Signature and Consent. An authorized representative of the issuer must sign Form 8038-G and any applicable certification. Also print the name and title of the person signing Form 8038-G. The authorized representative of the issuer signing this form must have the authority to consent to the disclosure of the issuer's return information, as necessary to process this return, to the person(s) that have been designated in Form 8038-G.
Signature and Consent. UNDER PENALTIES OF PERJURY UNDER THE LAWS OF THE UNITED STATES OF AMERICA, I CERTIFY THAT ALL OF THE INFORMATION PROVIDED ON THIS FORMER PARTICIPANT CLAIM FORM IS TRUE, CORRECT AND COMPLETE AND THAT I SIGNED THIS FORMER PARTICIPANT CLAIM FORM. Participant Signature Date (Required) PART 4: SUBSTITUTE IRS FORM W-9 TAXPAYER IDENTIFICATION NUMBER Enter Your Social Security Number: □□□-□□-□□□□ CERTIFICATION Under penalties of perjury, I certify that:
Signature and Consent. My signature below indicates that I am the parent/legal guardian of this child, and that he/she is not a xxxx of the state or other agency. I have read the above information about the study, Exercise Aspects of
Signature and Consent. Paid Preparer and belief, they are true, correct, and complete. I further declare that I consent to the IRS’s disclosure of the issuer’s return information, as necessary to process this return, to the person that I have authorized above. Signature of issuer’s authorized representative Date Type or print name and title Print/Type preparer’s name Preparer’s signature Date Check if PTIN self-employed Use Only Firm’s name ▶ Firm’s address ▶ Firm’s EIN ▶ Phone no. Form 8038-G (Rev. 10-2021) Form 8038-GC(Rev. October 2021)Department of the Treasury Internal Revenue Service Information Return for Small Tax-Exempt Governmental Bond Issues, Leases, and Installment Sales ▶ Under Internal Revenue Code section 149(e) Caution: If the issue price of the issue is $100,000 or more, use Form 8038-G. ▶ Go to xxx.xxx.xxx/Xxxx0000XX for instructions and the latest information. OMB No. 1545-0047 Part I Reporting Authority Check box if Amended Return ▶ 1 Issuer’s name 2 Issuer’s employer identification number (EIN) 3 Number and street (or P.O. box if mail isn’t delivered to street address) Room/suite 4 City, town, or post office, state, and ZIP code 5 Report number (For IRS Use Only)
Signature and Consent. An authorized representative of the issuer must sign Form 8038-GC and any applicable certification. Also, write the name and title of the person signing Form 8038-GC. The authorized representative of the issuer signing this form must have the authority to consent to the disclosure of the issuer’s return information, as necessary to process this return, to the person(s) that has been designated in this form. Note: If the issuer authorizes on line 6 the IRS to communicate with a person other than an officer or other employee of the issuer (such authorization shall include contact both in writing regardless of the address entered on lines 3 and 4, and by telephone), by signing this form, the issuer’s authorized representative consents to the disclosure of the issuer’s return information, as necessary to process this return, to such person.
Signature and Consent. An authorized representative of the issuer must sign Form 8038-G and any applicable certification. Also print the name and title of the person signing Form 8038-G. The authorized representative of the issuer signing this form must have the authority to consent to the disclosure of the issuer's return information, as necessary to process this return, to the person(s) that have been designated in Form 8038-G. Generally, anyone who is paid to prepare a return must sign it and fill in the other blanks in the Paid Preparer Use Only area of thereturn. The paid preparer must: Sign the return in the space provided for the preparer's signature (a facsimile signature isacceptable), Enter the preparer information, and Give a copy of the return to the issuer.
Signature and Consent. Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I further declare that I consent to the IRS’s disclosure of the issuer’s return information, as necessary to process this return, to the person that I have authorized above. Signature of issuer’s authorized representative 2/12/2021 Date Paid Preparer Use Only
