propose an installment agreement with the Internal Revenue Service (IRS) for paying off tax debts. This form outlines the taxpayer's financial situation and payment terms, allowing for a structured approach to settle outstanding tax obligations. For those considering this option, filling out the form is an essential step; click the button below to get started.

Article Structure

The IRS 433-D form is an essential tool for taxpayers who find themselves in a challenging financial situation and are looking to resolve their tax debts. This form is primarily used to establish a Direct Debit Installment Agreement with the IRS, allowing individuals to pay off their tax liabilities over time. By completing this form, taxpayers can propose a manageable payment plan that fits their budget while ensuring compliance with federal tax regulations. The form requires personal information, details about the taxpayer's financial situation, and a commitment to make regular payments. Understanding how to fill out this form correctly is crucial, as it can significantly impact one’s ability to settle tax debts without facing more severe consequences. Whether you are an individual taxpayer or a small business owner, knowing the ins and outs of the IRS 433-D form can help you regain control over your financial obligations and work towards a fresh start.

Form Sample

	Form 433-D	Department of the Treasury - Internal Revenue Service
	Form 433-D	Installment Agreement
	(July 2024)	Installment Agreement
	(July 2024)	(See Instructions on the back of this page)
		(See Instructions on the back of this page)

Name and address of taxpayer(s)

Social Security or Employer Identification Number (SSN/ITIN/EIN)

(Taxpayer)

(Spouse)

Your telephone numbers (including area code)

(Home)

(Work, cell or business)

For assistance, call:

1-800-829-3903 (Individual - Self-Employed/Business Owners, Businesses), or

1-800-829-7650 (Individuals - Wage Earners)

Submit a new Form W-4 to your employer to increase your

Or write

withholding.

(City, State, and ZIP Code)

Kinds of taxes (form numbers)

Tax periods

Amount owed as of

I / We agree to pay the federal taxes shown above, PLUS PENALTIES AND INTEREST PROVIDED BY LAW, as follows

and $

on the

of each month thereafter

I / We also agree to increase or decrease the above installment payments as follows:

Date of increase (or decrease)

Amount of increase (or decrease)

New installment payment amount

The terms of this agreement are provided on the back of this page. Review them thoroughly.

By initialing here and my signature below, I agree to the terms of this agreement, as provided in this form, if it is approved by the Internal Revenue Service.

Additional Conditions / Terms (To be completed by IRS)

By signing and submitting this form, I authorize the IRS to contact third parties and to disclose my tax information to third parties in order to process and administer this agreement over its duration.

DIRECT DEBIT — Attach a voided check or complete this part only if you choose to make payments by direct debit. Read the instructions on the back of this page.

a. Routing number b. Account number

I authorize the U.S. Treasury and its designated Financial Agent to initiate a monthly ACH debit (electronic withdrawal) entry to the financial institution account indicated for payments of my federal taxes owed, and the financial institution to debit the entry to this account. This authorization is to remain in full force and effect until I notify the Internal Revenue Service to terminate the authorization. If I wish to stop payment under my direct debit installment agreement, I may do so by contacting my financial institution either orally or in writing at least three (3) business days before the next scheduled electronic funds transfer. Alternatively, if there are at least fourteen (14) business days before the next scheduled electronic funds transfer, I may contact the Internal Revenue Service at the applicable toll-free number listed above. I also authorize the financial institutions involved in the processing of the electronic payments of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payments.

Debit Payments Self-Identifier

If you are unable to make electronic payments through a debit instrument (debit payments) by providing your banking information in a. and b. above, check the box below:

I am unable to make debit payments.

Note: Not checking this box indicates that you are able but choosing not to make debit payments. Refer to the Instructions to Taxpayer below for details on understanding user fees.

Your signature

Date

Title (if Corporate Officer or Partner)

Spouse’s signature (if a joint liability)

Date

FOR IRS USE ONLY

AGREEMENT LOCATOR NUMBER:

Check the appropriate boxes:

A NOTICE OF FEDERAL TAX LIEN (Check one box below)

RSI “1” no further review

AI “0” Not a PPIA

HAS ALREADY BEEN FILED

RSI “5” PPIA IMF 2 year review

AI “1” Field Asset PPIA

WILL BE FILED IMMEDIATELY

RSI “6” PPIA BMF 2 year review

AI “2” All other PPIAs

WILL BE FILED WHEN TAX IS ASSESSED

Agreement Review Cycle

Earliest CSED

MAY BE FILED IF THIS AGREEMENT DEFAULTS

Check box if pre-assessed modules included.

NOTE: A NOTICE OF FEDERAL TAX LIEN WILL NOT BE

Originator’s ID number

Originator Code

FILED ON ANY PORTION OF YOUR LIABILITY WHICH

REPRESENTS AN INDIVIDUAL SHARED RESPONSIBILITY

Name

Title

PAYMENT UNDER THE AFFORDABLE CARE ACT.

Agreement examined or approved by (Signature, title, function)

Date

Catalog Number 16644M

www.irs.gov

Form 433-D (Rev. 7-2024)

Part 1 — IRS Copy

	Form 433-D	Department of the Treasury - Internal Revenue Service
	Form 433-D	Installment Agreement
	(July 2024)	Installment Agreement
	(July 2024)	(See Instructions on the back of this page)
		(See Instructions on the back of this page)

Name and address of taxpayer(s)

Social Security or Employer Identification Number (SSN/ITIN/EIN)

(Taxpayer)

(Spouse)

Your telephone numbers (including area code)

(Home)

(Work, cell or business)

For assistance, call:

1-800-829-3903 (Individual - Self-Employed/Business Owners, Businesses), or

1-800-829-7650 (Individuals - Wage Earners)

Submit a new Form W-4 to your employer to increase your

Or write

withholding.

(City, State, and ZIP Code)

Kinds of taxes (form numbers)

Tax periods

Amount owed as of

I / We agree to pay the federal taxes shown above, PLUS PENALTIES AND INTEREST PROVIDED BY LAW, as follows

and $

on the

of each month thereafter

I / We also agree to increase or decrease the above installment payments as follows:

Date of increase (or decrease)

Amount of increase (or decrease)

New installment payment amount

The terms of this agreement are provided on the back of this page. Review them thoroughly.

By initialing here and my signature below, I agree to the terms of this agreement, as provided in this form, if it is approved by the Internal Revenue Service.

Additional Conditions / Terms (To be completed by IRS)

DIRECT DEBIT — Attach a voided check or complete this part only if you choose to make payments by direct debit. Read the instructions on the back of this page.

a. Routing number b. Account number

Debit Payments Self-Identifier

If you are unable to make electronic payments through a debit instrument (debit payments) by providing your banking information in a. and b. above, check the box below:

I am unable to make debit payments.

Note: Not checking this box indicates that you are able but choosing not to make debit payments. Refer to the Instructions to Taxpayer below for details on understanding user fees.

Your signature

Date

Title (if Corporate Officer or Partner)

Spouse’s signature (if a joint liability)

Date

FOR IRS USE ONLY

AGREEMENT LOCATOR NUMBER:

Check the appropriate boxes:

A NOTICE OF FEDERAL TAX LIEN (Check one box below)

RSI “1” no further review

AI “0” Not a PPIA

HAS ALREADY BEEN FILED

RSI “5” PPIA IMF 2 year review

AI “1” Field Asset PPIA

WILL BE FILED IMMEDIATELY

RSI “6” PPIA BMF 2 year review

AI “2” All other PPIAs

WILL BE FILED WHEN TAX IS ASSESSED

Agreement Review Cycle

Earliest CSED

MAY BE FILED IF THIS AGREEMENT DEFAULTS

Check box if pre-assessed modules included.

NOTE: A NOTICE OF FEDERAL TAX LIEN WILL NOT BE

Originator’s ID number

Originator Code

FILED ON ANY PORTION OF YOUR LIABILITY WHICH

REPRESENTS AN INDIVIDUAL SHARED RESPONSIBILITY

Name

Title

PAYMENT UNDER THE AFFORDABLE CARE ACT.

Agreement examined or approved by (Signature, title, function)

Date

Catalog Number 16644M

www.irs.gov

Form 433-D (Rev. 7-2024)

Part 2 — Taxpayer’s Copy

HOW TO PAY BY DIRECT DEBIT

INSTRUCTIONS TO TAXPAYER

If not already completed by an IRS employee, fill in the information in the spaces provided on the front of this form for:

•Your name (include spouse’s name if a joint return) and current address; Your social security number and/or employer identification number (whichever applies to your tax liability); Your home and work, cell or business telephone numbers;

•The amount you can pay now as a partial payment;

•The amount you can pay each month (or the amount determined by IRS personnel); and

•The date you prefer to make this payment (This must be the same day for each month, from the 1st to the 28th). We must receive your payment by this date. If you elect the direct debit option, this is the day you want your payment electronically withdrawn from your financial institution account.

Review the terms of this agreement. When you’ve completed this agreement form, sign and date it. Then, return Part 1 to IRS at the address on the letter that came with it or the address shown in the “For assistance” box on the front of the form.

Terms of this agreement

By completing and submitting this agreement, you (the taxpayer) agree to the following terms:

•This agreement will remain in effect until your liabilities (including penalties and interest) are paid in full, the statutory period for collection has expired, or the agreement is terminated. You will receive a notice from us prior to termination of your agreement.

•You will make each payment so that we (IRS) receive it by the monthly due date stated on the front of this form. If you cannot make a scheduled payment, contact us immediately.

•This agreement is based on your current financial condition. We may modify or terminate the agreement if our information shows that your ability to pay has significantly changed. You must provide updated financial information when requested.

•While this agreement is in effect, you must file all federal tax returns and pay any (federal) taxes you owe on time.

•We will apply your federal tax refunds or overpayments (if any) to the entire amount you owe, including the shared responsibility payment under the Affordable Care Act, until it is fully paid or the statutory period for collection has expired.

Understanding user fees

• You must pay a $178 user fee if you enter into a non-Direct Debit agreement.

• You must pay a $107 user fee if you enter into a Direct Debit agreement. Your first draft will be the cost of the user fee or your agreed upon monthly payment, whichever is more.

• For low-income taxpayers (at or below 250% of Federal poverty guidelines), the user fee is reduced to $43. The reduced user fee will be waived if you agree to make electronic payments through a debit instrument by providing your banking information in the Direct Debit section of this Form. For low-income taxpayers, unable to make electronic payments through a debit instrument, the reduced user fee will be reimbursed upon completion of the installment agreement. See Debit Payment Self-Identifier on Page 1 and Form 13844 for qualifications and instructions.

• Lower user fees may be available through our online system. To determine if your agreement qualifies, visit www.IRS.gov/your-account.

• If you default on your installment agreement, you must pay a $89 reinstatement fee if we reinstate the agreement. We have the authority to deduct this fee from your first payment(s) after the agreement is reinstated. For low-income taxpayers (at or below 250% of Federal poverty guidelines), the reinstatement fee is reduced to $43. The reduced reinstatement fee will be waived if you agree to make electronic payments through a debit instrument. For low-income taxpayers, unable to make electronic payments through a debit instrument, the reduced reinstatement fee will be reimbursed upon completion of the installment agreement.

• We will apply all payments on this agreement in the best interests of the United States. Generally, we will apply the payment to the oldest collection statute, which is normally the oldest tax year or period.

• We can terminate your installment agreement if:

• You do not make monthly installment payments as agreed. You do not pay any other federal tax debt when due. You do not provide financial information when requested.

• If we terminate your agreement, we may collect the entire amount you owe, EXCEPT the Individual Shared Responsibility Payment under the Affordable Care Act, by levy on your income, bank accounts or other assets, or by seizing your property.

• We may terminate this agreement at any time if we find that collection of the tax is in jeopardy.

• This agreement may require managerial approval. We’ll notify you when we approve or don’t approve the agreement.

• We may file a Notice of Federal Tax Lien if one has not been filed previously, but we will not file a Notice of Federal Tax Lien with respect to the individual shared responsibility payment under the Affordable Care Act.

• You authorize the IRS to contact third parties and to disclose your tax information to third parties in order to process and administer this agreement over its duration.

Instead of sending us a check, you can pay by direct debit (electronic withdrawal) from your checking account at a financial institution (such as a bank, mutual fund, brokerage firm, or credit union). To do so, fill in Lines a and b. Contact your financial institution to make sure that a direct debit is allowed and to get the correct routing and account numbers.

Line a. The first two digits of the routing number must be 01 through 12 or 21 through 32. Don’t use a deposit slip to verify the number because it may contain internal routing numbers that are not part of the actual routing number.

Line b. The account number can be up to 17 characters. Include hyphens but omit spaces and special symbols. Enter the number from left to right and leave any unused boxes blank.

CHECKLIST FOR MAKING INSTALLMENT PAYMENTS:

1.Write your social security or employer identification number on each payment.

2.Make your check or money order payable to “United States Treasury.”

3.Make each payment in an amount at least equal to the amount specified in this agreement.

4.Don’t double one payment and skip the next without contacting us first.

5.Enclose a copy of the reminder notice, if you received one, with each payment using the envelope provided. Make a payment even if you do not receive a reminder notice. Write the type of tax, the tax period and "Installment Agreement" on your payment. For example, "1040, 12/31/2022, Installment Agreement”. You should choose the oldest unpaid tax period on your agreement. Mail the payment to the IRS address indicated on the front of this form.

6.If you didn’t receive an envelope, call the number at the top of Part 2.

7.In the event that the payment withdrawal doesn’t occur as scheduled, allow one additional month before contacting us to report any issues.

8.To make voluntary payments electronically, go to www.IRS.gov/Payments for payment options.

This agreement will not affect your liability (if any) for backup withholding under Public Law 98-67, the Interest and Dividend Compliance Act of 1983

QUESTIONS? — If you have any questions, about the direct debit process or completing this form, call the applicable telephone number on your notice or the telephone number at the top of this form for assistance.

Catalog Number 16644M

www.irs.gov

Form 433-D (Rev. 7-2024)

Part 2 — Taxpayer’s Copy

⇩ PDF

Document Specifications

Fact Name	Description
Purpose	The IRS Form 433-D is used to set up an installment agreement for paying off tax debts over time.
Eligibility	Taxpayers who owe federal taxes and want to pay in installments can use this form.
Information Required	Taxpayers must provide personal information, financial details, and the amount owed.
Submission Process	The completed form can be submitted online, by mail, or by fax to the IRS.
State-Specific Forms	Some states have their own forms for installment agreements, governed by state tax laws.
Payment Options	Taxpayers can choose to make payments via direct debit, check, or money order.
Approval Time	Typically, the IRS processes the form within 30 days, but it can take longer in some cases.
Default Consequences	If payments are missed, the IRS can terminate the agreement and demand full payment.
Additional Resources	The IRS website offers guidance and FAQs for taxpayers needing assistance with the form.

Steps to Filling Out IRS 433-D

After obtaining the IRS Form 433-D, you will need to complete it accurately to proceed with your payment arrangement. This form is essential for establishing an installment agreement with the IRS. Follow the steps below to fill it out correctly.

Begin by entering your name and Social Security number at the top of the form.
Provide your address, including city, state, and ZIP code.
Fill in your phone number and the best time to reach you.
Indicate your filing status for tax purposes.
List the total amount you owe the IRS in the designated section.
Specify the monthly payment amount you propose to make.
Enter the date you would like the payments to start.
Provide your bank account information if you choose direct debit for payments.
Review the form for accuracy and completeness.
Sign and date the form at the bottom.

Once you have completed the form, submit it to the IRS according to the instructions provided. Keep a copy for your records.

More About IRS 433-D

What is IRS Form 433-D?

IRS Form 433-D is a form used by taxpayers to request a direct debit installment agreement with the Internal Revenue Service (IRS). This agreement allows individuals to pay their tax liabilities over time through automatic deductions from their bank accounts.

Who should use Form 433-D?

Taxpayers who owe taxes and cannot pay the full amount immediately may consider using Form 433-D. This form is particularly useful for those who prefer to set up a payment plan that automatically deducts payments from their bank account.

How do I fill out Form 433-D?

To fill out Form 433-D, you will need to provide personal information, including your name, address, Social Security number, and bank account details. Additionally, you must indicate the amount you owe and propose a monthly payment amount that you can afford.

What are the payment options available with Form 433-D?

When completing Form 433-D, you can choose a monthly payment amount that fits your budget. The IRS will review your proposal and may accept it or suggest a different amount based on your financial situation.

How long does it take to process Form 433-D?

Processing times can vary. Generally, it may take the IRS several weeks to review and approve your installment agreement request. You should receive a confirmation once your agreement is established.

What happens if I miss a payment?

If you miss a payment under your installment agreement, the IRS may consider your agreement in default. This could lead to penalties, interest, or even the possibility of the IRS taking collection actions against you.

Can I change my payment amount after submitting Form 433-D?

Yes, you can request a change to your payment amount after your agreement is in place. You will need to contact the IRS to discuss your situation and provide updated financial information for review.

Is there a fee to set up an installment agreement with Form 433-D?

Yes, there may be a fee associated with setting up an installment agreement. The fee can vary depending on whether you choose to have payments deducted directly from your bank account or if you opt for other payment methods.

What should I do if my financial situation changes?

If your financial situation changes and you are unable to make your payments, contact the IRS immediately. They may be able to offer alternatives, such as adjusting your payment plan or temporarily suspending payments.

Where can I obtain IRS Form 433-D?

You can obtain IRS Form 433-D from the official IRS website. It is available for download in PDF format. You can also request a paper form by contacting the IRS directly.

Common mistakes

Not providing accurate personal information. Ensure that your name, address, and Social Security number are correct.
Failing to include all income sources. Report all forms of income, including wages, self-employment earnings, and other income.
Incorrectly estimating monthly expenses. Be realistic and thorough when detailing your monthly living expenses.
Omitting assets. List all assets, such as bank accounts, real estate, and vehicles, even if they seem insignificant.
Not signing the form. A missing signature can delay processing and may result in rejection of the application.
Using outdated information. Ensure that all information is current and reflects your financial situation as of the date of submission.
Not providing supporting documentation. Attach necessary documents that validate your financial claims, such as pay stubs or bank statements.
Ignoring instructions. Read the instructions carefully to avoid common pitfalls and ensure compliance with IRS requirements.
Submitting the form without a plan. Have a clear understanding of how the information provided will affect your tax situation.
Failing to keep a copy. Always retain a copy of the completed form for your records and future reference.

Documents used along the form

The IRS 433-D form is essential for individuals entering into an installment agreement with the IRS. However, several other forms and documents may accompany it to ensure a smooth process. Below is a list of these documents, each serving a unique purpose.

Form 1040: This is the standard individual income tax return form. It provides the IRS with a summary of your income, deductions, and tax liability for the year.
Form 9465: This form is used to request an installment agreement with the IRS. It outlines your proposal for how you plan to pay your tax debt over time.
Form 433-A: This is a Collection Information Statement for individuals. It details your financial situation, including income, expenses, and assets, which helps the IRS assess your ability to pay.
Form 433-B: This form is similar to 433-A but is designed for businesses. It provides a comprehensive overview of the business's financial health.
Form 2848: This is a Power of Attorney and Declaration of Representative form. It allows someone else to represent you before the IRS regarding your tax matters.
Form 8821: This form is used to authorize the IRS to disclose your tax information to a designated individual or organization, facilitating communication about your tax situation.
Tax Returns: Providing copies of previous tax returns can help the IRS understand your financial history and current obligations.
Financial Statements: These documents detail your assets, liabilities, and overall financial status, supporting your case for an installment agreement.
Payment Records: Keeping records of any payments made toward your tax debt can help demonstrate your commitment to resolving your obligations.

Each of these documents plays a crucial role in the process of negotiating and maintaining an installment agreement with the IRS. Ensuring that all necessary forms are completed accurately can facilitate a smoother resolution to your tax issues.

Similar forms

The IRS Form 433-D is a crucial document used for setting up an installment agreement with the Internal Revenue Service. Similar to the 433-D, Form 9465 serves as a request for an installment agreement. While the 433-D formalizes the agreement after approval, the 9465 is the initial request that taxpayers submit to propose a payment plan. Both forms require financial information, but the 9465 focuses on the taxpayer’s ability to pay and outlines proposed monthly payments.

Another document that shares similarities with the IRS 433-D is Form 656, which is used for an Offer in Compromise. Like the 433-D, Form 656 requires detailed financial information to assess the taxpayer's situation. However, while the 433-D establishes a payment plan for existing tax debt, Form 656 is a request to settle the debt for less than the total amount owed. Both forms aim to facilitate taxpayer compliance, but they serve different purposes in resolving tax liabilities.

Form 2848, the Power of Attorney and Declaration of Representative, is also comparable to the IRS 433-D. This form allows a taxpayer to authorize someone to act on their behalf in tax matters. While the 433-D is focused on payment arrangements, Form 2848 ensures that a designated representative can negotiate or communicate with the IRS regarding these agreements. Both forms are essential for managing tax obligations, but they address different aspects of taxpayer representation.

Form 8821, the Tax Information Authorization, is another document that aligns with the IRS 433-D. This form allows taxpayers to designate individuals to receive and inspect their tax information. Like the 433-D, which involves financial disclosure for payment plans, Form 8821 ensures that authorized persons can access necessary information to assist in tax matters. Both forms promote better communication between taxpayers and the IRS, facilitating smoother transactions.

Form 1040, the U.S. Individual Income Tax Return, is a fundamental document that, while not directly a payment arrangement form, shares the goal of tax compliance with the IRS 433-D. Filing a 1040 is essential for reporting income and calculating tax liability, which may lead to the need for an installment agreement if taxes owed cannot be paid in full. Both forms are part of the broader tax process, emphasizing the importance of accurate reporting and payment of taxes.

Finally, Form 9465-FS, the Installment Agreement Request for Short-Term Payment Plans, is similar to the IRS 433-D in that it addresses payment arrangements. This form is designed for taxpayers who can pay their tax debt within 120 days. While the 433-D sets up a longer-term payment plan, both forms require financial details and aim to ease the burden of tax payments. They provide options for taxpayers to manage their tax liabilities effectively.

Dos and Don'ts

When filling out the IRS 433-D form, it is important to follow certain guidelines to ensure accuracy and compliance. Here are some do's and don'ts to keep in mind:

Do read the instructions carefully before starting the form.
Do provide accurate and complete information to avoid delays.
Do double-check all figures and calculations for correctness.
Do sign and date the form before submission.
Don't leave any required fields blank; fill in all necessary information.
Don't submit the form without reviewing it for errors or omissions.

By following these guidelines, you can help ensure that your submission is processed smoothly and efficiently.

Misconceptions

The IRS 433-D form is often misunderstood. Here are seven common misconceptions about this form:

It’s only for people who owe a lot of money. Many believe that only those with large tax debts need to fill out this form. In reality, anyone who wants to set up a payment plan with the IRS may need to use it, regardless of the amount owed.
You can fill it out quickly and easily. Some think the form is straightforward. However, it requires detailed financial information, which can take time to gather and complete accurately.
Submitting the form guarantees approval of a payment plan. While the form is necessary for requesting a payment plan, approval is not guaranteed. The IRS reviews each case individually and considers various factors.
Once submitted, you cannot make changes. Some people believe that after submitting the form, they cannot make any changes. In fact, you can contact the IRS to update your information if your financial situation changes.
It’s only for individual taxpayers. Many think that only individuals can use the 433-D form. However, businesses can also use it if they need to set up a payment plan for tax debts.
Filing the form stops all collection actions. Some believe that submitting the form halts all IRS collection activities. While it may provide some relief, it does not automatically stop actions like levies or liens.
You don’t need to provide documentation. Some assume that the form is all that’s needed. In reality, you may need to provide supporting documents to verify your financial situation.

Understanding these misconceptions can help taxpayers navigate the process more effectively. Always consider seeking professional advice if you’re unsure about how to proceed.

Key takeaways

The IRS 433-D form is an important document used for various financial arrangements with the Internal Revenue Service. Here are some key takeaways to consider when filling out and using this form:

Purpose of the Form: The IRS 433-D form is primarily used to establish an installment agreement for paying off tax debts over time.
Accurate Information: Ensure that all information provided on the form is accurate and complete. This includes personal details, financial information, and any proposed payment amounts.
Supporting Documents: Be prepared to submit supporting documents, such as proof of income and expenses, to help the IRS assess your financial situation.
Review Terms: Carefully review the terms of the installment agreement before signing. Understand the payment schedule and any interest or penalties that may apply.
Keep Records: Maintain copies of the completed form and any correspondence with the IRS. This will be helpful for future reference and to track your payment progress.

By following these guidelines, individuals can navigate the process of using the IRS 433-D form more effectively.