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Department of the Treasury -- Internal Revenue Service

8508

Request for Waiver From Filing

Form

OMB Number

(Rev. May 2000)

Information Returns on Magnetic Media

1545--0957

Department of the Treasury

(Forms W-2, W-2G, 1042S, 1098, 1099 Series, 5498, 5498-MSA, and 8027)

Internal Revenue Service

(Please type or print in black ink when completing this form - see instructions on back.)

Note: Only the person required to file on magnetic media can file Form 8508. A transmitter cannot file Form 8508 for the payer, unless he or

she has a power of attorney. If you have a power of attorney, attach a letter to the Form 8508 stating this fact.

1. Type of submission

Original

Reconsideration

Payer name and complete address. (A separate 8508 form must be

Waiver

Federal identification

filed for each payer requesting a waiver.)

requested for

number (9-digit EIN/SSN)

Name

tax year

(Enter one

Address

I I I I I I I I I I

year only)

Zip

City

State

Name and title of person to contact about this request if IRS needs

Telephone number

additional information.

(

)

Est. Volume of Forms Checked That

(c)

Waiver

(a)

(b)

(a)

(c)

(b)

Waiver

You expect to file

You wish to

You will be

You wish to

You will be

You expect to

Requested for

next tax year

filing in total

file on paper

filing in total

file next tax year

1042S

1099-OID

1098

1099-PATR

1098-E

1099-R

1098-T

1099-S

1099-A

5498

5498-MSA

1099-B

8027

1099-C

1099-DIV

W-2

W-2AS

1099-G

W-2G

1099-INT

1099-LTC

W-2GU

1099-MISC

W-2PR

1099-MSA

W-2VI

N o

Is this waiver requested for corrections ONLY?

Yes

Is this the first time you have requested a waiver from the magnetic media filing requirements for any of the forms listed in Block 7?

Yes

(skip to signature line)

No ( Complete block 10 or attach a detailed explanation of why you need a waiver)

10.

Enter two current cost estimates given to you by third parties who would prepare your files for you.

Cost estimates for any reason other than the preparation of magnetic media will not be acceptable.

Attach these two written cost estimates to the Form 8508. Failure to provide cost estimates and/or

signature will result in 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.

11. Signature

Title

Date

Cat. No. 63499V

Form 8508 (Rev.5-2000)

For Paperwork Reduction Act Notice, see back of this form.

Form 8508 - Request For Waiver From Filing Information Returns On Magnetic Media - 2000

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