8038-CP Return for Credit Payments to Issuers of Qualified Bonds

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Verify & Print Form
Form

8038-CP

Return for Credit Payments
to Issuers of Qualified Bonds

(Rev. January 2022)

Department of the Treasury
Internal Revenue Service

Part I
1

▶

OMB No. 1545-0047

Go to www.irs.gov/Form8038CP for instructions and the latest information.

Information on Entity That Is To Receive Payment

Check if Amended Return (see instructions) ▶
2

Name of entity that is to receive payment of the credit

Employer identification number (EIN)

DRAFT AS OF
September 16, 2021
DO NOT FILE
3

Number and street (or P.O. box no. if mail is not delivered to street address)

4

City, town, or post office; state; and ZIP code

5

Name and title of designated contact person whom the IRS may contact for more information

Part II

Room/suite

6

Telephone number of contact person shown on line 5

8

EIN

Reporting Authority

7

Issuer’s name (if same as line 1, enter “SAME” and skip lines 8, 9, 11, 15, and 16)

9

Number and street (or P.O. box no. if mail is not delivered to street address)

Room/suite

10

Report number (see instructions)

11

City, town, or post office; state; and ZIP code

12

Date of issue (MM/DD/YYYY)

13

Name of issue

14

CUSIP number (see instructions)

15

Name and title of officer or other person whom the IRS may contact for more information

16

Telephone number of contact person shown on line 15

17a
c

Check applicable box (see instructions) ▶
Variable rate bond
Enter code number for type of bonds (see instructions) . .

Part III
18
19a
b

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Fixed rate bond
b Enter the issue price ▶
. . . . . . . . . .

17b

Payment of Credit (For specified tax credit bonds with multiple maturities, see instructions.)

Interest payment date to which this payment of credit relates (MM/DD/YYYY)
Interest payable to bondholders on the interest payment date. See instructions .

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19a

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%
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19c

a
b

For specified tax credit bonds only, enter the applicable credit rate determined under sec. 54A(b)(3)
.
For specified tax credit bonds only, complete Schedule A and enter amount from Schedule A, line 3 .
Amount of credit allowed for the interest payment date (complete only line 20a, 20b, 20c, 20d, 20e, or 20f)
Build America bonds. Multiply line 19a by 35% (0.35) . . . . . . . . . . . . . . .
Recovery zone economic development bonds. Multiply line 19a by 45% (0.45) . . . . . . . .

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20a
20b

c
d
e

New clean renewable energy bonds, enter the smaller of lines 19a or 19c
Qualified energy conservation bonds, enter the smaller of lines 19a or 19c
Qualified zone academy bonds, enter the smaller of lines 19a or 19c . .

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20c
20d
20e

f

Qualified school construction bonds, enter the smaller of lines 19a or 19c

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20f

Adjustment to previous credit payments (complete line 21a OR line 21b only):
Net increase to previous payments
. . . . . . . . . . . . .

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21a

Net decrease to previous payments
. . . . . . . . . . . . . . . . . . . . .
Enter explanation code for lines 21a or 21b (see instructions) . . . . . . . . . . .
Amount of credit payment requested. Combine either line 20a, 20b, 20c, 20d, 20e, or 20f with line 21a or line 21b
Has there been a change to the debt service schedule most recently filed with the IRS? . . . . . .

.

21b

c
20

21
a
b
c
22
23a
b
24a
b

.
.

If “Yes,” enter the explanation code and attach the revised debt service schedule (see instructions)
Have you paid or will you pay all the interest from line 19a on or before the date from line 18? See instructions
If “No,” enter the explanation code (see instructions) . . . . . . . . . . . . . .

25

Is this return submitted for the final interest payment date for the bonds? . . .
26
Enter direct deposit information below:
Direct
▶ b Type:
a Routing number
Deposit
c Account number

Paid
Preparer
Use Only

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Checking

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22
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Yes

No

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Yes

No

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Yes

No

Savings

Under penalties of perjury, I declare that I have examined this return, and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and complete. I further declare that I authorize the IRS to send the requested refundable credit payment to the entity
identified in Part I, and I consent to the disclosure of the issuer’s return information, as necessary to process the refundable credit payment, to the
designated contact person(s) listed above in Parts I and II, as applicable.

▲

Signature
and
Consent

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.

▶
Date

Signature of issuer

Print/Type preparer’s name
Firm’s name

▶

Firm’s address

▶

Preparer’s signature

For Paperwork Reduction Act Notice, see the separate instructions.

Type or print name and title
Date

Check
if PTIN
self-employed
Firm’s EIN

▶

Phone no.
Cat. No. 52810E

Form 8038-CP (Rev. 1-2022)