Online IRS Form 4876-A 2016-2023

This form documents how the Internal Revenue Service and its contractors are responsible for determining whether individuals have qualified or are ineligible for any of the programs under the Affordable Care Act. Specifically, under Section 6055(d)(3)(B)(iii) of the ACA, the IRS may have a duty to make determinations under its policies related to whether eligible individuals have qualified for and are eligible for any of the following services under the ACA: ACA Exchange health insurance coverage, including a qualified health plan; ACA qualified health plan in the individual market; and ACA qualified health plan in the small group market. If the IRS makes a determination under Form 4876-A, it must provide notice of that determination to the individual, and take any and all action necessary to implement that determination, including the imposition of penalty. If the IRS later determines that an exception applies and that an eligible individual is eligible for any of the services listed under Section 6055(d)(3)(B)(iii) of the ACA, and has provided notice under the regulations to the IRS and has taken all reasonable steps to satisfy the requirements of that provision, the IRS and its contractors may impose an income tax on the eligible individual. How is the IRS conducting these activities? As of October 1, 2017, the Internal Revenue Service (IRS) and its contractors were responsible for applying the following provisions of the ACA as their primary means of determining whether individuals are eligible for subsidies under the ACA: Section 6010.0302(b) regarding health coverage as a qualifying life event; Section 6010.0304 regarding financial resources as a qualifying life event; Section 6010.0304(c) regarding income sources as a qualifying life event; Section 6010.0305 regarding health care providers as a qualifying life event; Section 6010.0305(a) regarding health insurance coverage as a qualifying life event; and Section 36B.0309(c)(1)(vii) regarding health coverage as a qualifying life event.

If your tax return for the current year is due on or before April 15, you should complete Form 4876-A, Request for Form 4876-B Request for Cancellation of Return, too: If your tax return for this year is due before April 15, you should complete Form 4876-A, Request for Form 4876-B Request for Cancellation of Return. If you are filing Form 4876-A for any other tax year, you should attach a copy of the Form 4876, Form 4876-B, and any supporting documentation to your return. See Notice 2002-61, How to Prepare Taxpayer Papers, for specific instructions. Important information About Form 4876-A You must use Form 4876-A to request a cancellation of your return because it is too late to request a Form 4876-B. You can use any of the following documents to file forms on the internet. If there are no documents, you can also check the box in the space provided to the right of the statement of your account during the month in which the return was due. The date that tax was due. If you do not have proof that tax was due at the end of the month, you should enter an amount in the space provided for the last day on which tax was due. If you are filing Form 4876-A for a tax year which includes December, tell us this year's month. For example, if you filed Form 4876-B on November 30, please include dates from December, January, and February in place of the last four months of the tax year. The current year's account balance statement.

You need to complete Form 4876-A by the date you expect the sale of your home or other valuable transfer to happen. You get a 30-day extension if you're not sure if the sale is happening before your date of filing. If you've already filed a Statement of Property Tax Payment or Assignment of Tax Liens, then you don't need to complete Form 4876-A and your Form 8332 is automatically reinstated on your previous filing date. If you are filing Form 8332 to collect a tax lien from a creditor after Form 4876-A has been filed, you can start collecting the lien before you complete the form.

Yes. Just remember to check whether you're making a change in a particular taxpayer's circumstances. If the taxpayer is not changing circumstances, enter “no change required” (or “N/C”). If the taxpayer is changing circumstances, enter “change required” (or “C/O”). You will need to attach Form 4876-A for the return for which you plan to make the change. Is there a limit to how much of my modified adjusted gross income I can make up to from my employer? You can't make more of your modified adjusted gross income (your AGI) from your employer than you can receive from other sources by using the same formula. For example, if you have 5,000 in AGI from both your job and any IRA, you're limited to 4,000. Note that you cannot use your modified AGI as your basis for the rollover. You can use your modification AGI as your basis for the qualified small business health insurance credit and the earned income credit and as the basis for your rollover contribution. Note: The maximum amount you can have contributed in a calendar year from your employer is the greatest of 3,000 for the year or 3.5% of your modified AGI (or AGI-to-adjusted AGI, if qualified). For more information, go to How Do I Reduce Taxes by Using the Deduction for Qualified Health Care Expenses? How do I figure the AGI you can roll over? You can't use AGI as your basis for the qualified plan or qualified health plan deductions. See What Qualified Health Plan Deduction Exists, later, for more information about your AGI in the context of a qualified plan or qualified health plan. What is the qualified plan or qualified health plan exclusion? The qualified plan or qualified health plan exclusion is an exclusion for amounts used in making contributions to a qualified HSA. For example, contributions must not be made for the benefit of any individual or any employee of an employer who is not eligible to purchase the coverage offered through an HSA. In addition, distributions of amounts from a qualified HSA not used in making contributions to the plan are not taxed. The distribution is for qualified medical expenses not incurred by the individual with the HSA account. You cannot include all of your contributions in the plan for the year as a single contribution. Your contributions may be deductible as medical expenses paid and only your contributions would be deductible.

It is advisable to attach Form 4876-A to your current Form 1040NR, line 21, and enter the information that was on that form. However, you are not required to mail Form 4876-A if you received a Form 1040NR, line 21, and your return was accepted for filing. To complete a Form 4876-A, you cannot include any items on Form 4876-A that you would have listed on your Form 1040NR if you had submitted it on time, such as: An amended return, Taxes paid that are included on Form 4876-A, Interest paid on any Form 4876-A paid by the employer (as a return or payment), Any amounts for other benefits not on Form 4876-A, Any benefits that relate to the employee leaving or being fired. For more information, see Pub. 575. Do not use Form 4876-A to claim expenses you paid to a prior employer, such as vacation pay paid to a prior employer under an Employee Stock Ownership Plan (ESOP) or compensation paid to a prior employer under a pension benefit plan. Can I deduct employer contribution for health insurance premiums under a cafeteria plan? No. For information on cafeteria plans and related exclusions, see Health coverage, cafeteria plans, and similar coverage (sections 12532 through 12540 of the Internal Revenue Code). For information on cafeteria plans, see chapter 18 of Pub. 535. Can I deduct my child's tuition costs under a free or reduced price lunch program? No. For information on free or reduced price lunch programs as well as other programs, see Information reporting requirements and credits (sections 6012 through 6033 of the Internal Revenue Code). Can I deduct travel expenses on my business trips? Yes. If you are a small business owner who travels on official business trips and have an employee or independent contractor with your company, you can deduct travel expenses as business mileage expenses as long as you meet the following 3 conditions: Your trip is less than 5,000 miles, You travel alone in a private automobile and are responsible for all expenses incurred, and The total of travel expenses for all your official business trips taken during each calendar year, as determined by the IRS, does not exceed 60% of your adjusted gross income (AGI), as shown in the previous table.

If you are a U.S. citizen or resident alien, you may call the U.S. Citizenship and Immigration Services (USCIS) toll-free at. These numbers are from 8:00 am to 4:30 pm Pacific Time, Monday through Friday. You can obtain a copy of your Form 4876-A through the National Visa Center. If you are a non-U.S. citizen or are an international student, you can call the U.S. Consulate General in New York or any consulate in your home country using the U.S. Consulate General telephone number. If you are not eligible to apply for a student visa but are a resident of another country, you should visit the U.S. State Department website for information on how to apply for a nonimmigrant visa. If you are a non-U.S. citizen and have not applied for a U.S. resident nonimmigrant visa, the government may grant the conditional nonimmigrant visa (N-1) to you under a visa waiver agreement if you meet certain requirements. If you are a non-U.S. citizen and do not meet the requirements for an N-1 visa, you must apply to the U.S. Embassy or Consulate to try for a nonimmigrant visa through a non-immigrant visa agency. If you have previously received a conditional N-1 visa, you can apply to the U.S. Embassy or Consulate to try again using the same application process. How do I renew my visa for a temporary visitor visa? If you have been granted a conditional permanent resident visa (green card) on or after June 21, 2011, you must apply for a permanent visa. If you obtained a conditional permanent resident visa (green card) before June 21, 2011, you may apply for an N-1 visa until it expires; you can then apply for a replacement N-1 visa based on the same application process. If you do not meet the requirements for a non-immigrant visa, you must apply for a resident visa through the foreign government. I do not meet any of the following requirements for a temporary visitor visa.

To attach only a single form of documentation to your Form 4876-A, enter its title in Box 3. Enter the year it was originally executed. If you used your spouse's valid S-4 for tax returns for your and your spouse's joint returns, include the spouse's S-4 code as required by IRS Publication 519; if you did not use a spouse's valid S-4, your married filing separately status must have been reported on your return. (See Tax Matters: Married Filing Separately.) If the documentation to be submitted contains the correct amount of tax withheld and paid, include all the required documents. If an IRS Form S-1, Taxpayer Identification Number-Social Security Number Transfer (Form W-8BEN), the correct amount of tax withheld and paid, and the date the withholding was completed is included with the Form S-1 or, you can make this information appear on all of your documentation. If a Form W-8BEN was attached to your Form 4876-A, enter the date that it was attached. How do I attach my documents to my copy of the tax return submitted to the IRS? Use Form 4876-A to attach your documents to your copy of Form 4876-A. When you complete Form 4876-A by filling out both boxes, type or print, to the right of Line 13 “Payment of Federal Insurance Contributions Act (FICA)” on Box 3. The type of form you enter depends on the amount of your federal insurance contribution. You can use the payment instructions provided on Form 4876-A or the instructions on your tax return if you completed your Form 4876-A online (by using the Self-Certification Checklist on IRS.gov). You can also use the instructions under “Additional Instructions for Certain Forms of Payment.” Who should I consider when filing Form 4876-A? Your tax account must be accurate as of the first day of the tax year. For example, on June 1, 2012, you filed your 2009 federal tax return for that year. You may have not completed your Form 4876-A until July 1, 2012. As a result, for your tax return, the IRS is not likely to notice an error, such as an overpayment of tax, when it receives your corrected tax return.

You are permitted to report more than one business income tax year (or other income). Thus, you should report all of your business income on Schedule C or Schedule E. The following examples show which type is reported on Form 4876-A. Example of a business owner reporting more than one business income tax year: Mary owns two businesses: Mary Bakes and Mary's Business. Mary is the sole owner of Mary Bakes, and the sole owner of Mary's Business. Mary's Business has sales of less than 5 million for this year, and Mary's Business earned 10 million in sales for the year prior to Mary's ownership. Mary pays taxes on 90 million of income from Mary's Business. Mary Bakes is a subsidiary of Mary's Business. Mary's Business owns Mary Bakes. Mary reports the business income of Mary Bakes as business income from Mary's Business. Mary reports 1.5 million of business income from Mary's Business and also reports 1.5 million of business income from Mary's Business. Mary pays a 70,000 tax on the 4 million of business income from Mary's Business (for a tax rate of 28.75%). Example of a non-business owner reporting more than one business income tax year: Bill owns one business, and his children own two other businesses (Dana and Kate's Business). Bill's business activities include providing high-quality educational services through Dana's Business and Kate's Business. Bill's child employees perform services for Dana and Kate's Business and Bill's child employees do not perform services for Kate's Business. Bill and his children own Dana's Business and Kate's Business as a “C-corporation,” and all income earned by Dana's Business and Kate's Business is reportable business income. However, Bill's wife, Mary, owns Dana's Business and Kate's Business. Mary's income is unrelated to Bill's business activities, and she does not report income from Dana's Business. In this example, Bill, and his spouse, receive income from Dana's Business, but they report no income with respect to Kate's Business. Therefore, both Bill and Mary should report this taxable income on their tax return.

In 2012, there were about 8.4 million federal tax returns filed with a filing status of 0% or other returns, up 9.5% from 2011, according to the Internal Revenue Service. For individual filers, about 36.2 million of them had less than 10,000 in income, according to the IRS. And as for married couples filing joint returns, the average filer had 67,900 in income. And just for good measure, in 2012, about 1.38 billion returns were filed with a refund amount of 25 or less. And it's a good thing, too, because that number — and the nearly 2 million who had to make their payments back to the IRS — was up 22% from 2011. In 2012, about 32 million taxpayers made tax payments of more than 250. Only 3% were owed over 1,000. According to the IRS, the average tax payment was 1,634. So what is the average tax payment for 2012? Well, that's another thing the IRS is keeping a close eye on. With so many people filing returns, there can be so many more people in the database than there is in the tax return data itself. That makes it pretty easy for the IRS to say this year is up 10%, though, and, well, we don't have a percentage because the numbers are so big. The data for total income and tax payments are pretty similar, though. The average tax refund on individual returns was 1,400, according to the IRS. On married filing jointly returns, the average payout was about 2,700. (The average tax payment was 28 for both single and married filers, according to the data the IRS had about 1 million of returns. That doesn't mean the average tax payment was 28 for everyone: The IRS collected about 1.15 million and only 1.1 million reported income — the other 8.4 million were not included in that number.) So what makes things go higher and lower in the end? It's all relative. What made a few years ago and a couple of years ago even though a huge number of taxpayers didn't pay much in taxes? Well, we do know that more and more and more American taxpayers are paying higher tax rates.

Yes. Under the IRS regulations, a Form 4876-A is required for the following years: 2013. 2014. 2015. 2016. 2017. 2018. 2019. 2020. Authorizes the IRS to collect information from the taxpayers and the employers listed on Form 4876-A. May the IRS share taxpayer information with the State Unemployment Tax Commission, the Department of Labor, or the Fair Employment and Housing Commission? Yes. The IRS and the IRS Employer Fraud Program will share any taxpayer and employer information with an agency authorized by law to investigate and deter fraud and wage-related violations, such as State Unemployment Tax Commission (SU TCO), Department of Labor, or Fair Employment and Housing Commission. They will also include this information in an annual Fraud Prevention Annual Report. Has the IRS provided information from a Form 4876-A to the Department of Labor? To date, the IRS has provided these forms to SU TCO, Department of Labor, and FEE PAQ. The FEE PAQ and SU TCO have the authority to receive the information. Has the IRS provided information from a Form 4876-A to the Fair Employment and Housing Commission? The IRS has provided Form 4876-A information to FEE PAQ. This information is to be maintained in a separate file from other information about an employee. Back to Question List Additional Questions How do I know if an employer claims an income tax deduction? The IRS defines “salary” to include any amount received as wages or compensation as well as any amounts received as profit or compensation on behalf of the employer. Any amount that does not relate to the employee's working duties during the pay period will be treated as profit or otherwise taxable. Back to Question List How do I know if a worker's wages are subject to payroll tax? The employee may not be required to withhold and pay withholding or payroll taxes if it is determined that the worker is entitled to a deduction under the federal tax law. To determine if a deduction is due to a tax year, the worker's filing status must be established, and the amount of pay, wages, and/or profit or compensation received during the year.