Form 8508 -Request For Waiver From Filing Information Returns Electronically

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Department of the Treasury - Internal Revenue Service
Request for Waiver From Filing
OMB Number
8508
Form
1545-0957
Information Returns Electronically
(November 2016)
(Forms W-2, W-2G, 1042-S, 1097-BTC, 1098 Series, 1099 Series, 3921, 3922, 5498 Series, and 8027, or ACA Forms
1095-B, 1095-C or an Authoritative Transmittal Form 1094-C (Refer to Instructions for Form 1094-C and 1095-C))
(Please type or print in black ink when completing this form - Refer to instructions on the back.)
Note: Only the person required to file electronically can sign Form 8508. A transmitter cannot sign Form 8508 for the payer, unless a
power of attorney has been established. If you have a power of attorney, attach a copy to this form.
1. Type of submission
Original
Reconsideration
2. Payer name, complete address, and contact person name and telephone number (if
3. Taxpayer Identification Number
different than payer name.
(9-digit EIN/SSN)
(A separate Form 8508 must be filed for each payer requesting
a waiver.)
Payer name
4. Contact person
Address
Telephone number
City
State
Zip code
Email address
5. Waiver
Enter the Number of Returns that:
Waiver
Enter the Number of Returns that:
Requested
Requested
(a) You expect to file
(b) You expect to file
(a) You expect to file
(b) You expect to file
for:
for:
on paper
next tax year
on paper
next tax year
1042-S
1099-OID
1094-C/1095-C
1099-PATR
1095-B
1099-Q
1097-BTC
1099-R
1098
1099-S
1098-C
1099-SA
1098-E
3921
1098-Q
3922
1098-T
5498
1099-A
5498-ESA
1099-B
5498-SA
1099-C
8027
1099-CAP
W-2
1099-DIV
W-2AS
1099-G
W-2G
1099-INT
W-2GU
1099-K
W-2PR
1099-LTC
W-2VI
1099-MISC
1099-MISC NEC
6. Is this waiver requested for corrections ONLY?
Yes
No
7. Is this the first time you requested a waiver from the electronic filing requirements for any of the forms listed in Block 5?
Yes
No
(Skip to signature line)
(Complete Block 8 if your request is due to undue hardship)
8. Enter two current cost estimates provided to you by third parties for software, software upgrades or
programming for your current system, or costs to prepare your files for you.
$
Cost estimates for any reason other than the preparation of electronic files will not be acceptable.
Attach the two current cost estimates to Form 8508.
$
Note: Failure to provide current cost estimates and/or signature will result in a denial of your waiver request.
Under penalties of perjury, I declare that I have examined this document, including any accompanying statements, and to the
best of my knowledge and belief, it is true, correct, and complete.
9. Signature
Title
Date
8508
Catalog Number 63499V
Form
(Rev. 11-2016)

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