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Form
8038-CP
Return for Credit Payments
to Issuers of Qualified Bonds
(Rev. January 2022)
Department of the Treasury
Internal Revenue Service
Part I
▶
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) ▶
1
Name of entity that is to receive payment of the credit
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
OMB No. 1545-0047
2
Employer identification number (EIN)
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
c
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Fixed rate bond
b Enter the issue price ▶
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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)
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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
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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? . . . . . .
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21b
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21
a
b
c
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23a
b
24a
b
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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.
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Signature
and
Consent
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Date
Signature of issuer
Print/Type preparer’s name
Firm’s name
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Firm’s address
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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)
File Type | application/pdf |
File Title | Form 8038-CP (Rev. January 2022) |
Subject | Fillable |
Author | SE:W:CAR:MP |
File Modified | 2022-01-04 |
File Created | 2022-01-04 |