| APPENDIX A |
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| SAMPLE FORMAT FOR A LETTER RULING REQUEST |
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(Insert the date of request)
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| Internal Revenue
Service Commissioner, TE/GE Attention: SE:T:EP:RA P.O. Box 27063 McPherson
Station Washington, DC 20038
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| Dear Sir or Madam: |
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| (Insert the name of the taxpayer)
(the “Taxpayer”) requests a ruling on the proper treatment of
(insert the subject matter of the letter ruling request)
under § (insert the number) of the Internal
Revenue Code.
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| [If the taxpayer is requesting
expedited handling, the letter ruling request must contain a statement to
that effect. This statement must explain the need for expeditious handling.
See section 9.03(3).]
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| A. STATEMENT
OF FACTS |
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| 1. |
Taxpayer Information |
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| [Provide the statements required by sections
9.02(1)(a), (b), and (c) of Rev. Proc. 2005-4, 2005-1 I.R.B. . (Hereafter,
all references are to Rev. Proc. 2005-4 unless otherwise noted.)]
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| For example, a taxpayer that maintains
a qualified employee retirement plan and files an annual Form 5500 series
of returns may include the following statement to satisfy sections 9.02(1)(a),
(b), and (c):
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| The Taxpayer is a construction company
with principal offices located at 100 Whatever Drive, Wherever, Maryland 12345,
and its telephone number is (123) 456-7890. The Taxpayer’s federal employer
identification number is 00-1234567. The Taxpayer uses the Form 5500 series
of returns on a calendar year basis to report its qualified employee retirement
plan and trust.
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| 2. |
Detailed Description of the Transaction. |
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| [The ruling request must contain a complete
statement of the facts relating to the transaction that is the subject of
the letter ruling request. This statement must include a detailed description
of the transaction, including material facts in any accompanying documents,
and the business reasons for the transaction. See sections 9.02(1)(b), 9.02(1)(c),
and 9.02(2).]
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| B. RULING REQUESTED |
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| [The ruling request should contain a concise
statement of the ruling requested by the taxpayer.]
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| C. STATEMENT
OF LAW |
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| [The ruling request must contain a statement
of the law in support of the taxpayer’s views or conclusion, including
any authorities believed to be contrary to the position advanced in the ruling
request. This statement must also identify any pending legislation that may
affect the proposed transaction. See sections 9.02(6), 9.02(7), and 9.02(8).]
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| D. ANALYSIS |
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| [The ruling request must contain a discussion
of the facts and an analysis of the law. See sections 9.02(3), 9.02(6), 9.02(7),
and 9.02(8).]
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| E. CONCLUSION |
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| [The ruling request should contain a statement
of the taxpayer’s conclusion on the ruling requested.]
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| F. PROCEDURAL
MATTERS |
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| 1. Rev. Proc. 2005-4 statements |
| a. |
[The statement required by section 9.02(4).] |
| b. |
[The statement required by section 9.02(5).] |
| c. |
[The statement required by section 9.02(6)
regarding whether the law in connection with the letter ruling request is
uncertain and whether the issue is adequately addressed by relevant authorities.]
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| d. |
[The statement required by section 9.02(7)
when the taxpayer determines that there are no contrary authorities.]
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| e. |
[If the taxpayer wants to have a conference
on the issues involved in the letter ruling request, the ruling request should
contain a statement to that effect. See section 9.03(5).]
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| f. |
[If the taxpayer is requesting the letter
ruling to be issued by fax, the ruling request should contain a statement
to that effect. This statement must also contain a waiver of any disclosure
violations resulting from the fax transmission. See section 9.03(4).]
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| g. |
[If the taxpayer is requesting separate
letter rulings on multiple issues, the letter ruling request should contain
a statement to that effect. See section 9.03(1).]
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| 2. |
Administrative |
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| a. |
A Power of Attorney is enclosed. [See
sections 9.02(12) and 9.03(2).]
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| b. |
The deletions statement and checklist
required by Rev. Proc. 2005-4 are enclosed. [See sections 9.02(9) and 9.02(17).]
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| c. |
The required user fee is enclosed. [See
section 9.02(14).]
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Very truly yours, |
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(Insert the name of the taxpayer or the taxpayer’s
authorized representative)
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By: |
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Signature Date |
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Typed or printed name of person signing request |
| DECLARATION: [See
section 9.02(13).]
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| Under penalties of perjury, I declare
that I have examined this request, including accompanying documents, and to
the best of my knowledge and belief, the request contains all the relevant
facts relating to the request and such facts are true, correct, and complete.
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| (Insert the name of the taxpayer)
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| By: |
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| Signature Title Date |
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| Typed or printed name of person signing
declaration
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