Form 8038-R
(Rev. September 2017)
Department of the Treasury
Internal Revenue Service
Request for Recovery of Overpayments
Under Arbitrage Rebate Provisions
File a separate form for each issue.
See instructions.
Go to www.irs.gov/Form8038R for the latest information.
OMB No. 1545-1750
Part I Reporting Authority
1 Issuer’s name
2 Issuer’s employer identification number (EIN)
3 Number and street (or P.O. box if mail is not delivered to street address) Room/suite 4 Report number (For IRS Use Only)
5 City, town, or post office, state, and ZIP code 6 Date of issue
7 Name of issue 8 CUSIP number
9 Name and title of officer of the issuer or other person whom the IRS may call for more information
10 Telephone number of officer or other person
Part II Request for Refund of Amounts Paid Under Rebate Provisions (see instructions)
11 If the issue was outstanding on or prior to June 30, 1993, and the issuer elects not to apply the 1992 regulations, check
here. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Total amount paid under rebate provisions . . . . . . . . . . . . . . . . . . .
12
13 Rebate amount as of the most recent computation date . . . . .
13
14 Amounts (not included in line 12) required to be paid under section 148
as of the date the recovery is requested . . . . . . . . . . .
14
15 Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Amount of overpayment. Subtract line 15 from line 12 . . . . . . . . . . . . . . .
16
17 Computations and relevant facts that led to overpayment (see instructions). Attach additional sheets if necessary.
18 Schedule of payments (see instructions). Attach additional sheets if necessary.
Part III Other Information (see instructions) Check the “Yes” or “No” box for each question below.
Yes No
19 Was the overpayment paid as penalty in lieu of rebate under section 148(f)(4)(C)(vii)? . . . . . . . .
19
20 Has the final computation date for the issue occurred? . . . . . . . . . . . . . . . . . .
20
21
If an entity other than a governmental entity is to use proceeds of these obligations, enter the name and EIN of that
organization. If more than one, attach schedule.
Name
EIN
22
If the issuer wishes to authorize the IRS to communicate directly with a person who is a representative of the entity listed on
line 21, check the box and enter the name and telephone number of such person.
Name
Phone no.
Signature
and
Consent
Under penalties of perjury, I declare that I have examined this request for recovery of overpayment, including accompanying schedules and statements, and
to the best of my knowledge and belief, the facts represented in support of the request are true, correct, and complete. I further declare that I consent to the
IRS's disclosure of the issuer's return information, as necessary to process this return, to the persons that I have authorized on lines 9 and 22 above.
Signature of issuer’s authorized representative Date
Type or print name and title
Paid
Preparer
Use Only
Print/Type preparer’s name Preparer's signature Date
Check if
self-employed
PTIN
Firm's name
Firm's address
Firm's EIN
Phone no.
For Paperwork Reduction Act Notice, see the instructions.
Cat. No. 57334H
Form 8038-R (Rev. 9-2017)
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Form 8038-R (Rev. 9-2017)
Page 2
Section references are to the Internal Revenue Code unless otherwise
noted.
Future Developments
For the latest information about developments related to Form 8038-R,
such as legislation enacted after they were published, go to
www.irs.gov/Form8038R.
What’s New
Claims for recovery of overpayments cannot be filed later than the date
that is 2 years after (1) the date that is 60 days after the final
computation date of the issue to which the payment relates; or (2) with
respect to the portion of the overpayment paid more than 60 days after
the final computation date, the date that the payment was made to the
United States. See Rev. Proc. 2017-50, which is on page 234 of Internal
Revenue Bulletin 2017-37 at www.irs.gov/pub/irs-irbs/irb17-37.pdf.
General Instructions
Note: Use a separate Form 8038-R for each issue.
Purpose of Form
Form 8038-R is used by issuers of state and local bonds to request a
refund of amounts paid with Form 8038-T, Arbitrage Rebate, Yield
Reduction, and Penalty in Lieu of Arbitrage Rebate.
Payments made with Form 8038-T that may be recoverable include:
1. Yield reduction payments,
2. The arbitrage rebate to the United States,
3. A penalty in lieu of rebating arbitrage to the United States, or
4. A penalty to terminate the election to pay a penalty in lieu of
rebating arbitrage.
Recovery of Overpayment
In general, an issuer may recover an overpayment of rebate for an issue
of bonds by establishing to the IRS that the overpayment occurred. An
overpayment is the excess of the amount paid to the United States for
an issue under section 148 over the sum of the rebate amount for the
issue as of the most recent computation date and all amounts that are
otherwise required to be paid under section 148 as of the date the
recovery is requested.
An overpayment may be recovered only to the extent that a recovery
on the date that it is first requested wouldn’t result in an additional
rebate amount if that date were treated as a computation date.
Except for overpayments of penalty in lieu of rebate under section
148(f)(4)(C)(vii) and Regulations section 1.148-7(k), an overpayment of
less than $5,000 may not be recovered before the final computation
date. See Regulations section 1.148-3(i).
The amount of rebate overpayment is based on the amount actually
paid, not the future value of the amount paid.
Note: Regulations section 1.148-3(b) provides that as of any date, the
rebate amount for an issue is the excess of the future value, as of that
date, of all receipts on nonpurpose investments over the future value, as
of that date, of all payments on nonpurpose investments. The definitions
of payments and receipts in Regulations section 1.148-3(d), in part,
require inclusion of transactions (including, but not limited to,
acquisition, earnings, and return of principal) on a date for each
nonpurpose investment. Any cash flow representation to the contrary
may result in the understatement of rebate amount. Yield reduction
payments are determined using payments and receipts as described in
Regulations section 1.148-5(b)(1).
Processing the Request
When filing Form 8038-R, you must provide:
• All copies of Form(s) 8038-T related to the request for refund, and
• The computations of the overpayment and interest (if any) on line 17.
The computations must show all cash flows from the issue date to the
computation date reflecting the overpayment (for example, if a series of
reports were prepared, all such reports must be provided, unless the
last report details all cash flows). Provide any additional attachments if
needed.
Generally, this information will be sufficient to determine whether a
refund is appropriate. For refund claim rejections where there is a
procedural deficiency or where an issuer has failed to provide sufficient
information to enable a determination that an overpayment occurred, the
IRS will contact the issuer or its representative to resolve the deficiency.
If all the requested information isn’t timely received, a letter will be sent
explaining that the request for recovery is deficient and that its
processing is rejected.
For refund claim denials, in full or in part, if the IRS makes a
preliminary determination to deny a refund claim, the IRS will notify the
issuer in writing that it may submit additional information or participate
in a conference, or both. Additional information must be submitted
within 21 days of the request for additional information or the
conference. If the issuer fails to submit additional information or if the
IRS disagrees that an overpayment occurred, the IRS will send the
issuer a registered or certified letter denying the claim, subject to the
issuer's appeal rights.
The procedures for processing a request for refund are detailed in
Rev. Proc. 2008-37, which is on page 137 of Internal Revenue Bulletin
2008-29 at www.irs.gov/pub/irs-irbs/irb08-29.pdf as modified by Rev.
Proc. 2017-50.
An issuer is entitled to appeal a refund claim denial. See Rev. Proc.
2006-40, which is on page 694 of Internal Revenue Bulletin 2006-42 at
www.irs.gov/pub/irs-irbs/irb06-42.pdf, for details.
Where To File
File Form 8038-R, and attachments, with the Internal Revenue Service,
Ogden Submission Processing Center, Ogden, UT 84201.
Private delivery services. Filers can use certain private delivery
services (PDSs) designated by the IRS to meet the “timely mailing as
timely filing” rule for tax returns. Go to www.irs.gov/PDS for the current
list of designated services.
The PDS can tell you how to get written proof of the mailing date.
For the IRS mailing address to use if you’re using a PDS, go to
www.irs.gov/PDSstreetAddresses.
!
CAUTION
PDSs can’t deliver items to P.O. boxes. You must use the
U.S. Postal Service to mail any item to an IRS P.O. box
address.
Specific Instructions
Line 1. Enter the name of the governmental entity that issued the
bonds, not the name of the entity receiving the benefit of the financing.
Part I. Reporting Authority
Line 6. Enter the date of issue. This date should be identical to the date
on the corresponding Form 8038-T, Part I, line 6. This is generally the
first date on which there is a physical exchange of the bonds for the
purchase price.
Line 7. Enter the name of the issue. This name should be identical to the
name listed on the corresponding Form 8038-T, Part I, line 7. If there is
no name, please provide other identification of the issue.
Line 8. Enter the CUSIP (Committee on Uniform Securities
Identification Procedures) number of the bond with the latest maturity.
The CUSIP number should be identical to the CUSIP number listed on
the corresponding Form 8038-T, Part I, line 8. Enter “None” if the issue
doesn’t have a CUSIP number.
Lines 9 and 10. Enter the name, title, and telephone number of the
officer of the issuer whom the IRS may call for more information. If the
issuer designates a person other than an officer of the issuer (including
a legal representative or paid preparer) whom the IRS may call for more
information with respect to this return, enter the name, title, and
telephone number of such person here.
Note: By authorizing a person other than an authorized officer of the
issuer to communicate with the IRS and whom the IRS may call for
more information with respect to this return, the issuer authorizes the
IRS to communicate directly with the individual listed in line 9 and
consents to the disclosure of the issuer’s return information to that
individual, as necessary, in order to process this return.
Form 8038-R (Rev. 9-2017)
Page 3
Part II. Request for Refund
Line 11. Current Regulations sections 1.148-1 through 1.148-11 apply
to issues outstanding after June 30, 1993. If the issue was outstanding
prior to July 1, 1993, the 1992 regulations apply (that is, Regulations
sections 1.148-1 through 1.148-12 effective May 18, 1992 (T.D. 8418,
1992-1 C.B. 29)). However, check the box if the issue was outstanding
prior to July 1, 1993, and the issuer has elected not to apply the 1992
regulations; the current Regulations sections 1.148-1 through 1.148-11
apply.
Line 17. Provide the computations of the overpayment paid as part of a
rebate payment, penalty in lieu of rebate, or to terminate the penalty in
lieu of rebate. Also, include the computations for interest (if any). A
description of the facts that led to the overpayment must be included on
this form.
Line 18. Provide a schedule showing amounts and dates that payments
were made to the United States for the issue. Attach copies of Form(s)
8038-T that accompanied payments to the United States.
Part III. Other Information
Line 20. The final computation date is the date the issue is discharged.
For details, see Regulations section 1.148-3(e)(2).
Line 21. Enter the name and EIN of an entity, other than a governmental
entity, that is to use proceeds of these obligations. If more than one,
attach a schedule.
Line 22. If the issuer wishes to authorize the IRS to communicate
directly with a person who is a representative of the entity listed on line
21, check the box and enter the name and telephone number of such
person.
Note: By authorizing a person other than an authorized officer of the
issuer to communicate with the IRS and whom the IRS may contact with
respect to this return, the issuer authorizes the IRS to communicate
directly with the individual entered in line 22 and consents to disclose
the issuer's return information to that individual, as necessary, in order
to process this return.
Signature and Consent
An authorized representative of the issuer must sign Form 8038-R and
any applicable certification. Also print the name and title of the person
signing Form 8038-R.
The authorized representative of the issuer signing this form must
have the authority to consent to the disclosure of the issuer's return
information, including information provided on the issuer's
corresponding Form 8038-T, as necessary to process this return, to the
person(s) that have been designated in Form 8038-R.
Note: If authority is granted in line 9 or line 22 for the IRS to
communicate with a person other than an officer of the issuer, by
signing this form, the issuer's authorized representative consents to the
disclosure of issuer's return information, as necessary to process this
return, to such person.
Paid Preparer
If an authorized representative of the issuer filled in its return, the paid
preparer's space should remain blank. Anyone who prepares the return
but doesn't charge the organization shouldn't sign the return. Certain
others who prepare the return shouldn't sign. For example, a regular,
full-time employee of the issuer, such as a clerk, secretary, etc.,
shouldn’t sign.
Generally, anyone who is paid to prepare a return must sign it and fill
in the other blanks in the Paid Preparer Use Only area of the return.
The paid preparer must:
• Sign the return in the space provided for the preparer's signature (a
facsimile signature is acceptable),
• Enter the preparer information, and
• Give a copy of the return to the issuer.
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.
You are not required to provide the information requested on a form
that is subject to the Paperwork Reduction Act unless the form displays
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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, 5 hr., 30 min.; Learning about the law or the form,
3 hr., 16 min.; Preparing, copying, assembling, and sending the form
to the IRS, 3 hr., 30 min.
We welcome your comments about this form and instructions and
your suggestions for future editions.
You can send us comments from www.irs.gov/FormComments.
Or you can write to:
Internal Revenue Service
Tax Forms and Publications
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Do not send the form to this address. Instead, see Where To File,
earlier.
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