| 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 StationWashington, 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. 2010-4, 2010-1
I.R.B. . (Hereafter, all references are to Rev. Proc. 2010-4 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. 2010-4 statements |
| a. |
[The statement required by section
9.02(4).]
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| b. |
[The statement required by section
9.02(5).]
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| 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. 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. 2010-4 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 |
| Typed or printed name of person
signing declaration
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