Form 8952 - Application For Voluntary Classification Settlement Program (Vcsp) - Department Of Treasury Page 2
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Form 8952 (Rev. 11-2011)
Page
Taxpayer's Employer Identification Number (EIN)
Taxpayer's Name
Part IV
Payment Calculation using Section 3509(a) rates (see instructions)
Column A
Column B
Column C
Compensation paid to all
Compensation paid to all
classes of workers at or below
classes of workers above the
Totals
the social security wage base
social security wage base
(see instructions)
(see instructions)
18
Compensation paid to all classes of workers
to be reclassified for the most recently
completed tax year
.
.
.
.
.
.
.
.
19
Multiply
line
18,
Column
A
by
the
percentage (10.68% for compensation paid
in 2010 or 10.28% for compensation paid in
2011) (see instructions)
.
.
.
.
.
.
.
20
Multiply
line
18,
Column
B
by
the
percentage (3.24% for 2010 and for 2011) .
21
Total of line 19, Column A and line 20,
Column B .
.
.
.
.
.
.
.
.
.
.
.
22
Multiply the amount on line 21, Column C by
10%. This will be your VCSP payment
.
.
Caution. Do not send payment with Form 8952. You will submit payment later with your signed closing agreement. If you submit payment
with Form 8952, it may cause processing delay.
Part V
Taxpayer's Representations
(Note: Since the representations include the penalty of perjury statement, the representations under Part V must be signed by the
Taxpayer, not the Taxpayer's representative.)
A Treatment of Workers
1 Taxpayer wants to voluntarily reclassify certain workers as employees for federal income tax withholding, Federal Insurance
Contributions Act, and Federal Unemployment Tax Act taxes (collectively, federal employment taxes) for future tax periods.
2 Taxpayer is presently treating the workers as nonemployees.
3 Taxpayer has satisfied any Form 1099 requirements for each of the workers for the 3 preceding calendar years ending before the
date of this application.
4 Taxpayer has consistently treated the workers as nonemployees.
5 There is no dispute between Taxpayer and the Internal Revenue Service as to whether the workers are nonemployees or
employees for federal employment tax purposes.
B Examination
1 Taxpayer is not under examination by the Internal Revenue Service.
2 Taxpayer is not under examination by the Department of Labor or any state agency for the proper classification of the workers.
3a Taxpayer has not been examined previously by the Internal Revenue Service or the Department of Labor concerning the
classification of the workers; or,
b Taxpayer has been examined previously by the Internal Revenue Service or the Department of Labor concerning the
classification of workers and Taxpayer has complied with the results of the prior examination.
Extension of Period of Limitations
C
The Taxpayer understands that by participating in the VCSP, Taxpayer agrees to extend the period of limitations on assessment
of employment taxes for 3 years for the first, second, and third calendar years beginning after the date Taxpayer elects to begin
treating the workers as employees under the VCSP closing agreement. Taxpayer has the right to refuse to extend the period of
limitations on assessment or to limit the extension to particular issues or to a particular period of time. However, if Taxpayer
refuses to extend the period of limitations on assessment or provides only a limited extension, the IRS will not execute the
VCSP closing agreement.
Under penalties of perjury, I declare that I have examined this submission, including any accompanying documents, and to the best of my knowledge and
belief, all of the facts contained herein are true, correct, and complete.
Sign Here
Date
Your signature
Print/Type preparer's name
Preparer's signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Firm's name
Firm's EIN
Use Only
▶
▶
Firm's address
Phone no.
▶
8952
Form
(Rev. 11-2011)
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