Form 8038-TC - Information Return for Tax Credit Bonds

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Instructions for Form 8038-TC

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19:28 - 6-JAN-2010

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Instructions for Form
8038-TC

Department of the Treasury
Internal Revenue Service

(Rev. January 2010)
Information Return for Tax Credit Bonds
Section references are to the Internal
Revenue Code unless otherwise noted.

General Instructions
What’s New
The American Recovery and
Reinvestment Act of 2009 added
Qualified School Construction Bonds as
well as Qualified Energy Conservation
Bonds and consolidated those bonds
together with Qualified Forestry
Conservation Bonds, Qualified Zone
Academy Bonds, and New Clean
Renewable Energy Bonds under section
54A.

Purpose of Form
Form 8038-TC is used by the issuers of
the qualified tax credit bonds listed below
under Who Must File, to provide the IRS
with the information required by section
149(e).

Who Must File
Issuers of the following bonds must file a
separate Form 8038-TC for each qualified
tax credit bond issued after January 1,
2010.
• Qualified Forestry Conservation Bonds
• New Clean Renewable Energy Bonds
• Qualified Energy Conservation Bonds
• Qualified Zone Academy Bonds
• Qualified School Construction Bonds
• Clean Renewable Energy Bonds
• Midwestern Tax Credit Bonds
• All other qualified tax credit bonds
(except Build America Bonds which
should be reported on Form 8038-B,
Information Return for Build America
Bonds and Recovery Zone Economic
Development Bonds).

When To File
File Form 8038-TC on or before the 15th
day of the 2nd calendar month after the
close of the calendar quarter in which the
bond was issued. Form 8038-TC may not
be filed before the issue date and must be
completed based on the facts as of the
issue date.
Late Filing An issuer may be granted an
extension of time to file Form 8038-TC
under section 3 of Rev. Proc. 2002-48,
2002-37 I.R.B. 531, if it is determined that
the failure to file timely is not due to willful
neglect. Type or print at the top of the
form, “Request for Relief under section 3
of Rev. Proc. 2002-48.” Attach to the
Form 8038-TC a letter explaining why
Form 8038-TC was not filed on time. Also
indicate whether the bond issue in

question is under examination by the IRS.
Do not submit copies of the trust
indenture or other bond documents.

Where To File
File Form 8038-TC and any attachments
with Department of the Treasury, Internal
Revenue Service Center, Ogden, UT
84201-0020.
Private Delivery Services. You can use
certain private delivery services
designated by the IRS to meet the “timely
mailing as timely filing/paying” rule for tax
returns and payments. These private
delivery services include only the
following:
• DHL Express (DHL): DHL Same Day
Service.
• Federal Express (FedEx): FedEx
Priority Overnight, FedEx Standard
Overnight, FedEx 2Day, FedEx
International Priority, and FedEx
International First.
• United Parcel Service (UPS): UPS Next
Day Air, UPS Next Day Air Saver, UPS
2nd Day Air, UPS 2nd Day Air A.M., UPS
Worldwide Express Plus, and UPS
Worldwide Express.
The private delivery service can tell
you how to get written proof of the mailing
date.

Other Forms That May Be
Required
For submitting payment of arbitrage
rebate to the federal government use
Form 8038-T, Arbitrage Rebate, Yield
Reduction and Penalty in Lieu of
Arbitrage Rebate. For reporting Build
America Bonds, both Tax Credit and
Direct Pay, including Recovery Zone
Economic Development Bonds, use Form
8038-B.

Rounding to Whole Dollars
You should report the money items on
this return as whole dollars. To do so,
drop amounts less than 50 cents and
increase amounts from 50 cents through
99 cents to the next higher dollar.

Definitions
Qualified Tax Credit Bond. An
obligation issued under sections 54, 54A,
or 1400N(l) that entitles the taxpayer
holding such bond on one or more credit
allowance dates occurring during any
taxable year to a credit against the federal
income tax imposed for that taxable year.
Qualified Forestry Conservation Bond.
An obligation that is part of an issue 100
Cat. No. 54164P

percent of the available project proceeds
of which are to be used to finance one or
more qualified forestry conservation
purposes as defined in section 54B.
Qualified Zone Academy Bond. An
obligation that is part of an issue 100
percent of the available project proceeds
of which are to be used for a qualified
purpose with respect to a qualified zone
academy established by an eligible local
education agency as provided in section
54E.
Qualified School Construction Bond.
An obligation that is part of an issue 100
percent of the available project proceeds
of which are to be used for the
construction, rehabilitation, or repair of a
public school facility or for the acquisition
of land on which such a facility is to be
constructed with the proceeds as set forth
in section 54F.
Clean Renewable Energy Bond. An
obligation that is part of an issue 95
percent or more of the proceeds of which
are to be used for capital expenditures
incurred by qualified borrowers for one or
more eligible clean renewable energy
projects as defined in section 54.
New Clean Renewable Energy Bond.
An obligation that is part of an issue 100
percent of the available project proceeds
of which are to be used for capital
expenditures incurred by governmental
bodies, public power providers, or
cooperative electric companies for one or
more qualified renewable energy facilities
as defined in section 54C.
Qualified Energy Conservation Bond.
An obligation that is part of an issue 100
percent of the available project proceeds
of which are to be used for one or more
qualified energy conservation purposes
as defined in section 54D.
Midwestern Tax Credit Bond. An
obligation that is part of an issue of bonds
issued in connection with Midwestern
disaster areas in any state in which a
Midwestern disaster area is located. See
section 1400N(l) for more information
about these requirements.
Issue. Generally, bonds are treated as
part of the same issue if they are issued
by the same issuer, on the same date,
and in a single transaction, or series of
related transactions.
Issue price. The issue price of
obligations is generally determined under
Regulations section 1.148-1(b). Thus,
when issued for cash, the issue price is
the price at which a substantial amount of

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Instructions for Form 8038-TC

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the obligations are sold to the public. To
determine the issue price of an obligation
issued for property, see sections 1273
and 1274 and the related income tax
regulations.
Sale proceeds. Sale proceeds are
determined under Regulations section
1.148-1(b) as any amount actually or
constructively received from the sale of
the issue, including amounts used to pay
underwriters’ discount or compensation
and accrued interest, other than
pre-issuance accrued interest. Sale
proceeds also include, but are not limited
to, amounts derived from the sale of a
right that is associated with a bond, and
that is described in section 1.148-4(b)(4).
Sale proceeds shall also include the
proceeds from the sale of credit strips.
See also section 1.148-4(h)(5) treating
amounts received upon the termination of
certain hedges as sale proceeds.
Arbitrage. The issuer must comply with
the arbitrage requirements of sections
148 and 54A.

attach a schedule with the name of each
purchaser of the tax credit bonds or tax
credit strips, each purchaser’s EIN and
the CUSIP numbers associated with the
bonds and the stripped tax credits. If the
issue does not have a CUSIP number,
write, “None.” If the issue either has no
CUSIP number or is privately placed,
attach a schedule with each purchaser’s
EIN, name and address.

Part II—Type of Issue

Specific Instructions

Line 1. Identify the type of tax credit
bonds issued by entering the
corresponding three digit code as follows:
• 101 - Qualified Forestry Conservation
Bonds
• 102 - New Clean Renewable Energy
Bonds
• 103 - Qualified Energy Conservation
Bonds
• 104 - Qualified Zone Academy Bonds
• 105 - Qualified School Construction
Bonds
• 106 - Clean Renewable Energy Bonds
• 107 - Midwestern Tax Credit Bonds
• 108 - Other

Part I—Reporting Authority

Line 2. Enter title of bond.

Amended return. An issuer may file an
amended return to change or add to the
information reported on a previously filed
return for the same date of issue. If you
are filing to correct errors or change a
previously filed return, check the
“Amended Return” box in the heading of
the form.
The amended return must provide all
the information reported on the original
return, in addition to the new or corrected
information. Attach an explanation of the
reason for the amended return and write
across the top, “Amended Return
Explanation.”
Line 1. Enter the name of the entity
issuing the bonds, not the name of the
entity receiving the benefit of the
financing.
Line 2. An issuer that does not have an
employer identification number (EIN)
should apply for one on Form SS-4,
Application for Employer Identification
Number. You can get this form on the IRS
website at www.irs.gov or by calling
1-800-TAX-FORM (1-800-829-3676). You
may receive an EIN by telephone by
following the instructions for Form SS-4.
Line 4. This line is for IRS Use Only. Do
not make any entries in this box.
Line 7. The date of issue is generally the
date on which the issuer exchanges the
bonds for the underwriter’s (or other
purchaser’s) funds.
Line 8. If there is no name of the issue,
please provide other identification of the
issue.
Line 9. Enter the Committee on Uniform
Securities Identification Procedures
(CUSIP) number of the latest maturity on
line 9. Attach a schedule with a complete
list of CUSIP numbers for each bond. If
some or all of the tax credits are stripped,

Part III—Description of
Obligations
Line 1. See Issue price under Definitions
on page 1.
Line 2. The stated redemption price at
maturity of the entire issue is the sum of
the stated redemption prices at maturity
of each bond issued as part of the issue.
Line 3. Enter the last date on which any
of the bonds will mature. If more than one
maturity, attach a schedule for each
principal payment date.
Line 4. The applicable credit rate is the
daily rate set by the Secretary under
section 54A(b)(3) determined as of the
first day on which there is a binding,
written contract for the sale or exchange
of the bond. Such a rate is posted by the
Bureau of Public Debt on its internet site
for State and Local Government Series
securities at http://www.treasurydirect.
gov. See Notice 2009-15.
Line 5. Enter the maximum term set by
the Secretary under section 54A(d)(5)
applicable during each calendar month in
which the tax credit bonds are sold. The
maximum term is posted by the Bureau of
Public Debt on its internet site for State
and Local Government Series securities
at http://www.treasurydirect.gov.
Line 6. Enter the applicable maximum
permitted yield for the sinking fund
expected to be used to repay the issue
under section 54A(d)(4)(C). The permitted
sinking fund yield is set by the Secretary
consistent with the maximum term
determined under section 54A(d)(5) and
is posted by the Bureau of Public Debt on
its internet site for State and Local
Government Series securities at http://
www.treasurydirect.gov.

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Part IV— Proceeds of Issue
Line 1. See Sale proceeds, under
Definitions on page 1.
Note. If the bond is stripped at issuance,
line 1 must include sale proceeds of the
principal and sale proceeds of the credit
strips.
Line 2. Enter the amount of the
proceeds that will be used to pay bond
issuance costs, including underwriter’s
fees, fees for trustees and bond counsel.
Note. Bond issuance costs for tax credit
bonds issued under section 54A are
limited to 2 percent of sale proceeds.
Line 3. Estimate expected investment
proceeds on the sale proceeds of the
issue, including proceeds received by the
issuer from the sale of tax credits that
have been stripped from the bonds.
Line 4. For all tax credit bonds issued
under section 54A expected available
project proceeds shall be calculated by
subtracting line 2 from line 1 and adding
line 3. For Midwestern Tax Credit Bonds
(Code 107) and for Clean Renewable
Energy Bonds (Code 104) read line 4
substituting “proceeds” for “available
project proceeds” add lines 1 and 3 and
enter that amount on line 4.
Note. Do not subtract line 2, bond
issuance cost.
Line 5. For Midwestern Tax Credit
Bonds, insert the amount of state pledged
matching funds.
Line 6. Enter any amount of proceeds
not otherwise itemized in lines 1-5 and
describe the purpose for which the
proceeds are to be used.
Line 7. Total proceeds equal the sum of
lines 4 through 6.
Note. For Midwestern Tax Credit Bonds
matching pledged funds are included in
Total Proceeds for the purpose of
determining the percentage of proceeds
to be used for qualified purpose
expenditures. Thus, for Midwestern Tax
Credit Bonds matching pledged funds as
well as bond proceeds must be
accounted for in Part V For Qualified Tax
Credit Bonds issued under section 54A,
lines 4 and 7, available project proceeds
and total proceeds, respectively, should
equal the same amount.

Part V— Description of Use of
Proceeds for Qualified Purpose
Expenditures
Lines 1 through 13. Enter the dollar
amount of proceeds allocated to each
qualified purpose expenditure on the
corresponding line.
Line 14. Enter total qualified purpose
expenditures equal to the sum of amounts
entered in line 1 through line 13.
Line 15. To determine the percentage of
total proceeds to be used for qualified
purpose expenditures, divide line 14 in
Part V by line 7 in Part IV Then multiply
the result by 100.
Line 16. Determine the proceeds of the
issue used to reimburse the issuer for

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amounts paid for a qualified purpose prior
to the issuance of the bonds. See
Regulations section 1.150-2.
Line 17. Subject to certain exceptions
under Regulations section 1.150-2(f), an
issuer must adopt an official intent, as
described in Regulations section
1.150-2(e), to reimburse itself for
preissuance expenditures within 60 days
after payment of the original expenditure.
Enter the date the official intent was
adopted.

Part VI— Allocation of National,
State, Tribal, or Local Bond
Limitation Amount
Line 1a. Enter the amount of volume cap
allocated to the issue by bond type.
Attach a copy of the national (for
example, from the Department of the
Treasury or IRS), state, tribal, or local
allocations with respect to the issue.
Check the tribal box if the allocation is
provided by the Department of Interior.
Failure to attach the appropriate
allocation certification will result in a delay
in processing the report. The appropriate
officials must certify that the issue has
been designated as one or more types of
qualified tax credit bonds. In the space in
the Part VI box, enter the year in which
the allocation was received and if the
allocation is a carryforward of unused
volume cap, write “carryforward.”
Lines 1b through 1d. Check the
corresponding box indicating whether the
allocation is national, state, or tribal. If the
allocation is local, write “local” in the box.
Line 2. If the allocation is from a state,
enter the state abbreviation.

Part VII— Miscellaneous
Line 1a. Check the box if there is a
reserve fund described in section
54A(d)(4)(C) (sinking fund) that is
expected to repay the issue at maturity.
Line 1b. A reserve may be funded in
unequal periodic installments so long as it
is funded no sooner than in equal periodic
installments. Check the box if the reserve
fund is funded no sooner than in equal
periodic payments.
Line 1c. Check the box if the reserve
fund is expected to result in an amount
greater than the amount necessary to
repay the issue and the yield on the
reserve fund is not greater than the
permitted sinking fund yield (Part III, line
6).
Line 1d. For purposes of monitoring the
arbitrage requirements of section 148,
such monitoring shall include the
arbitrage requirements of section 54A. If
the issuer has established such
procedures, check the box.
Line 2. The issuer must certify that
applicable state and local law
requirements governing conflicts of
interest are satisfied with respect to the
bond issue. See section 54A(d)(6). If
these requirements are met, check the
box in line 2.

Line 3. If some or all of the tax credits
are stripped, check the box.
Note. Submit the information required
under Part I, line 9.
Line 4. If an issuer fails to spend 100
percent of the available project proceeds
of the issue by the close of the 3-year
expenditure period (including any
extensions granted), the issuer must
redeem all of the nonqualified bonds
within 90 days after the end of such
expenditure period. See 54A(d)(2)(B). If
the issuer has established procedures to
meet this requirement, check the box.
Line 5. “Other” is reserved for future tax
credit bonds.

Part VIII—Consent to
Disclosure of Certain
Information From This Return
Line 1. If the issuer consents to the
IRS’s publication, through a website or
other publication, of its name and
address, name and description of bond
issue, date of issuance, CUSIP numbers,
final maturity date, stated redemption
price at maturity, applicable credit rate
and maximum term to assist in the proper
reporting of interest, tax credits, or other
benefits under section 6049, check the
box next to “Yes.”

Schedule A. New Clean
Renewable Bonds
(CREBs) under section
54A and 54C
Part I— Issuer Questions
Line 1. A public power provider is a state
utility with a service obligation as such
terms are defined in section 217 of the
Federal Power Act. If the issuer is a
public power provider, check “Yes.”
Line 2. A cooperative electric company
is a mutual or cooperative electric
company described in section 501(c)(12)
or section 1381(a)(2)(c). If the issuer is a
cooperative electric company, check
“Yes.”
Line 3. A governmental body is any
state or Indian tribal government, or any
political subdivision thereof. If the issuer
is a governmental body, check “Yes.”
Line 4. A clean renewable energy bond
lender is a lender which is a cooperative
owned by, or has outstanding loans to,
100 or more cooperative electric
companies and is in existence on
February 1, 2002, and shall include any
affiliated entity which is controlled by such
lender. If the issuer is a clean renewable
energy bond lender, check “Yes.”
Line 5. If the issuer is a not-for-profit
electric utility which has received a loan
or loan guarantee under the Rural
Electrification Act, check “Yes.”
Line 6. Notice 2009-33 provides that,
except in limited circumstances involving
reimbursements to which section
54A(d)(2)(D) applies, costs of acquiring

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existing facilities generally will be treated
as nonqualified costs. If any of the
available project proceeds have been
used to acquire existing facilities, check
“Yes.”
Line 7. Notice 2009-33 provides that
refinancing costs (as contrasted with
costs of enhancements, repair or
rehabilitation of existing facilities),
generally will be treated as nonqualified
costs. If any of the available project
proceeds have been used to refinance
existing facilities, check “Yes.”
Line 8. Notice 2009-33 provides that an
allocation limitation of new CREB volume
cap is valid for 3 years after the date of
the letter issuing the allocation (the
“allocation date.”) If the allocation date is
within 3 years of the issue date, check
“Yes.”
Line 9. A new CREB must be
designated as such by a qualified issuer.
If these bonds have been designated as
new CREBs, check “Yes.” See section
54C(a) for more information.
Line 10. For IRS Use Only.

Part III— List of Qualified
Renewable Energy Facilities
Line 1. A “Qualified Renewable Energy
Facility” means a qualified facility as
determined under section 45(d) (without
regard to paragraph (8) and (10) and to
any placed in service date) owned by a
public power provider, a governmental
body, or a cooperative electric company.
List the type of qualified renewable
energy facility to be financed by the
bonds, the location of the facility, the
owner(s) of the facility, the owner’s EIN
and the amount of available project
proceeds to be used for that facility. (If
more than one facility, attach a schedule.)

Schedule B. Qualified
Energy Conservation
Bonds (QECBs) under IRC
sections 54A and 54D
Part I— Issuer and Project
Questions
Line 1. A QECB must be designated as
such by the issuing state or local
government. See section 54D(a). If these
bonds have been designated as QECBs,
check “Yes.”
Line 2. Section 54D(e)(B) provides that
the amount allocated to a large local
government may, if unused, be
reallocated by such local government to
the state in which such local government
is located. If the bonds are issued based
on an allocation that has been reallocated
from a large local government to a state,
check “Yes.”
Line 4. A large local government means
any municipality or county if such
municipality or county has a population of
100,000 or more. If the issuer is a large
local government, check “Yes.”

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Line 6. If the issuer issued the bonds
based on a volume cap allocation
received by another authorized entity
(that allocated volume cap to the issue),
provide the name of such authorized
entity. If more than one authorized entity
allocated volume cap to the bond issue,
attach a schedule listing the names of,
and amount of bonds for, each such
authorized entity.
Lines 7 through 10. For IRS Use Only.

Part III— List of Conservation
Purposes and Use of Proceeds
Line 1. Eligible issuers of QECBs
include states, political subdivisions as
defined for purposes of section 103, and
entities empowered to issue bonds on
behalf of any such entity under rules
similar to those for determining whether a
bond issued on behalf of a state or
political subdivision constitutes an
obligation of that State or political
subdivision for purposes of section 103
and Regulation section 1.103-1(b).
Further, eligible issuers include otherwise
eligible issuers in conduit financing issues
(as defined in Regulations section
1.150-1(b)). List each type of qualified
conservation purpose described under
section 54D(f) to be financed by the
bonds, the location of the facility (if
applicable), and the amount of available
project proceeds to be used for each
qualified conservation purpose. If the
bonds are private activity bonds, provide
the name and EIN of the private user(s).
(If more than one purpose, facility, owner
or user, attach schedule.)

Schedule C. Qualified
Zone Academy Bonds
(QZABs) under IRC
sections 54A and 54D
Part I— Academy and Issuer
Information
Line 1. If the school is located in a
designated empowerment zone, check
“Yes.”
Line 2. If the school is located in a
designated enterprise community, check
“Yes.”
Line 5. If for any calendar year the
allocation for a state exceeds the amount
of bonds issued for such year, the
limitation may be carried over but only to
the first 2 years following the year in
which the unused limitation arose.
Limitation amounts are treated on a
first-in, first-out basis. If the bonds or any
portion of the bonds are issued under a
carryover limitation, check “Yes” and
enter the year in which the limitation
arose.
Line 7. In order for a bond to be a
“qualified zone academy bond,” the issuer
must certify that it has written
commitments from private entities to
make qualified contributions having a
present value (as of the date of issuance

of the issue) of not less than 10% of the
proceeds of the issue. If the eligible local
educational agency that established the
qualified zone academy has received
such written commitments, check “Yes.”
Line 9. A QZAB must be designated as
such by the issuing state or local
government within the jurisdiction that the
school is located. If these bonds have
been designated as QZABs, check “Yes”.
See section 54E(a)(3) for more
information.

amount of bonds for, each such local
education agency.
Line 2. If the issuer issued the bonds
based on a volume cap allocation
received by another authorized entity
(that allocated volume cap to the issue),
provide the name of such authorized
entity. If more than one authorized entity
allocated volume cap to the bond issue,
attach a schedule listing the names of,
and amount of bonds for, each such
authorized entity.

Part II—Description of the
Private Business Contribution

Signature

Lines 1 through and including 4.
Qualified private business contributions
under section 54E(d)(4) are: (a)
equipment for the use in the qualified
zone academy (including state-of-the art
technology and vocational equipment); (b)
technical assistance in developing
curriculum or in training teachers in order
to promote appropriate market driven
technology in the classroom; (c) services
of employees as volunteer mentors; (d)
internships, field trips, or other
educational opportunities outside the
academy for students, or (e) any other
property or service specified by the
eligible local education agency. List the
value of the dollar amount of each private
contribution on the corresponding line.
Line 5. For items not listed in lines 1
through 4, enter the value of the amount
contributed on line 5 and provide a
description of such contribution.
Lines 6 through 10. For IRS Use Only.

Part III—Private Business
Contributor
Line 1. Enter the name of the donor of
the private business contribution.
Line 2. Enter the donor’s EIN. (If multiple
donors, attach a schedule.)

Schedule D. Qualified
School Construction
Bonds (QSCBs) under
sections 54A and 54F
Part I— Use of Proceeds
Line 1. An Indian school is a school
funded by the Bureau of Indian Affairs.
Line 3. A QSCB must be designated as
such by the issuing state or local
government. See section 54F(a). If these
bonds have been designated as QSCBs,
check “Yes.”
Lines 8 through 10. For IRS Use Only.

Part III— Issuer Information
Line 1. If the issuer is not the local
education agency in the jurisdiction of
which the public school facility for which
the proceeds will be used is located, enter
the name of such local education agency.
If the issuer is issuing bonds for more
than one local educational agency, attach
a schedule listing the names of, and

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An authorized representative of the issuer
must sign and date Form 8038-TC and
any applicable certification. Also print the
name and title of the person signing Form
8038-TC.

Paid Preparer
If an authorized representative of the
issuer filled in this return, the paid
preparer’s space should remain blank.
Anyone who prepares the return but does
not charge the organization should not
sign the return. Certain others who
prepare the return should not sign. For
example, a regular, full-time employee of
the issuer, such as a clerk, secretary, etc,
should not sign.
Generally, anyone who is paid to
prepare a return must sign it and fill in the
other blanks in the Paid Preparer’s Use
Only area of the return. The paid preparer
must:
• Sign the return in the space provided
for the preparer’s signature,
• Enter the preparer information, and
• Give a copy of the return to the issuer.
Privacy Act and Paperwork Reduction
Act Notice. We ask for the information
on this form to carry out the Internal
Revenue laws of the United States. You
are required to give us the information.
We need it to ensure that you are
complying with these laws. Section 6109
requires paid preparers to provide their
identifying number.
You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the form displays a valid OMB
control number. Books or records relating
to a form or its instructions must be
retained as long as their contents may
become material in the administration of
any Internal Revenue law. Generally, tax
returns and return information are
confidential, as required by section 6103.
The time needed to complete and file
this form will vary depending on individual
circumstances. The estimated average
time is:
Recordkeeping . . . . . . . . .
Learning about the law or the
form . . . . . . . . . . . . . . . . .
Preparing, copying,
assembling, and sending the
form to the IRS . . . . . . . . . .

2721hr.,
hrs.,
44 min.
3 min.
hr., 25 25
min.min.
32hrs.,
hr., 16 24
min. min.
65hrs.,

If you have comments concerning the
accuracy of these time estimates or
suggestions for making this form simpler,

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Instructions for Form 8038-TC

19:28 - 6-JAN-2010

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

we would be happy to hear from you. You
can write to the Internal Revenue Service,
Tax Products Coordinating Committee,
SE:W:CAR:MP:T:T:SP, 1111 Constitution
Ave. NW, IR-6526, Washington, DC

20224. Do not send the form to this
address. Instead, see Where To File on
page 1.

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