Form 433-H Installment Agreement Request Checklist (2024)
Overview and Purpose
Form 433-H is the IRS installment agreement request and financial disclosure statement for wage earners resolving tax liabilities through monthly payments. The July 2024 revision enables the IRS to assess a taxpayer's financial capacity and establish payment arrangements for debts exceeding $50,000 or those requiring more than 72 months to be satisfied.
Eligibility Requirements
Use Form 433-H if you earn wages and your tax liability exceeds $50,000 or cannot be paid within 72 months. Self-employed individuals and business operators must use Form 433-D instead. If you owe $50,000 or less and can pay within 72 months, use Form 9465 or apply online at IRS.gov for lower fees.
Taxpayers who can pay within 180 days should call the number on their notice to arrange a no-fee short-term plan. Those in bankruptcy or accepting offers-in-compromise should contact the IRS at 1-800-829-1040.
Pre-Filing Requirements
All required tax returns must be filed before submitting Form 433-H. The IRS will deny any request if returns remain unfiled, with no exceptions. Consider alternative payment options, such as bank loans or credit cards, which may be less expensive than IRS interest and penalties.
Gather documentation, including bank statements, investment statements, pay stubs, bills, insurance documents, loan statements, property valuations, and proof of income.
Completing the Form Header
Enter full legal names, Social Security Numbers, or Individual Taxpayer Identification Numbers for the taxpayer and spouse, current mailing address, county of residence, and all telephone numbers. Indicate household members claimable on the current year’s return by age category (under 65 and 65 and over). Select the address change box if your current address differs from the one on your last filed return.
Part 1: Installment Agreement Request
Line 1 requires the total amount owed from tax returns or notices, including the form number and tax period. Line 2 captures additional balances, including existing installment agreements. Line 3 adds Lines 1 and 2 to calculate the total owed.
Line 4 shows the payment included with the request. Attach a check or money order payable to the United States Treasury with name, address, SSN or ITIN, phone number, tax year, and form number. Do not send cash. Line 5 shows the remaining balance after payment.
Line 6 establishes the proposed monthly payment. Make payments as large as possible to minimize interest and penalties. If you have an existing agreement, enter the total proposed payment for all liabilities. Leave blank for the IRS to determine the amount based on the financial statement.
Line 7 selects the payment due date from the 1st through the 28th of the month.
Payment Method Selection
Lines 8a and 8b establish direct debit, the most reliable payment method. Line 8a requires a nine-digit bank routing number, with the first two digits between 01 and 12 or 21 and 32. Line 8b requires an account number up to 17 characters. Include hyphens but omit spaces. Do not include the check number. Signing authorizes the U.S. Treasury to initiate monthly ACH debits. To revoke, contact the U.S. Treasury Financial Agent at 1-800-829-1040 at least 14 business days before the next payment.
Line 8c applies to low-income taxpayers unable to make electronic payments. Check only if adjusted gross income is at or below 250% of the federal poverty guidelines, and you cannot make debit payments. Not checking indicates that you are able but choosing not to make debit payments, which affects fee waiver eligibility.
Line 9 allows for payroll deduction by attaching a completed Form 2159, signed by both you and your employer.
Part 2: Financial Information
Section A lists all bank accounts, including checking, online payment services, savings, and money market accounts, even with zero balances. Include institution name, account number, type, current balance, and business use indicator.
Report all investments, including certificates of deposit, trusts, IRAs, Keogh plans, SEP plans, 401(k) plans, mutual funds, stocks, bonds, and commodities. Disclose cryptocurrency holdings, including type, wallet or exchange name, email address, storage locations, and current U.S. dollar value.
Section B covers real estate, including primary residences, vacation properties, timeshares, and vacant land. Report description, location, monthly payment, financing details, current market value, balance owed, equity, year purchased, purchase price, and refinancing information.
Section C lists vehicles with make, model, and year (write “lease” if leased), as well as whole life insurance policies and other valuable property. Include monthly payment, purchase year, final payment date, current value, balance owed, and equity.
Section D requires all credit cards and lines of credit, including those with zero balances, to list the card type, credit limit, balance owed, and minimum monthly payment.
Employment and Income
Section E provides the current employer name and address for the taxpayer and spouse. Attach pay stubs or report pay frequency, gross pay per period, taxes withheld, and length of employment.
Section F documents monthly non-wage income, including alimony, child support, self-employment income, rental income, unemployment benefits, pension distributions, interest and dividends, Social Security benefits, partnership and S-corporation distributions, LLC income, agricultural subsidies, gambling income, oil credits, and IRA distributions.
Monthly Living Expenses
Section G requires monthly living expenses. Convert non-monthly expenses by dividing quarterly by 3, multiplying weekly by 4.3, biweekly by 2.17, or semi-monthly by 2.
Box 1 covers food and personal care using IRS National Standards at IRS.gov (search “Collection Financial Standards”). Include food, housekeeping supplies, clothing, personal care products, and miscellaneous expenses not exceeding standard amounts.
Box 2 includes transportation costs for gas, insurance, licenses, parking, maintenance, repairs, and public transportation.
Box 3 details housing and utilities, including rent (report mortgage in Section B), electricity, oil, gas, water, trash, telephones, cell phones, cable, internet, real estate taxes, insurance (if not included in the mortgage), and maintenance. List actual and IRS-allowed amounts.
Box 4 captures medical expenses, including health insurance premiums and out-of-pocket costs for medical services, prescriptions, dental expenses, eyeglasses, and contact lenses. Cosmetic procedures are generally not allowed.
Box 5 includes child or dependent care, estimated tax payments (quarterly amount divided by 3), term life insurance (whole life in Section C), employer-required and voluntary retirement contributions, union dues, delinquent state and local taxes, federally guaranteed student loans, and court-ordered payments with supporting documentation.
Other necessary expenses for health, welfare, or income production may be allowed with justification.
Fees and Agreement Terms
Setup fees are $178 for check, money order, or credit card; $107 for Direct Debit; $69 for online application; and $43 for low-income taxpayers. Low-income taxpayers with an adjusted gross income at or below 250% of the federal poverty guidelines receive a complete fee waiver with Direct Debit or a $43 fee reimbursement upon completion, regardless of whether Direct Debit is used. Short-term payment plans under 180 days incur no fee, although interest and penalties continue to accrue.
The IRS responds within 30 days; however, this timeframe may be longer for returns filed after March 31. Approved agreements outline the terms, fees, first payment date, and monthly payment amount. By accepting, you agree to make timely payments, file future returns on time, pay future liabilities in full, maintain adequate withholding or estimated payments, and provide updated financial information when requested. The IRS may terminate for late payments, unpaid balances on new returns, or materially incomplete or inaccurate information.
Filing Instructions
Mail the completed Form 433-H with attachments to the appropriate IRS address based on location. Review for accuracy before signing. Both the taxpayer and their spouse must sign and date, under penalty of perjury, certifying that all information is true, correct, and complete. Retain copies of Form 433-H and supporting documentation for verification requests.
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This checklist is for educational purposes only and does not constitute tax or legal advice. Always review official IRS instructions and consult a qualified professional for guidance.
