Instructions For Form 8921 (2007) - Internal Revenue Service

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Department of the Treasury
Instructions for Form 8921
Internal Revenue Service
(August 2007)
Applicable Insurance Contracts Information Return
If filing using a private delivery service, the private delivery
Section references are to the Internal Revenue Code unless
service can tell you how to get written proof of the mailing date.
otherwise noted.
General Instructions
Penalty
There is a penalty under section 6721 for the failure to file a
Purpose of Form
required Form 8921 by the required filing date. See When and
Where to File earlier. Other penalties are imposed for failure to
Generally, an applicable exempt organization must file a Form
include all information and required attachments, or for
8921 for each structured transaction under which it makes
inclusion of incorrect information. See sections 6721 and
reportable acquisitions of applicable insurance contracts. See
6724(d)(1)(B)(xiv).
Definitions below for terms used in these instructions and Form
8921. For more information on the reporting requirements, see
If one or more failures are due to intentional disregard of the
section 6050V. See When and Where to File below regarding
filing requirement (or the correct information reporting
filing deadlines.
requirement), then the penalty per failure is the greater of (a)
$100 or (b) 10% of the value of the benefit of any applicable
Who Must File
insurance contract for which information is required to be
included on the return. In this case, the penalty imposed for
Applicable exempt organizations must file Form 8921 if they
such intentional disregard is not taken into account in applying
acquire a direct or indirect interest in an applicable insurance
any calendar year limitation. See section 6721(e).
contract after August 17, 2006, and on or before August 17,
2008, regardless of the date of the structured transaction itself.
No penalty shall be imposed for any failure if it is shown that
A separate Form 8921 must be filed with respect to each
such failure is due to reasonable cause and not to willful
separate structured transaction to which the organization is a
neglect. See section 6724(a).
party. See Definitions below.
Definitions
How to Complete Form
Applicable Exempt Organization
In order to be considered complete, Form 8921 must be
An applicable exempt organization is generally a religious,
completed in its entirety with all required attachments. If the
charitable, scientific, literary, educational, amateur sports or
information required exceeds the space provided, attach
similar organization, a governmental organization, a fraternal
additional sheets. The additional sheets must be in the same
society operating on a lodge system, a veterans’ organization,
order as the lines to which they correspond. Include your
an Indian tribal government, a cemetery company, or an
organization’s name, employer identification number (EIN), and
employee stock ownership plan. See section 6050V(d)(3) for
the structured transaction identifier (STI) at the top of each
more details. The term “organization,” when used in these
additional sheet.
instructions, refers to an applicable exempt organization.
Round off cents to whole dollars. To round, drop amounts
Applicable Insurance Contract
under 50 cents and increase amounts from 50 to 99 cents to
An applicable insurance contract is any life insurance, annuity,
the next dollar. For example, $1.39 becomes $1 and $2.50
or endowment contract in which both an applicable exempt
becomes $3. If two or more amounts must be added to figure
organization and a person other than an applicable exempt
the amount to enter on a line, include cents when adding the
organization have directly or indirectly held an interest (whether
amounts and round off only the total.
or not at the same time). However, a contract is not an
applicable insurance contract if:
When and Where to File
Each person directly or indirectly holding an interest in the
If an applicable exempt organization makes a reportable
contract (other than an applicable exempt organization) has an
acquisition after August 17, 2006, and on or before August 17,
insurable interest in the insured under the contract that is
2008, it must file a Form 8921 according to the following
independent of the applicable exempt organization’s interest in
schedule.
the contract,
The sole interest in the contract of each involved person is as
IF reportable
AND on or before...
THEN file an initial or
a named beneficiary, or
acquisitions were
subsequent Form
Under certain circumstances, the sole interest in the contract
made, or new or
8921 by...
of each person other than an applicable exempt organization is
corrected information
as a beneficiary of one or more trusts holding an interest in the
was obtained, after...
contract, or as a trustee who holds an interest in the contract
solely in a fiduciary capacity. See section 6050V(d)(2).
August 17, 2006,
August 17, 2007,
November 1, 2007
Broker/Advisor
August 17, 2007,
August 17, 2008,
October 31, 2008
A broker/advisor is any person that, for compensation, supplies
If any information required by Form 8921 is unavailable at the
professional services to the other parties to the structured
time of filing, or if any information already provided changes or
transaction. This transaction role includes persons providing
is found to be in error, then an updated or corrected Form 8921
legal, financial, accounting, or other advice, as well as persons
must be filed according to the above schedule.
providing brokerage or investment banking services.
Where to send. Send Form 8921 to the following address.
Contract Beneficiary
Department of the Treasury
A contract beneficiary is any person eligible to receive death or
Internal Revenue Service
endowment benefits, in the case of life or endowment
Ogden, UT 84201-0027
insurance, or annuity payments in the case of annuities. There
Cat. No. 49348T

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