Internal Revenue Bulletin:  2014-1 

January 2, 2014 

APPENDIX A
SAMPLE FORMAT FOR A LETTER RULING REQUEST
  (Insert the date of request)
[for Employee Plans]
Internal Revenue Service
Attention: EP Letter Rulings
P.O. Box 27063
McPherson Station
Washington, D.C. 20038

 
[for Exempt Organizations]
Internal Revenue Service
Attention: EO Letter Rulings
P.O. Box 27720
McPherson Station
Washington, D.C. 20038
 
Dear Sir or Madam:    
(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.  
[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).]  
A. STATEMENT OF FACTS  
1.Taxpayer Information    
[Provide the statements required by sections 9.02(1)(a), (b), and (c) of Rev. Proc. 2014–4, 2014-1 I.R.B. 125. (Hereafter, all references are to Rev. Proc. 2014–4 unless otherwise noted.)]  
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):  
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.  
2.Detailed Description of the Transaction.    
[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).]  
B. RULING REQUESTED  
[The ruling request should contain a concise statement of the ruling requested by the taxpayer.]  
C. STATEMENT OF LAW  
[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).]  
D. ANALYSIS  
[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).]  
E. CONCLUSION  
[The ruling request should contain a statement of the taxpayer’s conclusion on the ruling requested.]  
F. PROCEDURAL MATTERS  
1. Rev. Proc. 2014–4 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.]  
d. [The statement required by section 9.02(7) when the taxpayer determines that there are no contrary authorities.]  
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).]  
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).]  
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).]  
2. Administrative  
a. A Power of Attorney is enclosed. [See sections 9.02(12) and 9.03(2).]  
b. The deletions statement and checklist required by Rev. Proc. 2014–4 are enclosed. [See sections 9.02(9) and 9.02(17).]  
c. The required user fee is enclosed. [See section 9.02(14).]  
  Very truly yours,  
  (Insert the name of the taxpayer or the taxpayer’s authorized representative)  
  By:  
  ________ _____  
  SignatureDate  
  Typed or printed name  
  of person signing request  
>DECLARATION: [See section 9.02(13).]  
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.  
(Insert the name of the taxpayer)    
By:    
Signature TitleDate  
_________    
Typed or printed name of    
person signing declaration    

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