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Irs Form 1040ez Fillable

Irs form 1040ez fillable Publication 519 - Introductory Material Table of Contents Future Developments IntroductionOrdering forms and publications. Irs form 1040ez fillable Tax questions. Irs form 1040ez fillable What's New Reminders Future Developments For the latest information about developments related to Publication 519, such as legislation enacted after it was published, go to www. Irs form 1040ez fillable irs. Irs form 1040ez fillable gov/pub519. Irs form 1040ez fillable Introduction For tax purposes, an alien is an individual who is not a U. Irs form 1040ez fillable S. Irs form 1040ez fillable citizen. Irs form 1040ez fillable Aliens are classified as nonresident aliens and resident aliens. Irs form 1040ez fillable This publication will help you determine your status and give you information you will need to file your U. Irs form 1040ez fillable S. Irs form 1040ez fillable tax return. Irs form 1040ez fillable Resident aliens generally are taxed on their worldwide income, the same as U. Irs form 1040ez fillable S. Irs form 1040ez fillable citizens. Irs form 1040ez fillable Nonresident aliens are taxed only on their income from sources within the United States and on certain income connected with the conduct of a trade or business in the United States. Irs form 1040ez fillable The information in this publication is not as comprehensive for resident aliens as it is for nonresident aliens. Irs form 1040ez fillable Resident aliens are generally treated the same as U. Irs form 1040ez fillable S. Irs form 1040ez fillable citizens and can find more information in other IRS publications. Irs form 1040ez fillable Table A, Where To Find What You Need To Know About U. Irs form 1040ez fillable S. Irs form 1040ez fillable Taxes, provides a list of questions and the chapter or chapters in this publication where you will find the related discussion. Irs form 1040ez fillable Answers to frequently asked questions are presented in the back of the publication. Irs form 1040ez fillable Table A. Irs form 1040ez fillable Where To Find What You Need To Know About U. Irs form 1040ez fillable S. Irs form 1040ez fillable Taxes Commonly Asked Questions Where To Find The Answer Am I a nonresident alien or resident alien? See chapter 1. Irs form 1040ez fillable Can I be a nonresident alien and a resident alien in the same year? See Dual-Status Aliens in chapter 1. Irs form 1040ez fillable See chapter 6. Irs form 1040ez fillable I am a resident alien and my spouse is a nonresident alien. Irs form 1040ez fillable Are there special rules for us? See Nonresident Spouse Treated as a Resident  in chapter 1. Irs form 1040ez fillable See Community Income in chapter 2. Irs form 1040ez fillable Is all my income subject to U. Irs form 1040ez fillable S. Irs form 1040ez fillable tax? See chapter 2. Irs form 1040ez fillable See chapter 3. Irs form 1040ez fillable Is my scholarship subject to U. Irs form 1040ez fillable S. Irs form 1040ez fillable tax? See Scholarship Grants, Prizes, and Awards in chapter 2. Irs form 1040ez fillable See Scholarship and Fellowship Grants in chapter 3. Irs form 1040ez fillable See chapter 9. Irs form 1040ez fillable What is the tax rate on my income subject to U. Irs form 1040ez fillable S. Irs form 1040ez fillable tax? See chapter 4. Irs form 1040ez fillable I moved to the United States this year. Irs form 1040ez fillable Can I deduct my moving expenses on my U. Irs form 1040ez fillable S. Irs form 1040ez fillable return? See Deductions in chapter 5. Irs form 1040ez fillable Can I claim exemptions for my spouse and children? See Exemptions in chapter 5. Irs form 1040ez fillable I pay income taxes to my home country. Irs form 1040ez fillable Can I get credit for these taxes on my U. Irs form 1040ez fillable S. Irs form 1040ez fillable tax return? See Tax Credits and Payments in chapter 5. Irs form 1040ez fillable What forms must I file and when and where do I file them? See chapter 7. Irs form 1040ez fillable How should I pay my U. Irs form 1040ez fillable S. Irs form 1040ez fillable income taxes? See chapter 8. Irs form 1040ez fillable Am I eligible for any benefits under a tax treaty? See Income Entitled to Tax Treaty Benefits in chapter 8. Irs form 1040ez fillable See chapter 9. Irs form 1040ez fillable Are employees of foreign governments and international organizations exempt from U. Irs form 1040ez fillable S. Irs form 1040ez fillable tax? See chapter 10. Irs form 1040ez fillable Is there anything special I have to do before leaving the United States? See chapter 11. Irs form 1040ez fillable See Expatriation Tax in chapter 4. Irs form 1040ez fillable Comments and suggestions. Irs form 1040ez fillable   We welcome your comments about this publication and your suggestions for future editions. Irs form 1040ez fillable   You can write to us at the following address: Internal Revenue Service Tax Forms and Publications Division 1111 Constitution Ave. Irs form 1040ez fillable NW, IR-6526 Washington, DC 20224   We respond to many letters by telephone. Irs form 1040ez fillable Therefore, it would be helpful if you would include your daytime phone number, including the area code, in your correspondence. Irs form 1040ez fillable   You can send us comments from www. Irs form 1040ez fillable irs. Irs form 1040ez fillable gov/formspubs/. Irs form 1040ez fillable Click on “More Information” and then on “Comment on Tax Forms and Publications. Irs form 1040ez fillable ”   Although we cannot respond individually to each comment received, we do appreciate your feedback and will consider your comments as we revise our tax products. Irs form 1040ez fillable Ordering forms and publications. Irs form 1040ez fillable   Visit www. Irs form 1040ez fillable irs. Irs form 1040ez fillable gov/formspubs/ to download forms and publications, call 1-800-829-3676, or write to the address below and receive a response within 10 days after your request is received. Irs form 1040ez fillable Internal Revenue Service 1201 N. Irs form 1040ez fillable Mitsubishi Motorway Bloomington, IL 61705-6613 Tax questions. Irs form 1040ez fillable   If you have a tax question, check the information available on IRS. Irs form 1040ez fillable gov or call 1-800-829-1040. Irs form 1040ez fillable We cannot answer tax questions sent to either of the above addresses. Irs form 1040ez fillable What's New Personal exemption increased. Irs form 1040ez fillable  For tax years beginning in 2013, the personal exemption amount is increased to $3,900. Irs form 1040ez fillable U. Irs form 1040ez fillable S. Irs form 1040ez fillable real property interest. Irs form 1040ez fillable  Generally, the treatment of a regulated investment company (RIC) as a qualified investment entity (QIE) was scheduled to expire at the end of 2011. Irs form 1040ez fillable The provision has been extended through 2013. Irs form 1040ez fillable The special rules that apply to distributions from a QIE attributable to the gain from the sale or exchange of a U. Irs form 1040ez fillable S. Irs form 1040ez fillable real property interest will continue to apply to any distribution from a RIC in 2013. Irs form 1040ez fillable Beginning in 2014 (unless extended by legislation), a RIC will only be treated as a QIE for certain distributions from the RIC that are directly or indirectly attributable to distributions received by the RIC from a REIT. Irs form 1040ez fillable See Qualified investment entities under U. Irs form 1040ez fillable S. Irs form 1040ez fillable Real Property Interest. Irs form 1040ez fillable Interest-related dividends and short-term capital gain dividends received from mutual funds. Irs form 1040ez fillable  The exemption of tax on certain interest-related dividends and short-term capital gain dividends paid by a mutual fund or other regulated investment company was scheduled to expire at the end of 2011. Irs form 1040ez fillable These provisions have been extended through 2013. Irs form 1040ez fillable The exemption expires for amounts paid in tax years beginning after December 31, 2013 (unless extended by legislation). Irs form 1040ez fillable Multi-level marketing. Irs form 1040ez fillable  Clarification regarding the characterization and source of income received from multi-level marketing companies by distributors (upper-tier distributors) that are based on the sales or purchases of persons whom they have recruited and sponsored (lower-tier distributors) is provided. Irs form 1040ez fillable See Multi-level marketing under Personal Services in chapter 2. Irs form 1040ez fillable Additional Medicare Tax. Irs form 1040ez fillable  For 2013, you may be required to pay Additional Medicare Tax. Irs form 1040ez fillable Also, you may need to report Additional Medicare Tax withheld by your employer. Irs form 1040ez fillable For more information, see Additional Medicare Tax under Social Security and Medicare Taxes and Self-Employment Tax in chapter 8. Irs form 1040ez fillable For more information on Additional Medicare Tax, go to IRS. Irs form 1040ez fillable gov and enter “Additional Medicare Tax” in the search box. Irs form 1040ez fillable Reminders Refunds of certain withholding tax delayed. Irs form 1040ez fillable  Refund requests for tax withheld and reported on Form 1042-S, Form 8288-A, or Form 8805 may require additional time for processing. Irs form 1040ez fillable Allow up to 6 months for these refunds to be issued. Irs form 1040ez fillable Third party designee. Irs form 1040ez fillable  You can check the “Yes” box in the “Third Party Designee” area of your return to authorize the IRS to discuss your return with a friend, family member, or any other person you choose. Irs form 1040ez fillable This allows the IRS to call the person you identified as your designee to answer any questions that may arise during the processing of your return. Irs form 1040ez fillable It also allows your designee to perform certain actions such as asking the IRS for copies of notices or transcripts related to your return. Irs form 1040ez fillable Also, the authorization can be revoked. Irs form 1040ez fillable See your income tax return instructions for details. Irs form 1040ez fillable Change of address. Irs form 1040ez fillable . Irs form 1040ez fillable  If you change your mailing address, be sure to notify the Internal Revenue Service using Form 8822, Change of Address. Irs form 1040ez fillable Photographs of missing children. Irs form 1040ez fillable  The Internal Revenue Service is a proud partner with the National Center for Missing and Exploited Children. Irs form 1040ez fillable Photographs of missing children selected by the Center may appear in this publication on pages that would otherwise be blank. Irs form 1040ez fillable You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child. Irs form 1040ez fillable Prev  Up  Next   Home   More Online Publications
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Affordable Care Act Tax Provisions

Check out the new Affordable Care Act Tax Provisions Home Page

Información en Español: Disposiciones de La Ley del Cuidado de Salud de Bajo Precio
 

Update

The open enrollment period to purchase health insurance coverage for 2014 through the Health Insurance Marketplace runs from Oct. 1, 2013, through March 31, 2014. If you are seeking information about how to obtain health care coverage or financial assistance to purchase health care coverage for you and your family, visit the Health and Human Services website, HealthCare.gov.

Effect of Sequestration on Small Business Health Care Tax Credit

Pursuant to the requirements of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended, refund payments issued to certain small tax-exempt employers claiming the refundable portion of the Small Business Health Care Tax Credit under Internal Revenue Code Section 45R, are subject to sequestration. This means that refund payments processed on or after Oct.1, 2013, and on or before Sept. 30, 2014, to a Section 45R applicant will be reduced by the fiscal year 2014 sequestration rate of 7.2 percent, irrespective of when the original or amended tax return was received by the IRS. The sequestration reduction rate will be applied unless and until a law is enacted that cancels or otherwise impacts the sequester, at which time the sequestration reduction rate is subject to change.

Affected taxpayers will be notified through correspondence that a portion of their requested payment was subject to the sequester reduction and the amount.

IRC §7216, Disclosure or Use of Information by Tax Return Preparers

Final Treasury Regulations on rules and consent requirements relating to the disclosure or use of tax return information by tax return preparers became effective Dec. 28, 2012. For additional information about how these apply to services and education related to the Affordable Care Act, please see our questions and answers

Medical Loss Ratio (MLR)

Beginning in 2011, insurance companies are required to spend a specified percentage of premium dollars on medical care and quality improvement activities, meeting a medical loss ratio (MLR) standard. Insurance companies that are not meeting the MLR standard will be required to provide rebates to their consumers beginning in 2012. For information on the federal tax consequences to an insurance company that pays a MLR rebate and an individual policyholder who receives a MLR rebate, as well as information on the federal tax consequences to employees if a MLR rebate stems from a group health insurance policy, see our frequently asked questions.

Reporting Employer Provided Health Coverage in Form W-2

The Affordable Care Act requires employers to report the cost of coverage under an employer-sponsored group health plan on an employee’s Form W-2, Wage and Tax Statement, in Box 12, using Code DD. Many employers are eligible for transition relief for tax-year 2012 and beyond, until the IRS issues final guidance for this reporting requirement.

The amount reported does not affect tax liability, as the value of the employer excludible contribution to health coverage continues to be excludible from an employee's income, and it is not taxable. This reporting is for informational purposes only, to show employees the value of their health care benefits.

More information about the reporting can be found on Form W-2 Reporting of Employer-Sponsored Health Coverage.

Net Investment Income Tax

A new Net Investment Income Tax went into effect on Jan. 1, 2013. The 3.8 percent Net Investment Income Tax applies to individuals, estates and trusts that have certain investment income above certain threshold amounts. On Nov. 26, 2013, the IRS and the Treasury Department issued final regulations, which provide guidance on the general application of the Net Investment Income Tax and the computation of Net Investment Income. In addition, on Nov. 26, 2013, the IRS and the Treasury Department issued proposed regulations on the computation of net investment income as it relates to certain specific types of property. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Net Investment Income Tax, see our questions and answers.

Additional Medicare Tax

A new Additional Medicare Tax went into effect on Jan. 1, 2013. The 0.9 percent Additional Medicare Tax applies to an individual’s wages, Railroad Retirement Tax Act compensation and self-employment income that exceeds a threshold amount based on the individual’s filing status. The threshold amounts are $250,000 for married taxpayers who file jointly, $125,000 for married taxpayers who file separately and $200,000 for all other taxpayers. An employer is responsible for withholding the Additional Medicare Tax from wages or compensation it pays to an employee in excess of $200,000 in a calendar year. On Nov. 26, 2013, the IRS and the Department of the Treasury issued final regulations which provide guidance for employers and individuals relating to the implementation of Additional Medicare Tax, including the requirement to withhold Additional Medicare Tax on certain wages and compensation, the requirement to report Additional Medicare Tax, and the employer process for adjusting underpayments and overpayments of Additional Medicare Tax. In addition, the regulations provide guidance on the employer and individual processes for filing a claim for refund for an overpayment of Additional Medicare Tax. For additional information on the Additional Medicare Tax, see our questions and answers.

Minimum Value

On April 26, 2012, the Department of the Treasury and IRS issued Notice 2012-31, which provides information and requested public comment on an approach to determining whether an eligible employer-sponsored health plan provides minimum value. Additionally, on April 30, 2013, the Treasury Department and the IRS issued proposed regulations relating to minimum value of eligible employer-sponsored plans and other rules regarding the premium tax credit. Starting in 2014, whether such a plan provides minimum value will be relevant to eligibility for the premium tax credit and application of the employer shared responsibility payment.

Information Reporting on Health Coverage by Employers

On March 5, 2014, the Department of the Treasury and IRS issued final regulations on employer health insurance coverage information reporting. The information reporting relates to health insurance coverage that is offered by certain employers, referred to as applicable large employers, and reporting is to be provided by each member of an applicable large employer. Additionally, on July 9, 2013, the Department of the Treasury and the IRS issued Notice 2013-45, announcing transition relief for 2014 from this annual information reporting. Learn more about this reporting requirement by reading the fact sheet issued by the U.S. Department of the Treasury.

Information Reporting on Health Coverage by Insurers

On March 5, 2014, the Department of the Treasury and IRS issued final regulations on minimum essential coverage information reporting. The information reporting is to be provided by health insurance issuers, certain sponsors of self-insured plans, government agencies and certain other parties that provide health coverage. Additionally, on July 9, 2013, the Department of the Treasury and the IRS issued Notice 2013-45 announcing transition relief for 2014 from this annual information reporting. Learn more about this reporting requirement by reading the fact sheet issued by the U.S. Department of the Treasury.

Disclosure of Return Information

On Aug. 13, 2013, the Department of the Treasury and the IRS issued final regulations with rules for disclosure of return information to the Department of Health and Human Services that will be used to carry out eligibility determinations for advance payments of the premium tax credit, Medicaid and other health insurance affordability programs. For additional information on the final regulations, see our questions and answers.

Small Business Health Care Tax Credit

This credit helps small businesses and small tax-exempt organizations afford the cost of covering their employees and is specifically targeted for those with low- and moderate-income workers. The credit is designed to encourage small employers to offer health insurance coverage for the first time or maintain coverage they already have. In general, the credit is available to small employers that pay at least half the cost of single coverage for their employees. On Aug. 23, 2013, the Department of Treasury and the IRS issued proposed regulations, which include information on the transition of eligibility for the credit and requiring the purchase of insurance coverage through an Affordable Insurance Exchange (also known as a Health Insurance Marketplace). Additionally, IRS Notice 2014-06 provides transition relief for employers in certain counties in Washington and Wisconsin with no SHOP coverage available. Learn more by browsing our page on the Small Business Health Care Tax Credit for Small Employers.

Application of the Affordable Care Act to Health Reimbursement Arrangements, Health Flexible Spending Arrangements and Certain Other Employer Healthcare Arrangements

The Affordable Care Act’s market reforms apply to group health plans. On Sept. 13, 2013, the IRS issued Notice 2013-54, which explains how the Affordable Care Act’s market reforms apply to certain types of group health plans, including health reimbursement arrangements (HRAs), health flexible spending arrangements (health FSAs) and certain other employer healthcare arrangements, including arrangements under which an employer reimburses an employee for some or all of the premium expenses incurred for an individual health insurance policy. The notice also provides guidance on employee assistance programs or EAPs and on section 125(f)(3), which prohibits the use of pre-tax employee contributions to cafeteria plans to purchase coverage on an Affordable Insurance Exchange (also known as a Health Insurance Marketplace). The notice applies for plan years beginning on and after Jan. 1, 2014, but taxpayers may apply the guidance provided in the notice for all prior periods.  

DOL has issued a notice in substantially identical form to Notice 2013-54, DOL Technical Release 2013-03, and HHS will shortly issue guidance to reflect that it concurs with Notice 2013-54. On Jan. 24, 2013, DOL and HHS issued FAQs that addressed the application of the Affordable Care Act to HRAs.

On Jan. 9, 2014, DOL and HHS issued FAQs that addressed, among other things, future rules relating to excepted benefits.

Health Flexible Spending Arrangements

Effective Jan. 1, 2011, the cost of an over-the-counter medicine or drug cannot be reimbursed from Flexible Spending Arrangements (FSAs) or health reimbursement arrangements unless a prescription is obtained. The change does not affect insulin, even if purchased without a prescription, or other health care expenses such as medical devices, eye glasses, contact lenses, co-pays and deductibles. This standard applies only to purchases made on or after Jan. 1, 2011. A similar rule went into effect on Jan. 1, 2011, for Health Savings Accounts (HSAs), and Archer Medical Savings Accounts (Archer MSAs). Employers and employees should take these changes into account as they make health benefit decisions. For more information, see news release IR-2010-95, Notice 2010-59, Revenue Ruling 2010-23 and our questions and answers. FSA and HRA participants can continue using debit cards to buy prescribed over-the-counter medicines, if requirements are met. For more information, see news release IR-2010-128 and Notice 2011-5. Additionally, Notice 2013-57 provides information about the definition of preventive care for purposes of high deductible health plans associated with HSAs. 

In addition, starting in 2013, there are new rules about the amount that can be contributed to an FSA. Notice 2012-40 provides information about these rules and flexibility for employers applying the new rules. On Oct. 31, 2013, the Department of the Treasury and IRS issued Notice 2013-71, which provides information on a new $500 carryover option for employer-sponsored healthcare flexible spending arrangements. Learn more by reading the news release issued by the U.S. Department of the Treasury.

Further, Notice 2013-54 provides guidance regarding the application of the Affordable Care Act’s market reforms to certain health FSAs.   

Medical Device Excise Tax

On Dec. 5, 2012, the IRS and the Department of the Treasury issued final regulations on the new 2.3-percent medical device excise tax (IRC §4191) that manufacturers and importers will pay on their sales of certain medical devices starting in 2013. On Dec. 5, 2012, the IRS and the Department of the Treasury also issued Notice 2012-77, which provides interim guidance on certain issues related to the medical device excise tax. Additional information is available on the Medical Device Excise Tax page and Medical Device Excise Tax FAQs on IRS.gov.

Changes to Itemized Deduction for Medical Expenses

Beginning Jan. 1, 2013, you can claim deductions for medical expenses not covered by your health insurance when they reach 10 percent of your adjusted gross income. This change affects your 2013 tax return that you will file in 2014. There is a temporary exemption from Jan. 1, 2013, to Dec. 31, 2016, for individuals age 65 and older and their spouses. For additional information, see our questions and answers.

Health Insurance Premium Tax Credit

Starting in 2014, individuals and families can take a new premium tax credit to help them afford health insurance coverage purchased through an Affordable Insurance Exchange (also known as a Health Insurance Marketplace). The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit. The credit also can be paid in advance to a taxpayer’s insurance company to help cover the cost of premiums. On May 18, 2012, the Department of the Treasury and the IRS issued final regulations, which provide guidance for individuals who enroll in qualified health plans through Marketplaces and claim the premium tax credit, and for Marketplaces that make qualified health plans available to individuals and employers. On Jan. 30, 2013, the Department of the Treasury and IRS released final regulations on the premium tax credit affordability test for related individuals. On April 30, 2013, the Department of the Treasury and the IRS issued proposed regulations relating to minimum value of eligible employer-sponsored plans and other rules regarding the premium tax credit. Additionally, Notice 2013-41, issued on June 26, 2013, provides information for determining whether or when individuals are considered eligible for coverage under certain Medicaid, Medicare, CHIP, TRICARE, student health or state high-risk pool programs. This determination will affect whether the individual is eligible for the premium tax credit. On June 28, 2013, the Department of the Treasury and IRS issued proposed regulations on the new reporting requirements for Marketplaces. Notice 2014-23 was issued on March 26, 2014, and allows certain victims of domestic abuse to claim the premium tax credit while filing a return using the Married Filing Separately filing status for the 2014 calendar year. For more information on the credit, see our premium tax credit page and our questions and answers.

Individual Shared Responsibility Provision

Starting in 2014, the Individual Shared Responsibility provision calls for each individual to either have minimum essential coverage for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return. On Aug. 27, 2013, the Department of the Treasury and the IRS issued final regulations on the Individual Shared Responsibility provision. On Jan. 23, 2014, the Department of the Treasury and the IRS issued proposed regulations addressing several issues that were identified in the preamble to the final regulations. In particular, the proposed regulations provide that certain limited-benefit Medicaid and TRICARE coverage is not minimum essential coverage. The proposed regulations also address the treatment of health reimbursement arrangements and wellness program incentives for purposes of determining the exemption for individuals who cannot afford employer-sponsored coverage. Comments are due April 28, 2014, and may be submitted electronically, by mail or hand delivered to the IRS. Additionally, because individuals may not be aware that these limited-benefit government health programs are not minimum essential coverage at the time of enrollment, Notice 2014-10, issued on Jan. 23, 2014, provides transition relief from the shared responsibility payment for months in 2014 in which individuals have certain Medicaid coverage or limited-benefit coverage under chapter 55 of title 10, U.S.C. For additional information on the Individual Shared Responsibility provision, the final regulations and Notice 2013-42, see our ISRP page and questions and answers. Additional information on exemptions and minimum essential coverage is available in final regulations issued by the U.S. Department of Health & Human Services. The open enrollment period to purchase health insurance coverage for 2014 through the Health Insurance Marketplace runs from Oct. 1, 2013, through March 31, 2014.

Health Coverage for Older Children

Health coverage for an employee's children under 27 years of age is now generally tax-free to the employee. This expanded health care tax benefit applies to various work place and retiree health plans. These changes immediately allow employers with cafeteria plans –– plans that allow employees to choose from a menu of tax-free benefit options and cash or taxable benefits –– to permit employees to begin making pre-tax contributions to pay for this expanded benefit. This also applies to self-employed individuals who qualify for the self-employed health insurance deduction on their federal income tax return. Learn more by reading our news release or this notice.

Excise Tax on Indoor Tanning Services

A 10-percent excise tax on indoor UV tanning services went into effect on July 1, 2010. Payments are made along with Form 720, Quarterly Federal Excise Tax Return. The tax doesn't apply to phototherapy services performed by a licensed medical professional on his or her premises. There's also an exception for certain physical fitness facilities that offer tanning as an incidental service to members without a separately identifiable fee. For more information on the tax and how it is administered, see the Indoor Tanning Services Tax Center.

Adoption Credit

For tax years 2010 and 2011, the Affordable Care Act raised the maximum adoption credit per child and the credit was refundable. For more information related to the adoption credit for tax years 2010 and 2011, see our news release, tax tip, questions and answers, flyer, Notice 2010-66, Revenue Procedure 2010-31, Revenue Procedure 2010-35 and Revenue Procedure 2011-52.

For tax year 2012, the credit has reverted to being nonrefundable, with a maximum amount (dollar limitation) of $12,650 per child. If you adopted a child in 2012, see Tax Topic 607 for more information. 

Transitional Reinsurance Program

The ACA requires all health insurance issuers and self-insured group health plans to make contributions under the transitional Reinsurance Program to support payments to individual market issuers that cover high-cost individuals. For information on the tax treatment of contributions made under the Reinsurance Program, see our frequently asked questions.

Medicare Shared Savings Program

The Affordable Care Act establishes a Medicare shared savings program (MSSP) which encourages Accountable Care Organizations (ACOs) to facilitate cooperation among providers to improve the quality of care provided to Medicare beneficiaries and reduce unnecessary costs. More information can be found in Notice 2011-20, which solicited written comments regarding what additional guidance, if any, is needed for tax-exempt organizations participating in the MSSP through an ACO. This guidance also addresses the participation of tax-exempt organizations in non-MSSP activities through ACOs. Additional information on the MSSP is available on the Department of Health and Human Services website.

The Centers for Medicare and Medicaid Services has released final regulations describing the rules for the Shared Savings Program and accountable care organizations. Fact Sheet 2011-11 confirms that Notice 2011-20 continues to reflect IRS expectations regarding the Shared Savings Program and ACOs, and provides additional information for charitable organizations that may wish to participate.

Qualified Therapeutic Discovery Project Program

This program was designed to provide tax credits and grants to small firms that show significant potential to produce new and cost-saving therapies, support U.S. jobs and increase U.S. competitiveness. Applicants were required to have their research projects certified as eligible for the credit or grant. IRS guidance describes the application process.

Submission of certification applications began June 21, 2010, and applications had to be postmarked no later than July 21, 2010, to be considered for the program. Applications that were postmarked by July 21, 2010, were reviewed by both the Department of Health and Human Services (HHS) and the IRS. All applicants were notified by letter dated October 29, 2010, advising whether or not the application for certification was approved. For those applications that were approved, the letter also provided the amount of the grant to be awarded or the tax credit the applicant was eligible to take.

The IRS published the names of the applicants whose projects were approved as required by law. Listings of results are available by state.

Learn more by reading the IRS news release, the news release issued by the U.S. Department of the Treasury, the page on the HHS website and our questions and answers.

Group Health Plan Requirements

The Affordable Care Act establishes a number of new requirements for group health plans. Interim guidance on changes to the nondiscrimination requirements for group health plans can be found in Notice 2011-1, which provides that employers will not be subject to penalties until after additional guidance is issued. Additionally, TD 9575 and REG-140038-10, issued by DOL, HHS and IRS, provide information on the summary of benefits and coverage and the uniform glossary. Notice 2012-59 provides guidance to group health plans on the waiting periods they may apply before coverage starts. On March 19, 2013, HHS, DOL and IRS issued proposed regulations on the ninety-day waiting period limitation.. 

More information on group health plan requirements is available on the websites of the Departments of Health and Human Services and Labor and in additional guidance.

Further, Notice 2013-54 provides guidance regarding the application of the Affordable Care Act’s market reforms to certain types of group health plans, including health reimbursement arrangements (HRAs), health flexible spending arrangements (health FSAs) and certain other employer healthcare arrangements, including arrangements under which an employer reimburses an employee for some or all of the premium expenses incurred for an individual health insurance policy. 

Annual Fee on Health Insurance Providers

The Affordable Care Act created an annual fee on certain health insurance providers beginning in 2014. On Nov. 26, 2013, the Treasury Department and IRS issued final regulations on this annual fee imposed on covered entities engaged in the business of providing health insurance for United States health risks.

For additional information visit our Affordable Care Act Provision 9010 - Health Insurance Providers Fee page

Tax-Exempt 501(c)(29) Qualified Nonprofit Health Insurance Issuers

The Affordable Care Act requires the Department of Health and Human Services (HHS) to establish the Consumer Operated and Oriented Plan program (CO-OP program). It also provides for tax exemption for recipients of CO-OP program grants and loans that meet additional requirements under section 501(c)(29). IRS Notice 2011-23 outlined the requirements for tax exemption under section 501(c)(29) and solicited written comments regarding these requirements as well as the application process. Revenue Procedure 2012-11, issued in conjunction with temporary regulations and a notice of proposed rulemaking, sets out the procedures for issuing determination letters and rulings on the exempt status of organizations applying for recognition of exemption under 501(c)(29).

An overview of the CO-OP program is available on the HHS website.

Medicare Part D Coverage Gap “donut hole” Rebate

The Affordable Care Act provides a one-time $250 rebate in 2010 to assist Medicare Part D recipients who have reached their Medicare drug plan’s coverage gap. This payment is not taxable. This payment is not made by the IRS. More information can be found at www.medicare.gov.

Additional Requirements for Tax-Exempt Hospitals

The Affordable Care Act added new requirements for charitable hospitals (see Notice 2010-39 and Notice 2011-52). On June 26, 2012, the IRS published proposed regulations that provide information on the requirements for charitable hospitals relating to financial assistance and emergency medical care policies, charges for emergency or medically necessary care provided to individuals eligible for financial assistance, and billing and collections. On April 5, 2013, the IRS published proposed regulations on the requirement that charitable hospitals conduct community health needs assessments (CHNAs) and adopt implementation strategies at least once every three years. These proposed regulations also discuss the related excise tax and reporting requirements for charitable hospitals and the consequences for failure to satisfy the section 501(r) requirements. On August 15, 2013, the IRS published temporary regulations and proposed regulations providing information on which form to use when making an excise tax payment for failure to meet the CHNA requirements and the due date for filing the form. Notice 2014-2 confirms that hospital organizations can rely on proposed regulations under section 501(r) of the Internal Revenue Code published on June 26, 2012 and April 5, 2013, pending the publication of final regulations or other applicable guidance. Notice 2014-3 contains a proposed revenue procedure that provides correction and disclosure procedures under which certain failures to meet the requirements of section 501(r) will be excused.

Annual Fee on Branded Prescription Pharmaceutical Manufacturers and Importers

The Affordable Care Act created an annual fee payable beginning in 2011 by certain manufacturers and importers of brand name pharmaceuticals. On Aug. 15, 2011, the IRS issued temporary regulations and a notice of proposed rulemaking on the branded prescription drug fee. The temporary regulations describe the rules related to the fee, including how it is computed and how it is paid. On Aug. 5, 2013, the IRS issued Notice 2013-51, which provides additional guidance on the branded prescription drug fee for the 2014 fee year. For information on the fee for the 2012 fee year and for the 2013 fee year, see Notice 2011-92 and Notice 2012-74.

For additional information, visit our Affordable Care Act Provision 9008 Branded Prescription Drug Fee page.

Modification of Section 833 Treatment of Certain Health Organizations

The Affordable Care Act amended section 833 of the Code, which provides special rules for the taxation of Blue Cross and Blue Shield organizations and certain other organizations that provide health insurance. IRS Notice 2010-79 provides transitional relief and interim guidance on the computation of an organization’s taxpayer’s Medical Loss Ratio (MLR) for purposes of section 833, the consequences of nonapplication and changes in accounting method. Notice 2011-04 provides additional information and the procedures for qualifying organizations to obtain automatic consent to change its method of accounting for unearned premiums. Notice 2012-37 extends the transitional relief and interim guidance provided in Notice 2010-79 for another year to any taxable year beginning in 2012 and the first taxable year beginning after Dec. 31, 2012. 

On January 6, 2014, the IRS issued final regulations that describe how the MLR for purposes of section 833 is computed.

Limitation on Deduction for Compensation Paid by Certain Health Insurance Providers (amended section 162(m))

The Affordable Care Act amended section 162(m) of the Code to limit the compensation deduction available to certain health insurance providers. The amendment goes into effect for taxable years beginning after Dec. 31, 2012, but may affect deferred compensation attributable to services performed in a taxable year beginning after Dec. 31, 2009. On April 1, 2013, the Treasury Department and IRS issued proposed regulations on this provision. 

Employer Shared Responsibility Payment

The Affordable Care Act establishes that certain employers must offer health coverage to their full-time employees or a shared responsibility payment may apply. On Feb. 10, 2014, the Department of the Treasury and the IRS issued final regulations on the Employer Shared Responsibility provisions. For additional information on the Employer Shared Responsibility provisions and the proposed regulations, see our questions and answers. On July 9, 2013, the Department of the Treasury and the IRS announced transition relief from the Employer Shared Responsibility provisions for 2014. For more information, please see Notice 2013-45. For additional transition relief generally applicable to 2015, see the preamble to the final regulations.  

Patient-Centered Outcomes Research Institute Fee

The Affordable Care Act imposes the Patient-Centered Outcomes Research Institute (PCORI). Funded by the Patient-Centered Outcomes Research Trust Fund, the institute will assist patients, clinicians, purchasers and policy-makers in making informed health decisions by advancing clinical effectiveness research. The trust fund will be funded in part by fees paid by issuers of certain health insurance policies and sponsors of certain self-insured health plans.

The IRS and the Department of the Treasury have issued final regulations on this fee. Additional information on the fee is available on the PCORI page and in our questions and answers and chart summaryForm 720, Quarterly Federal Excise Tax Return, was revised to provide for the reporting and payment of the PCORI fee.

Retiree Drug Subsidies

Under § 139A of the Internal Revenue Code, certain special subsidy payments for retiree drug coverage made under the Social Security Act  are not included in the gross income of plan sponsors. Plan sponsors receive these retiree drug subsidy payments based on the allowable retiree costs for certain qualified retiree prescription drug plans. For taxable years beginning on or after Jan. 1, 2013, new statutory rules affect the ability of plan sponsors to deduct costs that are reimbursed through these subsidies. See our questions and answers for more information.

For More Information

For tips, fact sheets, questions and answers, videos and more, see our Affordable Care Act of 2010: News Releases, Multimedia and Legal Guidance page.

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Page Last Reviewed or Updated: 26-Mar-2014

 

The Irs Form 1040ez Fillable

Irs form 1040ez fillable 18. Irs form 1040ez fillable   Appendix This appendix contains models of the certificates, waivers, reports, and statements discussed in Part One. Irs form 1040ez fillable Model Certificate A   STATEMENT OF SUBSEQUENT SELLER     1. Irs form 1040ez fillable                 Name, address, and employer identification number of seller in subsequent sale             2. Irs form 1040ez fillable                 Name, address, and employer identification number of the buyer in subsequent sale             3. Irs form 1040ez fillable         Date and location of subsequent sale             4. Irs form 1040ez fillable         Volume and type of taxable fuel sold               The undersigned seller (“Seller”) has received the copy of the first taxpayer's report provided with this statement in     connection with Seller's purchase of the taxable fuel described in this statement. Irs form 1040ez fillable       Under penalties of perjury, Seller declares that Seller has examined this statement, including any accompanying     schedules and statements, and, to the best of Seller's knowledge and belief, they are true, correct and complete. Irs form 1040ez fillable                   Signature and date signed                   Printed or typed name of person signing this report                   Title—   Model Certificate B   FIRST TAXPAYER'S REPORT   1. Irs form 1040ez fillable                     First Taxpayer's name, address and employer identification number     2. Irs form 1040ez fillable                     Name, address, and employer identification number of the buyer of the taxable fuel subject to tax     3. Irs form 1040ez fillable           Date and location of removal, entry, or sale       4. Irs form 1040ez fillable           Volume and type of taxable fuel removed, entered or sold     5. Irs form 1040ez fillable Check type of taxable event:         Removal from refinery         Entry into United States         Bulk transfer from terminal by unregistered position holder       Bulk transfer not received at an approved terminal       Sale within the bulk transfer/terminal system       Removal at the terminal rack         Removal or sale by the blender                   6. Irs form 1040ez fillable           Amount of federal excise tax paid on account of the removal, entry, or sale                   The undersigned taxpayer (“Taxpayer”) has not received, and will not claim, a credit with respect to, or a refund of, the tax     on the taxable fuel to which this form relates. Irs form 1040ez fillable       Under penalties of perjury, Taxpayer declares that Taxpayer has examined this statement, including any accompanying     schedules and statements, and to the best of Taxpayer's knowledge and belief, they are true, correct and complete. Irs form 1040ez fillable             Signature and date signed               Printed or typed name of person signing this report               Title     Model Certificate C   NOTIFICATION CERTIFICATE OF TAXABLE FUEL REGISTRANT                           Name, address, and employer identification number of person receiving certificate       The undersigned taxable registrant (“Registrant”) hereby certifies under penalties of perjury that Registrant is registered     by the Internal Revenue Service with registration number and that Registrant's registration has not     been revoked or suspended by the Internal Revenue Service. Irs form 1040ez fillable                 Registrant understands that the fraudulent use of this certificate may subject Registrant and all parties making such     fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable                       Signature and date signed                         Printed or typed name of person signing                         Title of person signing                         Name of Registrant                         Employer identification number                         Address of Registrant     Model Certificate D   CERTIFICATE OF PERSON BUYING GASOLINE BLENDSTOCKS FOR USE OTHER THAN IN THE PRODUCTION OF FINISHED GASOLINE     (To support tax-free sales (other than LUST) under section 4081 of the Internal Revenue Code. Irs form 1040ez fillable )                 Name, address, and employer identification number of seller       The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:       The gasoline blendstocks to which this certificate relates will not be used to produce finished gasoline. Irs form 1040ez fillable       This certificate applies to the following (complete as applicable):       If this is a single purchase certificate, check here and enter:     1. Irs form 1040ez fillable Invoice or delivery ticket number       2. Irs form 1040ez fillable (number of gallons) of(type of gasoline blendstocks)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:     1. Irs form 1040ez fillable Effective date       2. Irs form 1040ez fillable Expiration date       (period not to exceed 1 year after the effective date)       3. Irs form 1040ez fillable Type (or types) of gasoline blendstocks     4. Irs form 1040ez fillable Buyer's account or order number         Buyer will not claim a credit or refund under section 6427(h) of the Internal Revenue Code for any gasoline blendstocks     covered by this certificate. Irs form 1040ez fillable         Buyer will provide a new certificate to the seller if any information in this certificate changes. Irs form 1040ez fillable       If Buyer resells the gasoline blendstocks to which this certificate relates, Buyer will be liable for tax unless Buyer obtains a     certificate from the purchaser stating that the gasoline blendstocks will not be used to produce finished gasoline and otherwise complies with the conditions of §48. Irs form 1040ez fillable 4081-4(b)(3) of the Manufacturers and Retailers Excise Tax Regulations. Irs form 1040ez fillable       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. Irs form 1040ez fillable       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Irs form 1040ez fillable     In addition, the Internal Revenue Service has not notified Buyer that the right to provide a certificate has been withdrawn from a purchaser to which Buyer sells gasoline blendstocks tax free. Irs form 1040ez fillable       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use     of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable             Signature and date signed               Printed or typed name of person signing               Title of person signing               Name of Buyer               Employer identification number               Address of Buyer     Model Certificate G   CERTIFICATE OF REGISTERED FEEDSTOCK USER     (To support tax-free removals and entries (other than LUST) of kerosene under section 4082 of the Internal Revenue Code. Irs form 1040ez fillable )         (Buyer) certifies the following under penalties of perjury:       Name of buyer         Buyer is a registered feedstock user with registration number . Irs form 1040ez fillable Buyer's registration has not been revoked     or suspended. Irs form 1040ez fillable         The kerosene to which this certificate applies will be used by Buyer for a feedstock purpose. Irs form 1040ez fillable                 This certificate applies to percent of Buyer's purchases from (name, address, and employer     identification number of seller) as follows (complete as applicable):       1. Irs form 1040ez fillable A single purchase on invoice or delivery ticket number . Irs form 1040ez fillable                 2. Irs form 1040ez fillable All purchases between (effective date) and (expiration date) (period not to exceed     one year after the effective date) under account or order number(s) . Irs form 1040ez fillable If this certificate applies only to Buyer's     purchases for certain locations, check here and list the locations. Irs form 1040ez fillable                                   If Buyer sells the kerosene to which this certificate relates, Buyer will be liable for tax on that sale. Irs form 1040ez fillable                 Buyer will provide a new certificate to the seller if any information in this certificate changes. Irs form 1040ez fillable                 If Buyer violates the terms of this certificate, the Internal Revenue Service may revoke the Buyer's registration. Irs form 1040ez fillable                 Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use of     this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable             Printed or typed name of person signing               Title of person signing               Employer identification number               Address of Buyer               Signature and date signed     Model Certificate J   CERTIFICATE OF PERSON BUYING COMPRESSED NATURAL GAS (CNG) FOR A NONTAXABLE USE     (To support tax-free sales of CNG under section 4041 of the Internal Revenue Code. Irs form 1040ez fillable )                                         Name, address, and employer identification number of seller                   (“Buyer”) certifies the following under penalties of perjury:     Name of buyer                     The CNG to which this certificate relates will be used in a nontaxable use. Irs form 1040ez fillable       This certificate applies to the following (complete as applicable):               If this is a single purchase certificate, check here and enter:       1. Irs form 1040ez fillable Invoice or delivery ticket number       2. Irs form 1040ez fillable (Gasoline gallon equivalents)       If this is a certificate covering all purchases under a specified account or order number, check here and enter:         1. Irs form 1040ez fillable Effective date         2. Irs form 1040ez fillable Expiration date         (period not to exceed 1 year after the effective date)         3. Irs form 1040ez fillable Buyer's account or order number       Buyer will not claim a credit or refund under section 6427 of the Internal Revenue Code for any CNG to which this certificate relates. Irs form 1040ez fillable       Buyer will provide a new certificate to the seller if any information in this certificate changes. Irs form 1040ez fillable       Buyer understands that if Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's     right to provide a certificate. Irs form 1040ez fillable       Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Irs form 1040ez fillable     In addition, the Internal Revenue Service has not notified Buyer that the right to provide a certificate has been withdrawn     from a purchaser to which Buyer sells CNG tax free. Irs form 1040ez fillable       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use     of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable             Printed or typed name of person signing               Title of person signing             Employer identification number               Address of Buyer               Signature and date signed     Model Certificate K   CERTIFICATE OF PERSON BUYING KEROSENE FOR USE IN AVIATION FOR     COMMERCIAL AVIATION OR NONTAXABLE USE     (To support operator liability for tax on removals of kerosene for use in aviation directly into the fuel tank of an aircraft in commercial aviation pursuant to § 4081 of the Internal Revenue Code or to support a tax rate of zero under § 4041(c) pursuant to §§4041(c) and 4082. Irs form 1040ez fillable )           Name, address, and employer identification number of position holder       The undersigned aircraft operator (“Buyer”) hereby certifies the following under the penalties of perjury:       The kerosene for use in aviation to which this certificate relates is purchased (check one): for     use on a farm for farming purposes; for use in foreign trade (reciprocal benefits required for foreign registered airlines); for use in certain helicopter and fixed-wing air ambulance uses; for use other than as a fuel in the propulsion engine of an aircraft; for the exclusive use of a qualified blood collector organization; for the exclusive use of a nonprofit educational organization; for the exclusive use of a state; for use in an aircraft owned by an aircraft museum; for use in military aircraft; or for use in commercial aviation (other than foreign trade). Irs form 1040ez fillable       With respect to kerosene for use in aviation purchased after June 30, 2005, for use in commercial aviation     (other than foreign trade), Buyer's registration number is. Irs form 1040ez fillable Buyer's registration has not been suspended or revoked by the Internal Revenue Service. Irs form 1040ez fillable       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Irs form 1040ez fillable Invoice or delivery ticket number       2. Irs form 1040ez fillable Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Irs form 1040ez fillable Effective date       2. Irs form 1040ez fillable Expiration date (period not to exceed 1 year after the effective date)       3. Irs form 1040ez fillable Buyer's account number       Buyer agrees to provide the person liable for tax with a new certificate if any information in this certificate changes. Irs form 1040ez fillable       If the kerosene for use in aviation to which this certificate relates is being bought for use in commercial aviation     (other than foreign trade), Buyer is liable for tax on its use of the fuel and will pay that tax to the government. Irs form 1040ez fillable       If Buyer sells or uses the kerosene for use in aviation to which this certificate relates for a use other than the use     stated above, Buyer will be liable for tax. Irs form 1040ez fillable       Buyer understands that it must be prepared to establish by satisfactory evidence the purpose for which the     fuel purchased under this certificate was used. Irs form 1040ez fillable     Buyer has not been notified by the Internal Revenue Service that its right to provide a certificate has been withdrawn. Irs form 1040ez fillable     If Buyer violates the terms of this certificate, the Internal Revenue Service may withdraw Buyer's right to provide a certificate. Irs form 1040ez fillable       The fraudulent use of this certificate may subject Buyer and all parties making any fraudulent use of this certificate     to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Waiver L WAIVER FOR USE BY ULTIMATE PURCHASERS OF KEROSENE FOR CERTAIN USES IN AVIATION (To support vendor's claim for a credit or payment under § 6427(l)(4)(C)(i) of the Internal Revenue Code. Irs form 1040ez fillable )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs form 1040ez fillable The kerosene to which this waiver relates is purchased for — (check one):       1. Irs form 1040ez fillable □ Use on a farm for farming purposes,       2. Irs form 1040ez fillable □ Use in foreign trade (reciprocal benefits required for foreign registered airlines),       3. Irs form 1040ez fillable □ Use in certain helicopter and fixed-wing air ambulance uses,       4. Irs form 1040ez fillable □ The exclusive use of a qualified blood collector organization,       5. Irs form 1040ez fillable □ The exclusive use of a nonprofit educational organization,       6. Irs form 1040ez fillable □ Use in an aircraft owned by an aircraft museum,       7. Irs form 1040ez fillable □ Use in military aircraft, or       8. Irs form 1040ez fillable □ Use in commercial aviation (other than foreign trade). Irs form 1040ez fillable     B. Irs form 1040ez fillable This waiver applies to the following (complete as applicable):       This is a single purchase waiver:           1. Irs form 1040ez fillable Invoice or delivery ticket number           2. Irs form 1040ez fillable Number of gallons       This is a waiver covering all purchases under a specified account or order number:           1. Irs form 1040ez fillable Effective date           2. Irs form 1040ez fillable Expiration date (period not to exceed 1 year after the effective date)           3. Irs form 1040ez fillable Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Irs form 1040ez fillable       If Buyer uses the kerosene for use in aviation to which this waiver relates for a use other than the use stated above, Buyer will be liable for tax. Irs form 1040ez fillable       Buyer understands that by signing this waiver, Buyer gives up its right to claim any credit or payment for the kerosene for use in aviation used in a nontaxable use. Irs form 1040ez fillable       Buyer acknowledges that it has not and will not claim any credit or payment for the kerosene for use in aviation to which this waiver relates. Irs form 1040ez fillable       Buyer understands that the fraudulent use of this waiver may subject Buyer and all parties making such fraudulent use of this waiver to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate M   CERTIFICATE FOR STATE USE OR NONPROFIT EDUCATIONAL     ORGANIZATION USE     (To support vendor's claim for a credit or payment under § 6416(a)(4) of the Internal Revenue Code. Irs form 1040ez fillable )                       Name, address, and employer identification number of ultimate vendor       The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under the penalties of perjury:       Buyer will use the gasoline or aviation gasoline to which this certificate relates (check one):     For the exclusive use of a state or local government; or     For the exclusive use of a nonprofit educational organization. Irs form 1040ez fillable       This certificate applies to the following (complete as applicable):     This is a single purchase certificate:       1. Irs form 1040ez fillable Invoice or delivery ticket number       2. Irs form 1040ez fillable Number of gallons     This is a certificate covering all purchases under a specified account or order number:       1. Irs form 1040ez fillable Effective date       2. Irs form 1040ez fillable Expiration date (period not to exceed 1 year after the effective date)       3. Irs form 1040ez fillable Buyer's account number       Buyer will provide a new certificate to the vendor if any information in this certificate changes. Irs form 1040ez fillable       Buyer understands that by signing this certificate, Buyer gives up its right to claim any credit or payment for the gasoline or aviation gasoline to which this certificate relates. Irs form 1040ez fillable       Buyer acknowledges that it has not and will not claim any credit or payment for the gasoline or aviation gasoline to which this certificate relates. Irs form 1040ez fillable       Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Waiver N   WAIVER FOR USE BY ULTIMATE PURCHASERS OF DIESEL FUEL OR     KEROSENE USED IN INTERCITY BUS TRANSPORTATION     (To support vendor's claim for a credit or payment under § 6427 of the Internal Revenue Code. Irs form 1040ez fillable )                       Name, address, and employer identification number of ultimate vendor       The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under the penalties of perjury:       The diesel fuel or kerosene to which this waiver relates is purchased for use in intercity bus transportation. Irs form 1040ez fillable       This waiver applies to the following (complete as applicable):     This is a single purchase waiver:       1. Irs form 1040ez fillable Invoice or delivery ticket number       2. Irs form 1040ez fillable Number of gallons     This is a waiver covering all purchases under a specified account or order number:       1. Irs form 1040ez fillable Effective date       2. Irs form 1040ez fillable Expiration date (period not to exceed 1 year after the effective date)       3. Irs form 1040ez fillable Buyer's account number       Buyer will provide a new waiver to the vendor if any information in this waiver changes. Irs form 1040ez fillable       If Buyer uses the diesel fuel or kerosene to which this waiver relates for a use other than in intercity bus transportation, Buyer will be liable for tax. Irs form 1040ez fillable       Buyer understands that by signing this waiver, Buyer gives up its right to claim any credit or payment for the diesel fuel or kerosene used in intercity bus transportation. Irs form 1040ez fillable       Buyer acknowledges that it has not and will not claim any credit or payment for the diesel fuel or kerosene to which this waiver relates. Irs form 1040ez fillable       Buyer understands that the fraudulent use of this waiver may subject Buyer and all parties making such fraudulent use of this waiver to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate O   CERTIFICATE FOR BIODIESEL     Certificate Identification Number:     (To support a claim related to biodiesel or a biodiesel mixture under section 6426 of the Internal Revenue Code. Irs form 1040ez fillable )     The undersigned biodiesel producer (“Producer”) hereby certifies the following under penalties of perjury:   1. Irs form 1040ez fillable             Producer's name, address, and employer identification number (EIN)   2. Irs form 1040ez fillable             Name, address, and EIN of person buying the biodiesel from Producer   3. Irs form 1040ez fillable       Date and location of sale to buyer   4. Irs form 1040ez fillable This certificate applies to gallons of biodiesel. Irs form 1040ez fillable   5. Irs form 1040ez fillable Producer certifies that the biodiesel to which this certificate relates is:       % Agri-biodiesel (derived solely from virgin oils)       % Biodiesel other than agri-biodiesel       This certificate applies to the following sale:       Invoice or delivery ticket number       Total number of gallons of biodiesel sold under that invoice or delivery ticket number (including biodiesel not covered by this certificate)       Total number of certificates issued for that invoice or delivery ticket number   6. Irs form 1040ez fillable             Name, address, and employer identification number of reseller to whom certificate is issued (only in the case of certificates reissued to a reseller after the return of the original certificate)   7. Irs form 1040ez fillable Original Certificate Identification Number (only in the case of certificates reissued to a reseller after return of the original certificate). Irs form 1040ez fillable       Producer is registered as a biodiesel producer with registration number . Irs form 1040ez fillable  Producer's registration has not been suspended or revoked by the Internal Revenue Service. Irs form 1040ez fillable       Producer certifies that the biodiesel to which this certificate relates in monoalkyl esters of long chain fatty acids derived from plant or animal matter that meets the requirements of the American Society of Testing and Materials D6751 and the registration requirements for fuels and fuel additives established by EPA under section 211 of the Clean Air Act (42 U. Irs form 1040ez fillable S. Irs form 1040ez fillable C. Irs form 1040ez fillable 7545). Irs form 1040ez fillable       Producer understands that the fraudulent use of this certificate may subject Producer and all parties making any fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Model Certificate P CERTIFICATE OF STATE USE (To support vendor's claim for credit or payment under section 6427 of the Internal Revenue Code. Irs form 1040ez fillable )               Name, Address, and Employer Identification Number of Vendor     The undersigned buyer (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs form 1040ez fillable Buyer will use the diesel fuel or kerosene to which this certificate relates for the exclusive use of a state or local government, or the District of Columbia. Irs form 1040ez fillable     B. Irs form 1040ez fillable This certificate applies to the following (complete as applicable):       1. Irs form 1040ez fillable   If this is a single purchase certificate, check here □ and enter:           a. Irs form 1040ez fillable Invoice or delivery ticket number           b. Irs form 1040ez fillable Number of gallons       2. Irs form 1040ez fillable   If this is a certificate covering all purchases under a specified account or order number, check here □  and enter:           a. Irs form 1040ez fillable Effective date           b. Irs form 1040ez fillable Expiration date   (period not to exceed 1 year after effective date)           c. Irs form 1040ez fillable Buyer's account or order number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Irs form 1040ez fillable     ▪ If Buyer uses the diesel fuel or kerosene to which this certificate relates for a purpose other than stated in the certificate, Buyer will be liable for any tax. Irs form 1040ez fillable     ▪ Buyer acknowledges that it has not and will not claim any credit or payment for the diesel fuel or kerosene to which this certificate relates. Irs form 1040ez fillable     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate Q CERTIFICATE OF ULTIMATE PURCHASER OF KEROSENE FOR USE IN NONEXEMPT, NONCOMMERCIAL AVIATION (To support vendor's claim for credit or payment under section 6427(l)(4)(C)(ii) of the Internal Revenue Code. Irs form 1040ez fillable )               Name, Address, and Employer Identification Number of Ultimate Vendor     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs form 1040ez fillable The kerosene to which this certificate relates is purchased for a nonexempt use in noncommercial aviation. Irs form 1040ez fillable     B. Irs form 1040ez fillable This certificate applies to the following (complete as applicable):       1. Irs form 1040ez fillable   If this is a single purchase certificate, check here □ and enter:           a. Irs form 1040ez fillable Invoice or delivery ticket number           b. Irs form 1040ez fillable Number of gallons       2. Irs form 1040ez fillable   This is a certificate covering all purchases under a specified account or order number:           a. Irs form 1040ez fillable Effective date           b. Irs form 1040ez fillable Expiration date   (period not to exceed 1 year after effective date)           c. Irs form 1040ez fillable Buyer's account number     ▪ Buyer will provide a new certificate to the vendor if any information in this certificate changes. Irs form 1040ez fillable     ▪ If Buyer uses the kerosene to which this certificate relates for a use other than the nontaxable use stated above, Buyer will be liable for tax. Irs form 1040ez fillable     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Certificate R CERTIFICATE OF BUYER OF TAXABLE FUEL FOR USE BY A STATE OR NONPROFIT EDUCATIONAL ORGANIZATION (To support credit card issuer's claim for credit, refund, or payment under section 6416(a)(4)(B) or section 6427(l)(5)(D) of the Internal Revenue Code. Irs form 1040ez fillable )               Name, Address, and Employer Identification Number of Credit Card Issuer. Irs form 1040ez fillable     The undersigned ultimate purchaser (“Buyer”) hereby certifies the following under penalties of perjury:     A. Irs form 1040ez fillable Buyer will use the taxable fuel to which this certificate relates for the exclusive use of a state; or     B. Irs form 1040ez fillable Buyer will use the gasoline to which this certificate relates for the exclusive use of a nonprofit educational organization. Irs form 1040ez fillable     C. Irs form 1040ez fillable This certificate applies to all purchases made with the credit card identified below during the period specified:           a. Irs form 1040ez fillable Effective date of certificate           b. Irs form 1040ez fillable Expiration date of certificate   (period not to exceed 2 years after effective date)           c. Irs form 1040ez fillable Buyer's account number     ▪ Buyer will provide a new certificate to the credit card issuer if any information in this certificate changes. Irs form 1040ez fillable     ▪ Buyer understands that by signing this certificate, Buyer gives up its right to claim a credit or payment for the taxable fuel purchased with the credit card to which this certificate relates. Irs form 1040ez fillable     ▪ Buyer acknowledges that it has not and will not claim any credit or payment for the taxable fuel purchased with the credit card to which this certificate relates. Irs form 1040ez fillable     ▪ Buyer understands that the fraudulent use of this certificate may subject Buyer and all parties making such fraudulent use of this certificate to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing           Title of person signing           Name of Buyer           Employer identification number           Address of Buyer           Signature and date signed   Model Statement S   STATEMENT OF BIODIESEL RESELLER     (To support a claim related to biodiesel or a biodiesel mixture under section 6426 of the Internal Revenue Code. Irs form 1040ez fillable )     The undersigned biodiesel producer (“Reseller”) hereby certifies the following under penalties of perjury:   1. Irs form 1040ez fillable                   Reseller's name, address, and employer identification number (EIN)   2. Irs form 1040ez fillable                   Name, address, and EIN of Reseller's buyer   3. Irs form 1040ez fillable       Date and location of sale to buyer   4. Irs form 1040ez fillable Volume of biodiesel sold   5. Irs form 1040ez fillable Certificate Identification Number on the Certificate for Biodiesel       Reseller has bought the biodiesel described in the accompanying Certificate for Biodiesel and Reseller has no reason to believe that any information in the certificate is false. Irs form 1040ez fillable       Reseller has not been notified by the Internal Revenue Service that its right to provide a certificate or statement has been withdrawn. Irs form 1040ez fillable       Reseller understands that the fraudulent use of this statement may subject Reseller and all parties making any fraudulent use of this statement to a fine or imprisonment, or both, together with the costs of prosecution. Irs form 1040ez fillable           Printed or typed name of person signing this certificate           Title of person signing           Signature and date signed   Prev  Up  Next   Home   More Online Publications