Form 8870

(Rev. October 2021)

Department of the Treasury 

Internal Revenue Service 

Information Return for Transfers Associated 

With Certain Personal Benefit Contracts

(Under section 170(f)(10))

▶ Go to www.irs.gov/Form8870 for instructions and the latest information.

OMB No. 1545-0047 

Page 1 of 

For the accounting period beginning , , and ending , . 

Print or 

type. 

See 

Specific 

Instructions. 

Name of organization 

Number and street (or P.O. box if mail is not delivered to street address) Room/suite 

City or town, state or country, and ZIP code 

Employer identification number 

Telephone number 

Check ▶ if exemption application 

is pending 

Type of organization: Organization exempt under section 501(c)( ) ◀ (insert number)

Section 4947(a)(1) nonexempt charitable trust Section 664(d)(2) charitable remainder unitrust 

Section 664(d)(1) charitable remainder annuity trust Other section 170(c) organization 

Part A. Personal Benefit Contracts 

(a)

Item 

number 

(b) 

Contract Issuer 

Name, address, and ZIP code 

(c) 

Policy number 

No. 1 

No. 2 

No. 3 

No. 4 

No. 5 

Part B. Premiums Paid on Personal Benefit Contracts by the Organization or Treated as Paid by the Organization 

(a) 

Item number 

from Part A 

(b) 

Date premium 

paid by the 

organization 

(c) 

Amount of premium 

paid by the 

organization 

(d) 

Date premium 

paid by others 

(e) 

Amount of 

premium paid by 

others 

(f) 

Total of amounts in 

columns (c) and (e) 

No. 

No. 

No. 

No. 

No. 

(g) Total of amounts in column (f) . . . . . . . . . . . . . . . . . . . . . . . ▶ (g) 

(h) Amount from line (g) of Part B of the Continuation Schedule . . . . . . . . . . . . . ▶ (h) 

(i) Total. (Add lines (g) and (h). Enter total here and include this amount on line 8 of Part I of the

Form 4720.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶ (i) 

For Paperwork Reduction Act Notice, see the instructions. Cat. No. 28906R Form 8870 (Rev. 10-2021) 
Form 8870 (Rev. 10-2021) Page 2 

Part C. Beneficiaries 

(a) 

Item number 

from Part A 

(b) 

Beneficiary’s name, address, and 

ZIP code 

(c) 

Beneficiary’s SSN or EIN 

No. 

No. 

No. 

No. 

No. 

Part D. Transferors 

(a) 

Item number 

from Part A 

(b) 

Transferor’s name, address, and 

ZIP code 

(c) 

Date organization 

received transfer 

(d) 

Amount of 

transfer 

No. 

No. 

No. 

No. 

No. 

Sign 

Here 

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge 

and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

▲

Signature of officer Date ▲

Type or print name and title.

Paid 

Preparer 

Use Only

Print/Type preparer’s name Preparer’s signature Date Check if 

self-employed 

PTIN

Firm’s name ▶

Firm’s address ▶

Firm’s EIN ▶

Phone no. 

Form 8870 (Rev. 10-2021) 
Form 8870 (Rev. 10-2021) Page 3 

Continuation Schedule (You may duplicate this Schedule. See instructions.) Page of

Part A. Personal Benefit Contracts (cont.) 

(a)

Item 

number 

(b) 

Contract Issuer 

Name, address, and ZIP code 

(c) 

Policy number 

No. 

No. 

No. 

Part B. Premiums Paid on Personal Benefit Contracts by the Organization or Treated as Paid by the Organization (cont.) 

(a) 

Item number 

from Part A 

(b) 

Date premium 

paid by the 

organization 

(c) 

Amount of 

premium paid by 

the organization 

(d) 

Date premium 

paid by others 

(e) 

Amount of 

premium paid 

by others 

(f) 

Total of amounts in 

columns (c) and (e) 

No. 

No. 

No. 

(g) Total premiums. Add the amounts in column (f). (Enter here and on Part B, page 1, line (h).) . . ▶ (g) 

Part C. Beneficiaries (cont.) 

(a) 

Item number 

from Part A 

(b) 

Beneficiary’s name, address, 

and ZIP code 

(c) 

Beneficiary’s SSN or EIN 

No. 

No. 

No. 

Part D. Transferors (cont.) 

(a) 

Item number 

from Part A 

(b) 

Transferor’s name, address, and 

ZIP code 

(c) 

Date organization 

received transfer 

(d) 

Amount of 

transfer 

No. 

No. 

No. 

Form 8870 (Rev. 10-2021) 
Form 8870 (Rev. 10-2021) Page 4 

General Instructions 

Section references are to the Internal Revenue Code unless 

otherwise noted. 

Future Developments

For the latest information about developments related to 

Form 8870 and its instructions, such as legislation enacted after 

they were published, go to www.irs.gov/Form8870. 

Who Must File 

Section 170(f)(10) requires a charitable organization described in 

section 170(c) or a charitable remainder trust described in 

section 664(d) to complete and file Form 8870 if it paid 

premiums after February 8, 1999, on certain life insurance, 

annuity, and endowment contracts (personal benefit contracts). 

Note. Section 170(f)(10)(A) denies a charitable contribution 

deduction for a transfer to a “charitable organization” if the 

charitable organization pays any premium on a personal benefit 

contract with respect to the transferor. If there is an 

understanding or expectation that any other person will pay any 

premium on the personal benefit contract, that payment is 

treated as made by the organization. 

Section 170(f)(10)(F)(iii) requires a charitable organization to 

report annually: 

1. The amount of any premiums it paid on a personal benefit 

contract to which section 170(f)(10) applies, 

2. The name and taxpayer identification number (TIN) of each 

beneficiary under each contract to which the premiums relate, 

and 

3. Any other information the Secretary may require. 

Definitions 

Charitable organization. A charitable organization is an 

organization described in section 170(c). For purposes of this 

form, a charitable remainder trust, as defined in section 664(d), 

is also a charitable organization. 

Personal benefit contract. In general, section 170(f)(10)(B) 

defines a “personal benefit contract,” with respect to the 

transferor, as any life insurance, annuity, or endowment 

contract that benefits, any direct or indirect beneficiary, the 

transferor, a member of the transferor’s family, or any other 

person designated by the transferor (other than an organization 

described in section 170(c)). 

Exception for charitable gift annuity. Under section 170(f)

(10)(D), a person receiving payments under a charitable gift 

annuity (as defined in section 501(m)(5)) funded by an annuity 

contract purchased by a charitable organization is not treated 

as an indirect beneficiary of a personal benefit contract if the 

timing and amount of the payments under the annuity contract 

are substantially the same as the charitable organization’s 

obligations under the charitable gift annuity. 

For this exception to apply, the charitable organization must 

possess all the incidents of ownership and be entitled to all the 

payments under the annuity contract. 

Exception for charitable remainder trusts. Under section 

170(f)(10)(E), a person receiving annuity or unitrust payments 

from a charitable remainder trust is not treated as an indirect 

beneficiary of a life insurance, annuity, or endowment contract if 

the trust possesses all of the incidents of ownership under the 

contract and is entitled to all payments under the contract. 

When To File 

A charitable organization, other than a charitable remainder 

trust described in section 664(d), that paid premiums on a 

personal benefit contract must file Form 8870 by the fifteenth 

day of the fifth month after the end of the tax year. A charitable 

remainder trust described in section 664(d) must file Form 8870 

by April 15 following the calendar year during which it paid the 

premiums. 

If the regular due date falls on a Saturday, Sunday, or legal 

holiday, file on the next business day. A business day is any 

day that is not a Saturday, Sunday, or legal holiday. 

If the return is not filed by the due date (including any 

extension granted), attach a statement giving the reasons for 

not filing on time. 

Where To File 

Send the return to the Department of the Treasury, Internal 

Revenue Service, Ogden, UT 84201-0027. 

Private delivery services. You can use certain private delivery 

services (PDS) designated by the IRS to meet the “timely 

mailing as timely filing/paying rule” for tax returns and 

payments. Go to www.irs.gov/PDS for the current list of 

designated services.

The PDS can tell you how to get written proof of the mailing 

date. 

Extension of Time To File 

A charitable organization, including a charitable remainder trust, 

may obtain an extension of time to file Form 8870 by filing Form 

8868, Application for Extension of Time To File an Exempt 

Organization Return, on or before the due date of the return. 

Generally, the IRS will not grant an extension of time for more 

than 90 days. If more time is needed, file a second Form 8868 

for an additional 90-day extension. In no event will an extension 

of more than 6 months be granted to any domestic organization. 

Amended Return 

The organization may file an amended return at any time to 

change or add to the information reported on a previously filed 

return for the same period. 
Form 8870 (Rev. 10-2021) Page 5 

An amended return must provide all the information called for 

by the form and instructions, not just the new or corrected 

information. Write “Amended Return” at the top of an amended 

Form 8870. 

Signature 

To make the return complete, an officer of the organization 

authorized to sign it must sign in the space provided. For a 

corporation or association, this officer may be the president, 

vice president, treasurer, assistant treasurer, chief accounting 

officer, or other corporate or association officer, such as a tax 

officer. A receiver, trustee, or assignee must sign any return he 

or she files for a corporation or association. For a trust, the 

authorized trustee(s) must sign. 

Paid Preparer Use Only

Anyone who prepares the return but does not charge the 

organization should not sign the return. Certain others who 

prepare the return should not sign. For example, a regular, 

full-time employee of the lender, such as a clerk, secretary, etc., 

should not sign.

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 

the return. A paid preparer cannot use a social security number 

in the Paid Preparer Use Only box. The paid preparer must use 

a preparer tax identification number (PTIN). If the paid preparer 

is self-employed, the preparer should enter his or her address in 

the box. The paid preparer must: 

• Sign the return in the space provided for the preparer’s 

signature,

• Enter the preparer information, and 

• Give a copy of the return to the organization.

Penalties 

Returns required by section 170(f)(10)(F)(iii) are subject to the 

penalties applicable to returns required under section 6033. 

There are also criminal penalties for willful failure to file and for 

filing fraudulent returns and statements. See sections 7203, 

7206, and 7207. 

Other Returns You May Need To File 

Excise tax return. Section 170(f)(10)(F)(i) imposes on a 

charitable organization an excise tax equal to the premiums 

paid by the organization on any personal benefit contract, if the 

payment of premiums is in connection with a transfer for which 

a deduction is not allowed under section 170(f)(10)(A). 

For purposes of this excise tax, section 170(f)(10)(F)(ii) 

provides that premium payments made by any other person, 

pursuant to an understanding or expectation described in 

section 170(f)(10)(A), are treated as made by the charitable 

organization. 

A charitable organization liable for excise taxes under section 

170(f)(10)(F)(i) must file a return on Form 4720, Return of Certain 

Excise Taxes Under Chapters 41 and 42 of the Internal Revenue 

Code, to report and pay the taxes due. 

Information returns. Generally, an organization described in 

section 170(c) files either Form 990, Return of Organization 

Exempt From Income Tax, Form 990-EZ, Short Form Return of 

Organization Exempt From Income Tax, or Form 990-PF, 

Return of Private Foundation or Section 4947(a)(1) Trust Treated 

as a Private Foundation. 

A charitable remainder trust described in section 664(d) files 

Form 5227, Split-Interest Trust Information Return. 

Phone Help 

If you have questions and/or need help completing Form 8870, 

please call 877-829-5500. This toll-free telephone service is 

available Monday through Friday. 

Specific Instructions 

Completing the Heading of Form 8870 

Accounting period. Use Form 8870 to report either on a 

calendar year accounting period or on an accounting period 

other than a calendar year (either a fiscal year or a short period 

(less than 12 months)). This information should be the same 

information as reported on your Form 990, 990-EZ, 990-PF, or 

5227. 

Name and address. Include the suite, room, or other unit 

number after the street address. If the Post Office does not 

deliver mail to the street address, and the organization has a 

P.O. box, show the box number instead of the street address. 

For foreign addresses, enter information in the following 

order: city, province or state, and the name of the country. 

Follow the foreign country’s practice in placing the postal code 

in the address. Please do not abbreviate the country name. 

If a change in address occurs after the return is filed, use 

Form 8822, Change of Address, to notify the IRS of the new 

address. 

Employer identification number. The organization should 

have only one federal employer identification number (EIN). If 

it has more than one and has not been advised which to use, 

notify the Department of the Treasury, Internal Revenue 

Service, Ogden, UT 84201-0027. State what numbers the 

organization has, the name and address to which each 

number was assigned, and the address of its principal office. 

The IRS will advise the organization which number to use. 

Telephone number. Enter a telephone number of the 

organization that the IRS may use during normal business 

hours to contact the organization. If the organization does 

not have a telephone number, enter the telephone number of 

the appropriate organization official. 

Application pending. If the organization’s application for 

exemption is pending, check this box and complete the return. 

Type of organization. If the organization is exempt under 

section 501(c), check the applicable box and insert, within 

the parentheses, the number that identifies the type of section 

501(c) organization the filer is. Private foundations should enter 

“3” to indicate that they are a section 501(c)(3) organization. If 

the organization is a section 4947(a)(1) nonexempt charitable 

trust, a section 664 charitable remainder trust, or other section 

170(c) organization, check the applicable box. 

Part A. Personal Benefit Contracts 

Note. In Parts A through D, you will be reporting on personal 

benefit contracts for which you paid premiums or received 

transfers during the tax year. 

Use the Continuation Schedule if you have more than five 

personal benefit contracts to report. You may duplicate the 

Continuation Schedule and attach as many schedules as you 

need to Form 8870. Complete the Continuation Schedule 

following the Specific Instructions for Parts A through D. 

However, complete line (g) on only one Continuation Schedule. 

The figure on that Continuation Schedule should be the 

combined total of all your Continuation Schedules. Follow the 

line (g) instruction on page 3 of the form to carry the line (g) total 

amount to Part B, page 1, line (h). 

To avoid filing an incomplete return or having to respond to 

requests for missing information, complete all applicable line 

items. Make an entry (including a zero when appropriate). 

Column (a). Designate the first personal benefit contract you 

are reporting as item No. 1. Refer to the second personal 

benefit contract you are reporting as item No. 2, etc. In the 

Parts that follow, you are to provide more information for the 

personal benefit contract you identified as No. 1, No. 2, etc. 
Form 8870 (Rev. 10-2021) Page 6 

Part B. Premiums Paid on Personal Benefit Contracts 

by the Organization or Treated as Paid by the 

Organization 

If, in connection with any transfer to a charitable organization, 

the organization directly or indirectly pays premiums on any 

personal benefit contract, or there is an understanding or 

expectation that any person will directly or indirectly pay such 

premiums, the organization must report the following 

information. 

Premiums Paid by the Organization 

Note. Complete Part B for all premiums paid during the tax 

year for which the organization is filing Form 8870. 

Column (a). Identify all personal benefit contracts by the same 

item number you used in Part A. List these contracts in the 

consecutive order they were reported in Part A. 

Premiums Paid by Others but Treated as Paid by the 

Organization 

Column (f). Enter the total premiums from columns (c) and (e) 

paid by the organization, directly or indirectly, and other 

persons during the tax year, on each personal benefit contract. 

Line (i). Carry this total to Form 4720, line 8, Part I, to report the 

excise tax due. 

Part C. Beneficiaries 

Column (a). Identify all personal benefit contracts by the same 

item number you used in Part A. List these contracts in 

consecutive order. 

Column (b). Report the name, address, and ZIP code of the 

beneficiary under each personal benefit contract. 

Column (c). Enter the social security number (SSN) or employer 

identification number (EIN) of the beneficiary, entered in column 

(b), of each personal benefit contract. 

Part D. Transferors 

Report in Part D all transfers made during the tax year to the 

organization in connection with each personal benefit contract 

listed in Part A. 

Column (a). Identify all personal benefit contracts with the 

same item number you used in Part A. List these contracts in 

consecutive order. 

Column (b). Report the name, address, and ZIP code of each 

transferor of funds, transferred directly or indirectly, for use as 

premiums on each personal benefit contract. 

Paperwork Reduction Act Notice 

We ask for the information on this form to carry out the Internal 

Revenue laws of the United States. You are required to give us 

the information. We need it to ensure that you are complying 

with these laws and to allow us to figure and collect the right 

amount of tax.

You are not required to provide the information requested on 

a form that is subject to the Paperwork Reduction Act unless 

the form displays a valid OMB control number. Books or 

records relating to a form or its instructions must be retained as 

long as their contents may become material in the 

administration of any Internal Revenue law. Generally, tax 

returns and return information are confidential, as required by 

section 6103. However, certain returns and return information of 

tax-exempt organizations and trusts are subject to public 

disclosure and inspection, as provided by section 6104.

The time needed to complete and file this form will vary 

depending on individual circumstances. The estimated burden 

for tax-exempt organizations filing this form is approved under 

OMB control number 1545-0047 and is included in the 

estimates shown in the instructions for their information return.

If you have comments concerning the accuracy of these time 

estimates or suggestions for making this form simpler, we would 

be happy to hear from you. You can send us comments from 

www.irs.gov/FormComments. Or you can write to:

Internal Revenue Service 

Tax Forms and Publications Division 

1111 Constitution Ave. NW, IR-6526 

Washington, DC 20224

Do not send the tax form to this address. Instead, see Where 

To File on page 4.