Form 8508-I - Request For Waiver From Filing Information Returns Electronically
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48508-I
Request for Waiver From Filing
Form
Information Returns Electronically
(Rev. November 2015)
OMB No. 1545-2246
(For Form 8966)
Department of the Treasury
Information about Form 8508-I and its instructions is at
▶
Internal Revenue Service
Note: Only the person required to file electronically can file Form 8508-I. A transmitter cannot file Form 8508-I 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-I stating this fact.
1 Type of submission
Original
Reconsideration
2 Name of Filer
3 Number, street, and room or suite no. (if P.O. box, see instructions)
4a City or town
4b State/Province/Region
4c Country (including postal code)
5 Global Intermediary Identification Number (GIIN)
6 Taxpayer Identification Number (TIN)
.
.
.
6a Filer Point of Contact (POC) Name
6b Filer POC Email
6c Filer POC Phone Number
7 Name of Sponsored Entity or Intermediary, if applicable
8 Number, street, and room or suite no. (if P.O. box, see instructions)
9a City or town
9b State/Province/Region
9c Country (including postal code)
10 GIIN
11 TIN
.
.
.
12 Is the entity identified on line 2 a participating FFI or a registered deemed-compliant FFI reporting a U.S. account for which it has reporting
obligations as a condition of its applicable registered deemed-compliant FFI status?
Yes
No
13 Is this waiver requested for corrections only?
Yes
No
14 Check the appropriate reason for requesting this waiver, and provide the indicated documentation as attachments (see instructions).
a) Undue hardship - Attach all of the following documentation:
A description of the steps you have taken to meet the requirement to timely file the forms electronically and why the steps were
unsuccessful;
An estimate of the incremental cost of filing electronically;
A detailed computation supporting the above estimate, setting forth the cost of filing on paper and the cost of filing electronically;
The value of the entity's total assets at the end of the taxable year, as set forth on the applicable financial statements; and
The steps you will take to assure the ability to file future returns electronically.
b) Chapter 7 bankruptcy - Attach a copy of the bankruptcy petition and an explanation of how bankruptcy will create an undue hardship on
filing Form 8966.
c) Catastrophic event (e.g., natural disaster) - Attach supporting documentation including a statement describing the event, the date of the
event, and its effect on your ability to e-file.
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.
15 Signature
Title
Date
For Paperwork Reduction Act Notice, see page 3 of this form.
Form 8508-I (Rev. 11-2015)
Cat. No. 67333S
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