Fillable Tax Exempt Bonds Voluntary Closing Agreement Program Request Form 14429 March-2013

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Tax Exempt Bonds Voluntary Closing Agreement Program Request Form 14429 March-2013

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Catalog Number 60719A www.irs.gov
Form
14429 (3-2013)
Form 14429
(March 2013)
Department of the Treasury - Internal Revenue Service
Tax Exempt Bonds
Voluntary Closing Agreement Program Request
The Tax Exempt Bonds Voluntary Closing Agreement Program (TEB VCAP), described in Notice 2008-31, 2008-11 I.R.B. 592,
provides remedies for issuers of tax-advantaged bonds who voluntarily come forward to resolve a violation of the federal tax
requirements applicable to a bond issue which cannot be corrected under self-correction programs described in the Income Tax
Regulations (Regulations) or other published guidance. For this purpose, references to “tax-advantaged bonds” are references to tax-
exempt bonds, qualified tax credit bonds, and direct pay bonds, which are specified tax credit bonds, build America bonds and recovery
zone economic development bonds. Section 7.2.3 of the Internal Revenue Manual (IRM) provides additional procedural guidance on
how to submit a TEB VCAP request. TEB VCAP is administered by the office of Tax Exempt Bonds (TEB) within the Tax Exempt &
Government Entities division.
Purpose of this form
This form is to assist issuers in organizing their TEB VCAP submission requests and in ensuring that their submissions are complete in
accordance with the requirements under Notice 2008-31 and IRM 7.2.3. This form will also facilitate the process for accepting requests
and assigning requests to a specialist. This form does not alter the requirements of section 7121 of the Internal Revenue Code (Code),
Notice 2008-31, or IRM 7.2.3 applicable to TEB VCAP.
Who may use this form
An issuer of tax-advantaged bonds may submit a TEB VCAP submission request to resolve a violation or other tax matter jeopardizing
the tax-advantaged status of its bonds. While other parties (e.g., conduit borrower, trustee) may participate in a TEB VCAP request
with the permission of the issuer, only the issuer may use this form to submit a request and provide all required information under
penalties of perjury as to the truth, accuracy and completeness of such information. See IRM 7.2.3 for information on how to submit a
TEB VCAP request on an anonymous basis.
How to use this form
Answer each question by filling in the requested information in the corresponding box. If the question relates to information to be
included in the request, check the appropriate Yes or N/A option. When a question contains a place for a page number, insert the page
number(s) of the request that correspond to the information called for by a “Yes” answer to a question. Sign the form under penalty of
perjury, date the form, and include it at the beginning of your request.
Issuer Information
Unless otherwise noted, see IRM 7.2.3.2.1(2)(A) for more information
1. Issuer's name 2. Issuer's Employer Identification Number (EIN)
3. Is the Issuer’s name and EIN above different than that reported on the Form 8038 Series information return filed upon the issuance
of the bonds
Yes N/A
If Yes, please provide the name and EIN reported on the return
EINName
4. Issuer’s address (number, street)
City State ZIP code
5. Name and title of official of issuer who may be contacted for additional information
6. Telephone number of official of issuer listed on line 5
Note: With respect to a violation that affects multiple issuers or issues of bonds, such as a composite issue, each issuer of an affected
issue must join in the request and provide the information required in lines 1-6 in an attached schedule.
Page 2
Form 14429 (3-2013)
www.irs.govCatalog Number 60719A
Additional Party Information
If the issuer proposes to include additional parties to the closing agreement please provide
7. Additional party’s name 8. Additional party’s EIN
9. Address (number, street)
City ZIP codeState
10. Name and title of official of additional party who may be contacted for additional information
11. Phone number of official listed on line 10
12. Role of additional party (e.g., conduit borrower, trustee)
13. Is Form 8821, Tax Information Authorization, attached for the additional party to inspect and/or receive information about the
issuer? IRM 7.2.3.2.1(6)
Yes
Page number
N/A
14. Is Form 8821 attached for the issuer to inspect and/or receive information about the additional party? IRM 7.2.3.2.1(6)
Yes
Page number
N/A
Note: If more than one additional party, provide the information and Forms 8821 required in lines 7 through 14 for each additional party
on an attached schedule.
Authorized Representative Information
15. Is Form 2848, Power of Attorney and Declaration of Representative, for each authorized representative attached? IRM 7.2.3.2.1(6)
Yes
Page number
N/A
16. Name and title of authorized representative 17. PTIN of authorized representative
18. Telephone number of authorized representative
19. Address (number, street)
City ZIP codeState
Note: If more than one authorized representative, provide the information and Forms 2848 required in lines 15 through 19 for each
additional representative on an attached schedule.
Bond Information
See IRM 7.2.3.2.1(2)(B) for more information
20. Name of bond issue 21. Issue date of bond issue
22. CUSIP number (if any) reported on Form 8038 Series information return filed in connection with the issuance of the bond issue(s)
23. Issue price
24. Is a full debt service schedule for the issue showing principal maturities and interest rates (for variable rate issues include a
description of how the rate is set and the interest payments to the date of the request) attached
Yes
Page number
N/A
25. Is a copy of the Form 8038 Series information return filed in connection with the issuance of the bond issue(s) and submitted to the
IRS attached? IRM 7.2.3.2.1(5)
Yes
Page number
N/A
dd mmm yyyy
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Form 14429 (3-2013)
www.irs.govCatalog Number 60719A
26. If the request relates to a direct pay bond issue, is a copy of any Forms 8038-CP related to the bond issue(s) and submitted to the
IRS attached? IRM 7.2.3.2.1(5)
Yes
Page number
N/A
27. If the violation relates to the requirements of section 148 of the Code, is a copy of any Forms 8038-T and Forms 8038-R related to
the bond issue(s) and submitted to the IRS attached? IRM 7.2.3.2.1(5)
Yes
Page number
N/A
Violations
See IRM 7.2.3.2.1(2)(C) for more information
28. Which section(s) of the Code relates to the violation described in the request
§
29. Is a clear statement of the specific federal tax requirement which provides a basis for finding a violation included
Yes
Page number
N/A
30. Is a description of the identified violation(s) as well as the facts and circumstances pertaining to the nature of the identified violation
and its occurrence included
Yes
Page number
N/A
31. Is a statement as to when and how the facts surrounding the identified violation were discovered included
Yes
Page number
N/A
32. In the event that the issuer identifies a violation but requests TEB to consider as a factor in determining an appropriate resolution
that certain legal questions apply, has the issuer included the following information in its request
a) a description of established law supporting a determination that there is a credible basis for finding that a violation occurred
Yes
Page number
N/A
b) a description of such legal questions, and their application to the facts of the submission, supporting why TEB should consider
such legal questions as a factor in the appropriate resolution of the violation
Yes
Page number
N/A
33. If the issuer is submitting a request to resolve a violation pursuant to a resolution standard described under IRM 7.2.3.4.2 (Tax
Exempt Bonds) or IRM 7.2.3.4.3 (Certain Direct Pay Bonds), has the issuer additionally supplied any information required under the
relevant Identified Violation section
Yes
Page number
N/A
Settlement Terms
See IRM 7.2.3.2.1(2)(D) for more information
34. Has the issuer included a description of the issuer’s proposed settlement terms for resolving the identified violation
Yes
Page number
N/A
35. If the proposal includes the payment of a closing agreement amount, has the issuer included
a) an identification of the computation methodology described in IRM 4.81.6 used to determine the amount or a description of an
alternative computation methodology including a discussion of why such an alternative is appropriate under the facts and
circumstances
Yes
Page number
N/A
b) an identification of the source of funds to be used to pay the closing agreement amount
Yes
Page number
N/A
36. If the proposal includes the redemption, defeasance, tender, or purchase of any amount of the bonds comprising the bond issue,
has the issuer identified the source of funds to be used to effectuate such action and the maturities of the bonds subject to such
action
Yes
Page number
N/A
Statements of Good Faith
See IRM 7.2.3.2.1(2)(E) for more information
37. Has the issuer included a statement that the bond issue is not under examination or under consideration by the IRS Office of
Appeals
Yes
Page number
N/A
38. Has the issuer included a statement that the tax-advantaged status of the bonds is not at issue in any federal court
Yes
Page number
N/A
Page 4
Form 14429 (3-2013)
www.irs.govCatalog Number 60719A
39. Has the issuer included a statement as to whether the bonds are under review in any court (other than a federal court),
administrative agency, commission, or other proceeding (and identified the proceeding)
Yes
Page number
N/A
40. Has the issuer included a statement as to whether the issuer knew or reasonably expected on the issue date that the violation might
occur
Yes
Page number
N/A
41. Has the issuer included a description of the policies or procedures which have been or will be implemented to prevent this type of
violation from recurring with this or any other bond issues
Yes
Page number
N/A
42. Has the issuer included a statement that the request for a closing agreement was promptly undertaken upon the discovery of the
identified violation, including the date(s) of the violation, the date and circumstances surrounding the discovery of the violation, and
the date and nature of any actions taken in response to the discovery of violation (e.g., redemption, defeasance)
Yes
Page number
N/A
Identification of Previous TEB VCAP or Private Letter Ruling Requests
See IRM 7.2.3.2.1(2)(F)&(G) for more information
43. Has the issuer identified any previous and contemporaneous TEB VCAP requests (including anonymous requests) submitted either:
(1) with respect to the bond issue that is the subject of the request; or (2) pertaining to a violation that is of the same type as the
subject of the request provided that such request was submitted within the past five years, including the name(s) of the related bond
issue(s), brief summaries of the violation(s) identified and resolution thereof; or, if no previous or contemporary request has been
submitted, has the issuer included a statement to that effect
Yes
Page number
N/A
44. Has the issuer identified all previous or contemporaneous private letter ruling requests submitted by the issuer with respect to the
bonds and relating to the violation which is the subject of the TEB VCAP request, including a brief summary of the matters
addressed therein; or, if no previous or contemporaneous private letter ruling request has been submitted, has the issuer included a
statement to that effect
Yes
Page number
N/A
Conflicts, Disclosure, 3rd Party Fault, Other
See IRM 7.2.3.2.1(2)(H) through (K) for more information
45. Has the issuer described any explanation the representative(s) or other professionals have made to the issuer regarding conflicts of
interests relating to the bonds that might exist under Circular 230
Yes
Page number
N/A
46. Has the issuer identified a violation that has been disclosed on the Municipal Securities Rulemaking Board’s Electronic Municipal
Market Access System (EMMA) or to any state or local taxing jurisdiction that grants tax-advantaged treatment to the issuer’s
bonds, including a statement describing the disclosure and how it was made; or, if no disclosure has been made, a statement to that
effect
Yes
Page number
N/A
47. If the issuer wishes to assert that the violation was caused by another party and requests TEB to consider this as a factor in
determining an appropriate resolution, has the issuer included a statement that the violation was due to the acts or omissions of a
person or persons other than the issuer, together with a description of the circumstances surrounding the violation thereof, and any
information that the issuer has regarding such acts or omissions (including an identification of the person or persons whose acts or
omissions caused the violation)
Yes
Page number
N/A
48. Has the issuer attached an explanation of any other information relevant to the matters contained in or resolution of the TEB VCAP
request
Yes
Page number
N/A
Written Post-Issuance Compliance Monitoring Procedures
49. Has the issuer included an affirmative or negative statement as to whether the issuer has adopted comprehensive written
procedures intended to promote post-issuance compliance with, and to prevent violations of, the federal tax requirements for tax-
advantaged bonds? IRM 7.2.3.2.1(3)
Yes
Page number
N/A
Page 5
Form 14429 (3-2013)
www.irs.govCatalog Number 60719A
50. If the issuer has included an affirmative statement for line 49, has the issuer included a detailed description of the portion of such
comprehensive procedures which relate to the violation which is the subject of the TEB VCAP request identifying: 1) the authorized
person(s) that adopted the procedures; 2) the officer(s) with responsibility for monitoring compliance; 3) the frequency of compliance
check activities; 4) the nature of the compliance check activities undertaken; 5) and the date such procedures were originally
adopted and subsequently updated (if applicable)? IRM 7.2.3.2.1(3)
Yes
Page number
N/A
51. If the issuer has included an affirmative statement for line 49, has the issuer submitted information demonstrating that the issuer
had, either prior to the date of the violation, adopted “sufficient written procedures”, to ensure post-issuance compliance with federal
tax law requirements; or, after the violation, implemented such procedures and both timely identified the violation following such
implementation and submitted its request no later than 90 days after such identification? For purposes of this question, “sufficient
written procedures” must specify: the official with monitoring compliance responsibility; the frequency of at least annual compliance
checks; the nature of the compliance activities required to be undertaken; the procedures used to timely identify and elevate
resolution of a violation when it occurs, or is expected to occur; procedures for the retention of records material to substantiate
federal tax law compliance; and, an awareness of the availability of TEB VCAP and other remedial actions to resolve violations. A
mere reference to the bond documents is generally insufficient. IRM 7.2.3.4.4
Yes
Page number
N/A
Issuer Approval & Signature
Under penalties of perjury, I declare that I have examined this submission, including accompanying documents and statements, and to
the best of my knowledge and belief, the submission contains all the relevant facts relating to the request, and such facts are true,
correct, and complete
Signature of Official of Issuer Name of Official of Issuer Date signed
Note: TEB will only accept facts submitted by a party other than the issuer (e.g. conduit borrower, trustee) under penalties of perjury if
the issuer also certifies under penalties of perjury that to the best of the issuer’s knowledge that such facts are true and accurate. If the
issuer wishes to have another party submit facts under penalty of perjury, attached a separate penalty of perjury statement.
IRM 7.2.3.1.2(4)
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Tax Exempt Bonds Voluntary Closing Agreement Program Request Form 14429 March-2013

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Completed 14 May 2019

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