Rev. Proc. 2003-78, 2003-2 C.B. 1029, provides instructions for establishing an exemption from the section 4371 excise tax on insurance premiums paid to a foreign insurer or reinsurer when the exemption is based on the provisions of an income tax treaty to which the United States is a party. The instrument for acquiring the exemption is through a closing agreement between the foreign insurance company and the Commissioner of the Internal Revenue Service (IRS). Rev. Proc. 2015-46, 2015-39 I.R.B. 414, amends Rev Proc. 2003-78 to update the mailing address and contact number, formalize certain requirements and provide corresponding changes to the form closing agreements attached as Appendices A and B to Rev. Proc. 2003-78. Additional application information is discussed further below. Required Information for your Application: Closing agreement: Please submit the applicable form closing agreement, Appendix A (agreement for conventions with a qualified exemption) PDF or Appendix B (agreement for conventions with an anti-conduit limitation) PDF of Rev. Proc. 2015-46, in triplicate, each with an original signature. Penalty of perjury statement: A statement signed under penalty of perjury is required with the closing agreement application. The following page provides a sample penalty of perjury statement PDF. An agreement must be renewed and recertified every three years subject to a penalty of perjury statement. Note: A second sample PDF is provided for those with a closing agreement effective prior to October 10, 2003 that wish to recertify. User fees: Any foreign insurer or reinsurer wishing to enter into a closing agreement under Rev. Proc. 2003-78, as revised by Rev. Proc. 2015-46, should submit a request for a closing agreement. In addition, the applicant must pay a user fee as stated in Appendix A of Rev. Proc. 2016-1, 2016-1 I.R.B. 1, or any successor procedure. The current user fee is $12,000 as corrected in Rev. Proc. 2024-1. Please do not send a check with your application. Online payments can be made through Pay.gov if payment is made from a U.S. bank account. For further details, see Payment Instructions PDF. If the user fee is paid online, please include a copy of the payment receipt with your application. Payments by check must have “FET Program” noted in the memo section and must be mailed to: The Beckley Finance Center P.O. Box 9002 Beckley, WV 25802-9002 If sent by overnight mail, address to: The Beckley Finance Center 110 N. Heber Street Beckley, WV 25801 Letter of credit: A Letter of Credit (LOC) should be issued with a notice of non-renewal of not less than 90 days. The following page provides a Sample LOC PDF. The original LOC should be mailed to the following address: Internal Revenue Service 1248 N. University Dr, Stop 5780, Attn: CEASO Advisory Plantation, FL 33322 USA Form SS-4 (Application for Employer Identification Number (EIN)): An applicant must obtain an EIN independently before they apply for a Closing Agreement. If you do not already have an EIN, please refer to IRS Form SS-4 to request an EIN and include it in your application. List of responsible parties: The individuals responsible for the performance under the closing agreement are those individuals who are employees, officers or directors of the applicant with whom the IRS can resolve FET matters that arise under the closing agreement and have the authority to sign on the taxpayer's behalf. Please provide a list of those parties, including their name, corporate title, business address, telephone, fax and e-mail address for each person that is to be designated a responsible party. Please ensure it is signed by a person authorized to sign the application, and that the person’s name is printed below and the form is dated. The following page provides a sample form for listing responsible parties PDF under the agreement. Form 2848, Power of Attorney: If you desire to be represented by a third party with respect to the closing agreement, please include an IRS Form 2848 with your application. Please use the latest available version of IRS Form 2848. The IRS will periodically update a public list of foreign insurers or reinsurers that have entered into closing agreements with the IRS under Rev. Proc. 2003-78, as modified by Rev. Proc. 2015-46. Those foreign insurers or reinsurers wishing to be listed must file a consent to disclose tax information (as provided in the Consent PDF) with the IRS. Please indicate if you wish to be listed on your application. How to apply: Applications with all the above original documents (except for the LOC) should be sent via email to LBI.FET.Exemption@irs.gov. Please retain original copies of the documents submitted. Recertification documents should also be sent via email to this same address. If you have any questions, please contact Sammi Cen at LBI.FET.Exemption@irs.gov or eFax: 855-824–9494 References/related topics: Exemption from Section 4371 Excise Tax
