Application for Exemption From Self-Employment Tax OMB No. 1545-0168

for Use by Ministers, Members of Religious Orders

and Christian Science Practitioners

Form 4361

(Rev. December 2003) File Original

and Two Copies Department of the Treasury

Internal Revenue Service

File original and two copies and attach supporting documents. This exemption is granted only if the IRS returns a copy to you marked “approved.”

1 Name of taxpayer applying for exemption (as shown on Form 1040) Social security number

Number and street (including apt. no.) Telephone number (optional)

( )

City or town, state, and ZIP code

Please type or print

Date ordained, licensed, etc.

(Attach supporting

document. See instructions.)

2 3

4 Legal name of ordaining, licensing, or commissioning body or religious order

/ /

Number, street, and room or suite no. Employer identification number

City or town, state, and ZIP code

Enter the first 2 years, after the date shown on line 3, that you had net self-employment earnings of $400 or

more, any of which came from services as a minister, priest, rabbi, etc.; member of a religious order; or Christian

Science practitioner 

5

If you apply for the exemption as a licensed or commissioned minister, and your denomination also ordains ministers, please indicate how your

ecclesiastical powers differ from those of an ordained minister of your denomination. Attach a copy of your denomination’s bylaws relating to

the powers of ordained, commissioned, or licensed ministers.

6

7 I certify that I am conscientiously opposed to, or because of my religious principles I am opposed to, the acceptance (for services I perform

as a minister, member of a religious order not under a vow of poverty, or a Christian Science practitioner) of any public insurance that

makes payments in the event of death, disability, old age, or retirement; or that makes payments toward the cost of, or provides services

for, medical care. (Public insurance includes insurance systems established by the Social Security Act.)

I certify that as a duly ordained, commissioned, or licensed minister of a church or a member of a religious order not under a vow of poverty,

I have informed the ordaining, commissioning, or licensing body of my church or order that I am conscientiously opposed to, or because of

religious principles, I am opposed to the acceptance (for services I perform as a minister or as a member of a religious order) of any public

insurance that makes payments in the event of death, disability, old age, or retirement; or that makes payments toward the cost of, or

provides services for, medical care, including the benefits of any insurance system established by the Social Security Act.

I certify that I have never filed Form 2031 to revoke a previous exemption from social security coverage on earnings as a minister, member

of a religious order not under a vow of poverty, or a Christian Science practitioner.

I request to be exempted from paying self-employment tax on my earnings from services as a minister, member of a religious order not

under a vow of poverty, or a Christian Science practitioner, under section 1402(e) of the Internal Revenue Code. I understand that the

exemption, if granted, will apply only to these earnings. Under penalties of perjury, I declare that I have examined this application and to

the best of my knowledge and belief, it is true and correct.

Signature  Date 

Caution: Form 4361 is not proof of the right to an exemption from Federal income tax withholding or social security tax, the right to a parsonage

allowance exclusion (section 107 of the Internal Revenue Code), assignment by your religious superiors to a particular job, or the exemption or

church status of the ordaining, licensing, or commissioning body, or religious order.

For Internal Revenue Service Use

Approved for exemption from self-employment tax on ministerial earnings 

Disapproved for exemption from self-employment tax on ministerial earnings

By

(Director’s signature) (Date)

General Instructions

Section references are to the Internal

Revenue Code.

Purpose of form. File Form 4361 to apply for

an exemption from self-employment tax if you

are:

Form 4361 (Rev. 12-2003)

Check one box:

Member of religious order not under a vow of poverty

● An ordained, commissioned, or licensed

minister of a church;

● A member of a religious order who has not

taken a vow of poverty;

● A Christian Science practitioner; or

Cat. No. 41586H

● A commissioned or licensed minister of a

church or church denomination that ordains

ministers, if you have authority to perform

substantially all religious duties of your church

or denomination. If you are a duly ordained, commissioned,

or licensed minister of a church or a member

of a religious order not under a vow of

poverty, prior to filing this form you must

inform the ordaining, commissioning, or

licensing body of your church or order that

you are opposed to the acceptance of public

insurance benefits based on ministerial

service on religious or conscientious grounds.

This application must be based on your

religious or conscientious opposition to the

acceptance (for services performed as a

minister, member of a religious order not

under a vow of poverty, or Christian Science

practitioner) of any public insurance that

makes payments for death, disability, old age,

or retirement; or that makes payments for the

For Privacy Act and Paperwork Reduction Act Notice, see page 2

Christian Science practitioner Ordained minister, priest, rabbi

Commissioned or licensed minister (see line 6)

cost of, or provides services for, medical

care, including any insurance benefits

established by the Social Security Act.
Form 4361 (Rev. 12-2003) Page 2

Exempt earnings. Only earnings from

ministerial services are exempt from

self-employment tax.

Specific Instructions

Conducting religious worship services or

ministering sacerdotal functions are ministerial

services whether or not performed for a

religious organization.

Ministerial services also include those

performed under the authority of a church or

church denomination. Examples are

controlling, conducting, and maintaining

religious organizations, including religious

boards, societies, and other agencies integral

to these organizations.

Where to file. Mail the original and two

copies of this form to: Internal Revenue

Service, Drop Point S-849, Philadelphia,

PA 19255

You must be able to show that the body

that ordained, commissioned, or licensed you,

or your religious order, is exempt from

Federal income tax under section 501(a) as a

religious organization described in section

501(c)(3). You must also be able to show that

the body is a church (or convention or

association of churches) described in section

170(b)(1)(A)(i). To assist the IRS in processing

your application, you can attach a copy of the

exemption letter issued to the organization by

the IRS. If that is not available, you can

attach a letter signed by an individual

Line 3. Enter the date you were ordained,

commissioned, or licensed as a minister of a

church; became a member of a religious

order; or began practice as a Christian

Science practitioner. Do not file Form 4361

before this date. Attach a copy of the

certificate (or, if you did not receive one, a

letter from the governing body of your church)

that establishes your status as an ordained,

commissioned, or licensed minister; a

member of a religious order; or a Christian

Science practitioner.

● The organization for which you perform the

services did not arrange with your church for

your services.

● You perform the same services for the

organization as other employees not

designated as you were.

● You perform the same services before and

after the designation.

Nonexempt earnings. Exemption from

self-employment tax does not apply to

earnings from services that are not ministerial.

Earnings from the following entities are not

exempt even if religious services are

conducted or sacerdotal functions are

ministered: the United States; a state,

territory, or possession of the United States;

the District of Columbia; a foreign

government; or a subdivision of any of these

bodies. For example, chaplains in the U.S.

Armed Forces are considered commissioned

officers, not ministers. Similarly, chaplains in

state prisons or universities are considered

civil servants.

Indicating exemption on Form 1040. If the

IRS returns your application marked

“approved” and your only self-employment

income was from ministerial services, write

“Exempt—Form 4361” on the

self-employment tax line in the Other Taxes

section of Form 1040. If you had other

self-employment income, see Schedule SE

(Form 1040).

If your application is approved, a copy of

Form 4361 will be returned to you marked

“approved.” Keep this copy of Form 4361 for

your permanent records. Once the exemption

is approved, you cannot revoke it.

If your church assigns or designates you to

perform services for an organization that is

neither a religious organization nor an integral

agency of a religious organization, you are

performing ministerial services even though

they may not involve conducting religious

worship or ministering sacerdotal functions.

Your services are ordinarily not considered

assigned or designated by your church if any

of the following is true.

Privacy Act and Paperwork Reduction Act

Notice. The Privacy Act of 1974 and the

Paperwork Reduction Act of 1980 require that

when we ask you for information we must

first tell you our legal right to ask for the

information, why we are asking for it, and

how it will be used. We must also tell you

what could happen if we do not receive it and

whether your response is voluntary, required

to obtain a benefit, or mandatory under the

law.

The time needed to complete and file this

form will vary depending on individual

circumstances. The estimated average time

is: Recordkeeping, 6 min.; Learning about

the law or the form, 19 min.; Preparing the

form, 16 min.; Copying, assembling, and

sending the form to the IRS, 16 min.

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

write to the Tax Products Coordinating

Committee, Western Area Distribution Center,

Rancho Cordova, CA 95743-0001. Do not

send the form to this address. Instead, see

Where to file on this page.

Our authority to ask for information is

Internal Revenue Code sections 6001, 6011,

and 6012(a), which require you to file a return

or statement with us for any tax for which

you are liable. Your response is mandatory

under these sections. Section 6109 requires

that you provide your social security number

on what you file. This is so we know who you

are, and can process your return and other

papers. You must fill in all parts of the tax

form that apply to you. If you fail to provide

all or part of the information requested on

Form 4361, your application may be denied.

Generally, tax returns and return

information are confidential, as stated in

section 6103. However, section 6103 allows

or requires the Internal Revenue Service to

disclose or give the information shown on

your tax return to others as described in the

Code. For example, we may disclose your tax

information to the Department of Justice to

enforce the tax laws, both civil and criminal,

to cities, states, the District of Columbia, and

U.S. commonwealths or possessions. We

may also disclose this information to other

countries under a tax treaty, or to Federal and

state agencies to enforce Federal nontax

criminal laws and to combat terrorism.

Please keep this notice with your records. It

may help you if we ask you for other

information. If you have any questions about

the rules for filing and giving information,

please call or visit any Internal Revenue

Service office.

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.

Approval of application. Before your

application can be approved, the IRS must

verify that you are aware of the grounds for

exemption and that you want the exemption

on that basis. When your completed Form

4361 is received, the IRS will mail you a

statement that describes the grounds for

receiving an exemption under section 1402(e).

You must certify that you have read the

statement and seek exemption on the

grounds listed on the statement. The

certification must be made by signing a copy

of the statement under penalties of perjury

and mailing it to the IRS not later than 90

days after the date the statement was mailed

to you. If it is not mailed by that time, your

exemption will not be effective until the date

the signed copy is received by the IRS. Line 4. If you are a minister or belong to a

religious order, enter the legal name, address,

and employer identification number of the

denomination that ordained, commissioned,

or licensed you, or the order to which you

belong. Get the employer identification

number from your church or order.

When to file. File Form 4361 by the due date,

including extensions, of your tax return for the

2nd tax year in which you had at least $400

of net earnings from self-employment, any of

which came from services performed as a

minister, member of a religious order, or

Christian Science practitioner.

Do not file Form 4361 if:

● You ever filed Form 2031, Revocation of

Exemption From Self-Employment Tax for

Use by Ministers, Members of Religious

Orders, and Christian Science Practitioners;

or

Additional information. See Pub. 517, Social

Security and Other Information for Members

of the Clergy and Religious Workers.

● You belong to a religious order and took a

vow of poverty. You are automatically exempt

from self-employment tax on earnings for

services you perform for your church or its

agencies. No tax exemption applies to

earnings for services you perform for any

other organization.

Effective date of exemption. An exemption

from self-employment tax is effective for all

tax years ending after 1967 in which you

have net self-employment earnings of $400 or

more, if you receive any of it from ministerial

services. For example, if you had qualified net

earnings of $400 or more in 2001 and not

again until 2003, a valid Form 4361 filed by

April 15, 2004, would apply to 2001 and all

later years. See Pub. 517 to find out if you

are entitled to a refund of self-employment

tax paid in earlier years.

authorized to act for the organization stating

that the organization meets both of the above

requirements.