15397 Application for Extension of Time to Furnish Recipient S

Department of the Treasury - Internal Revenue Service

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Form

15397

(September 2023)

Application for Extension of Time to Furnish
Recipient Statements

OMB Number
1545-

(For Forms W-2, W-2G, 1042-S, 1094-C, 1095, 1097,
1098, 1099, 3921, 3922, 5498, and 8596)
Go to www.irs.gov/Form15397 for the latest information.

Do not use this form to request an extension to file information returns with the IRS (use Form 8809).
1

2

Issuer’s/Transmitter’s information (type or print clearly in black ink)

Issuer’s/Transmitter’s name

Taxpayer identification number (TIN)
(Enter the Issuer’s nine-digit number. Do
not enter hyphens)

Address
City

State/Country code

Contact name
3

Telephone number

ZIP code

Email address

If you are requesting an extension for more than one issuer/transmitter, enter the total number of issuers/transmitters and attach a
typed list of names and TINs (List must be 12pt font and legible). If sending an individual Form 15397 for each request, do not
enter an amount

See How to file in the instructions for details.

4

Check only the box(es) that apply. Do not enter the number of returns
Form(s)

✓ Here

Form(s)

✓ Here

1095-B

8596

1094-C, 1095-C

5498

W-2

1097, 1098, 1099, 3921, 3922, W-2G

5498-ESA

1099-NEC

5498-QA

1099-QA

5498-SA

5

✓ Here

Form(s)

1042-S

If you are requesting an extension to furnish copies of information returns to recipient(s), you must meet one of the following
criteria. Check the applicable box that describes your need for an extension
The transmitter suffered a catastrophic event in a federally declared disaster area that made the transmitter unable to resume
operations or made necessary records unavailable
Fire, casualty, or natural disaster affected the operation of the transmitter
Death, serious illness, or unavoidable absence of the individual responsible for filing the information returns affected the operation
of the transmitter
The transmitter was in the first year of establishment
The transmitter did not receive data on a payee statement such as Schedule K-1, Form 1042-S, or the statement of sick pay
required under section 31.6051-3(a)(1) in time to prepare an accurate information return

Under penalties of perjury, I declare that I have examined this form, including any accompanying statements, and, to the best of my
knowledge and belief, it is true, correct, and complete.
Signature

Catalog Number 93700B

Title

Date

www.irs.gov

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Form 15397 (9-2023)

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Instructions for Form 15397, Application for Extension of Time to Furnish Recipient Statements

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General Instructions

Specific Instructions

Purpose of form. Use Form 15397 to request a one-time extension of
up to 30 days to furnish copies of information returns (for the forms
shown on line 4) to your recipients for the current tax year.

Line 1. Enter the issuer’s/transmitter’s name, in care of name, and
complete mailing address, including room or suite number of the
transmitter requesting the extension of time. Use the name and address
where you want correspondence sent. For example, if you are a preparer
and want to receive correspondence, enter your client’s complete name,
care of (c/o) your firm, and your complete mailing address.

Who should file. Issuers/transmitters who need more time to furnish
copies of information returns to payees should file this form before the
filing due date. See When to file, later.
How to file. Complete, sign and fax Form 15397 no later than the date
the statements are due to the recipients (see When to File, later). Send
fax to:
Internal Revenue Service Technical Services Operation
Attn: Extension of Time Coordinator
Fax: 877-477-0572 (International: 304-579-4105)
Need help? If you have questions about Form 15397, call the IRS toll
free at 866-455-7438 or 304-263-8700 (not toll free). Persons with a
hearing or speech disability with access to TTY/TDD equipment can call
304-579-4827 (not toll free).
For additional information, see Pub. 1220 and Pub. 1187 on
www.irs.gov/publications.
When to file. File Form 15397 as soon as you know an extension of time
is needed but not before January 1st. Form 15397 must be filed by the
due date of the recipient statement(s). See General Instructions for
Certain Information Returns for a listing of recipient due dates, or visit
https://www.irs.gov/instructions/i1099gi
If you are requesting an extension of time to furnish recipient copies
of several types of forms, you may use one Form 15397, but you must
file Form 15397 by the earliest recipient due date. For example, if you
are requesting an extension of time to furnish recipient copies for both
Forms 1099 and 5498, you must file Form 15397 by the earlier due date
of the two information returns. Alternatively, if you have various due
dates, you can complete more than one Form 15397 to ensure that you
are granted the full 30-day extension. An extension cannot be granted if
a request is filed after the filing due date of the information returns.
If any due date falls on a Saturday, Sunday, or legal holiday, file by
the next business day.
Note: Any approved extension of time to file furnish recipient copies will
only extend the due date for furnishing statements to the payee or
recipient. It does not extend the due date for filing information returns
with the IRS.
Penalty. Issuer/transmitter may be subject to a late filing penalty if they
file a late return without receiving a valid extension. For more
information, see the applicable form instructions. Refer to part O in the
General Instructions for Certain Information Returns, and instructions for
the applicable forms.

The legal name and TIN on your extension request must be
exactly the same as the name you provided when you
applied for your EIN using Form SS-4, the Online Internet
CAUTION EIN Application, or the EIN Toll-Free Telephone Service. If a
name change has been submitted to the IRS, supply the current legal
name and TIN. Do not use abbreviations.

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Enter the name of someone who is familiar with this request whom
the IRS can contact if additional information is required. Provide your
telephone number and email address.
Line 2. Enter the issuer’s nine-digit employer identification number (EIN),
qualified intermediary employer identification number (QI-EIN),
withholding foreign partnership employer identification number (WP-EIN)
or withholding foreign trust employer identification number (WT-EIN). If
you are not required to have an EIN or QI-EIN, enter your social security
number.

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Do not enter hyphens.

CAUTION

Signature. Form 15397 must be signed by the issuer/transmitter or
person duly authorized to sign a return.
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. We use this information to determine if you qualify for an
extension of time to furnish statements to recipients. You are not
required to request an extension of time; however, if you request an
extension, you must provide this information. Section 6109 and its
regulations require you to provide your TIN. Failure to provide this
information may delay or prevent processing your request; providing
false or fraudulent information may subject you to penalties. Routine
uses of this information include giving it to the Department of Justice for
civil and criminal litigation, and to cities, states, the District of Columbia,
and U.S. commonwealths and possessions for use in administering their
tax laws. We may also disclose this information to other countries under
a tax treaty, to federal and state agencies to enforce federal nontax
criminal laws, or to federal law enforcement and intelligence agencies to
combat terrorism.
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 Code
section 6103.
The time needed to complete and file this form will vary depending on
individual circumstances. The estimated average time is:
Recordkeeping . . . . . . . . . . . . . . 4 min.
Learning about the law or the form . . . . . . . . 18 min.
Preparing and sending the form to the IRS . . . . . . 21 min.
If you have comments concerning the accuracy of these time
estimates or suggestions for making this form simpler, we would be
happy to hear from you. You can send us comments from
www.irs.gov/FormComments. Or you can send your comments to the
Internal Revenue Service, Tax Forms and Publications Division, 1111
Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the
form to this address. Instead, see How to file, earlier.

Catalog Number 93700B

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www.irs.gov

Form 15397 (9-2023)

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