Form 8038-R - Request For Recovery Of Overpayments Under Arbitrage Rebate Provisions Page 3

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Form 8038-R (Rev. 9-2017)
Page
Part II. Request for Refund
Paid Preparer
If an authorized representative of the issuer filled in its return, the paid
Line 11. Current Regulations sections 1.148-1 through 1.148-11 apply
preparer's space should remain blank. Anyone who prepares the return
to issues outstanding after June 30, 1993. If the issue was outstanding
but doesn't charge the organization shouldn't sign the return. Certain
prior to July 1, 1993, the 1992 regulations apply (that is, Regulations
others who prepare the return shouldn't sign. For example, a regular,
sections 1.148-1 through 1.148-12 effective May 18, 1992 (T.D. 8418,
full-time employee of the issuer, such as a clerk, secretary, etc.,
1992-1 C.B. 29)). However, check the box if the issue was outstanding
shouldn’t sign.
prior to July 1, 1993, and the issuer has elected not to apply the 1992
regulations; the current Regulations sections 1.148-1 through 1.148-11
Generally, anyone who is paid to prepare a return must sign it and fill
in the other blanks in the Paid Preparer Use Only area of the return.
apply.
Line 17. Provide the computations of the overpayment paid as part of a
The paid preparer must:
rebate payment, penalty in lieu of rebate, or to terminate the penalty in
• Sign the return in the space provided for the preparer's signature (a
lieu of rebate. Also, include the computations for interest (if any). A
facsimile signature is acceptable),
description of the facts that led to the overpayment must be included on
• Enter the preparer information, and
this form.
• Give a copy of the return to the issuer.
Line 18. Provide a schedule showing amounts and dates that payments
were made to the United States for the issue. Attach copies of Form(s)
Paperwork Reduction Act Notice. We ask for the information on this
8038-T that accompanied payments to the United States.
form to carry out the Internal Revenue laws of the United States. You
Part III. Other Information
are required to give us the information. We need it to ensure that you are
complying with these laws.
Line 20. The final computation date is the date the issue is discharged.
You are not required to provide the information requested on a form
For details, see Regulations section 1.148-3(e)(2).
that is subject to the Paperwork Reduction Act unless the form displays
Line 21. Enter the name and EIN of an entity, other than a governmental
a valid OMB control number. Books or records relating to a form or its
entity, that is to use proceeds of these obligations. If more than one,
instructions must be retained as long as their contents may become
attach a schedule.
material in the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by section
Line 22. If the issuer wishes to authorize the IRS to communicate
6103.
directly with a person who is a representative of the entity listed on line
21, check the box and enter the name and telephone number of such
The time needed to complete and file this form will vary depending
person.
on individual circumstances. The estimated average time is:
Recordkeeping, 5 hr., 30 min.; Learning about the law or the form,
Note: By authorizing a person other than an authorized officer of the
3 hr., 16 min.; Preparing, copying, assembling, and sending the form
issuer to communicate with the IRS and whom the IRS may contact with
to the IRS, 3 hr., 30 min.
respect to this return, the issuer authorizes the IRS to communicate
directly with the individual entered in line 22 and consents to disclose
We welcome your comments about this form and instructions and
the issuer's return information to that individual, as necessary, in order
your suggestions for future editions.
to process this return.
You can send us comments from
Signature and Consent
Or you can write to:
Internal Revenue Service
An authorized representative of the issuer must sign Form 8038-R and
Tax Forms and Publications
any applicable certification. Also print the name and title of the person
1111 Constitution Ave. NW, IR-6526
signing Form 8038-R.
Washington, DC 20224
The authorized representative of the issuer signing this form must
We respond to many letters by telephone. Therefore it would be
have the authority to consent to the disclosure of the issuer's return
helpful if you would include your daytime phone number, including the
information, including information provided on the issuer's
area code, in your correspondence.
corresponding Form 8038-T, as necessary to process this return, to the
person(s) that have been designated in Form 8038-R.
Although we cannot respond individually to each comment received,
we do appreciate your feedback and will consider your comments as we
Note: If authority is granted in line 9 or line 22 for the IRS to
revise our tax products.
communicate with a person other than an officer of the issuer, by
signing this form, the issuer's authorized representative consents to the
Do not send the form to this address. Instead, see Where To File,
disclosure of issuer's return information, as necessary to process this
earlier.
return, to such person.

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