Form 8038-R

(Rev. April 2011)

Department of the Treasury 

Internal Revenue Service 

Request for Recovery of Overpayments 

Under Arbitrage Rebate Provisions

▶ File a separate form for each issue. ▶ See instructions. 

OMB No. 1545-1750

Part I Reporting Authority 

1 Issuer’s name 2 Issuer’s employer identification number (EIN)

3 Number and street (or P.O. box if mail is not delivered to street address) Room/suite 4 Report number (For IRS Use Only)

5 City, town, or post office, state, and ZIP code 6 Date of issue 

7 Name of issue 8 CUSIP number 

9 Name and title of officer of the issuer or other person whom the IRS may call for more information 10 Telephone number of officer or other person 

Part II Request for Refund of Amounts Paid Under Rebate Provisions (see instructions) 

11 If the issue was outstanding on or prior to June 30, 1993, and the issuer elects not to apply the 1992 regulations, check 

here (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶

12 Total amount paid under rebate provisions . . . . . . . . . . . . . . . . . . . 12 

13 Rebate amount as of the most recent computation date . . . . . 13 

14 Amounts (not included in line 12) required to be paid under section 148

as of the date the recovery is requested . . . . . . . . . . . 14 

15 Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . 15 

16 Amount of overpayment. Subtract line 15 from line 12 . . . . . . . . . . . . . . . 16 

17 Computations and relevant facts that led to overpayment (see instructions). Attach additional sheets if necessary. 

18 Schedule of payments (see instructions). Attach additional sheets if necessary. 

Part III Other Information (see instructions) Check the “Yes” or “No” box for each question below. Yes No 

19 Was the overpayment paid as penalty in lieu of rebate under section 148(f)(4)(C)(vii)? . . . . . . . . ▶ 19 

20 Has the final computation date for the issue occurred? . . . . . . . . . . . . . . . . . . ▶ 20 

21 If an entity other than a governmental entity is to use proceeds of these obligations, enter the name and EIN of that 

organization. If more than one, attach schedule.

Name ▶ EIN ▶

22 If the issuer wishes to authorize the IRS to communicate directly with a person who is a representative of the entity listed on

line 21, check the box and enter the name and telephone number of such person.

Name ▶ Phone no. 

Signature 

and 

Consent

Under penalties of perjury, I declare that I have examined this request for recovery of overpayment, including accompanying schedules and statements, and 

to the best of my knowledge and belief, the facts represented in support of the request 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 persons that I have authorized on lines 9 and 22 above. 

▲

Signature of issuer’s authorized representative Date 

▲

Type or print name and title

For Paperwork Reduction Act Notice, see the instructions. Cat. No. 57334H Form 8038-R (Rev. 4-2011) 

Paid 

Preparer 

Use Only

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

self-employed

PTIN

Firm’s name ▶ Firm's EIN ▶

Firm's address ▶ Phone no.
Form 8038-R (Rev. 4-2011) Page 2 

What’s New 

Claims for recovery of overpayments cannot be filed later than the date 

that is 2 years after the final computation date under Regulations 

section 1.148-3(e)(2) for the applicable issue of bonds, or 2 years from 

July 1, 2008, for an issue of bonds whose final computation date is on 

or before June 24, 2008. See Rev. Proc. 2008-37, which is on page 137 

of Internal Revenue Bulletin 2008-29 at www.irs.gov/pub/irs-irbs/

irb08-29.pdf. 

General Instructions 

Section references are to the Internal Revenue Code unless otherwise 

noted. 

Note. Use a separate Form 8038-R for each issue. 

Purpose of Form 

Form 8038-R is used by issuers of state and local bonds to request a 

refund of amounts paid with Form 8038-T, Arbitrage Rebate, Yield 

Reduction, and Penalty in Lieu of Arbitrage Rebate. 

Payments made with Form 8038-T that may be recoverable include: 

1. Yield reduction payments, 

2. The arbitrage rebate to the United States, 

3. A penalty in lieu of rebating arbitrage to the United States, or 

4. A penalty to terminate the election to pay a penalty in lieu of 

rebating arbitrage. 

Recovery of Overpayment 

In general, an issuer may recover an overpayment of rebate for an issue 

of bonds by establishing to the Internal Revenue Service that the 

overpayment occurred. An overpayment is the excess of the amount 

paid to the United States for an issue under section 148 over the sum of 

the rebate amount for the issue as of the most recent computation date 

and all amounts that are otherwise required to be paid under section 

148 as of the date the recovery is requested. 

An overpayment may be recovered only to the extent that a recovery 

on the date that it is first requested would not result in an additional 

rebate amount if that date were treated as a computation date. 

Except for overpayments of penalty in lieu of rebate under section 

148(f)(4)(C)(vii) and Regulations section 1.148-7(k), an overpayment of 

less than $5,000 may not be recovered before the final computation 

date. See Regulations section 1.148-3(i). 

The amount of rebate overpayment is based on the amount actually 

paid, not the future value of the amount paid.

Note. Regulations section 1.148-3(b) provides that as of any date, the 

rebate amount for an issue is the excess of the future value, as of that 

date, of all receipts on nonpurpose investments over the future value, as 

of that date, of all payments on nonpurpose investments. The definitions 

of payments and receipts in Regulations section 1.148-3(d), in part, 

require inclusion of transactions (including, but not limited to, 

acquisition, earnings and return of principal) on a date for each 

nonpurpose investment. Any cash flow representation to the contrary 

may result in the understatement of rebate amount. Yield reduction 

payments are determined using payments and receipts as described in 

Regulations section 1.148-5(b)(1).

Processing the Request 

When filing Form 8038-R, you must provide: 

• All copies of Form(s) 8038-T related to the request for refund, and 

• The computations of the overpayment and interest (if any) on line 17. 

The computations must show all cash flows from the issue date to the 

computation date reflecting the overpayment (for example, if a series of 

reports were prepared all such reports must be provided, unless the last 

report details all cash flows). Provide any additional attachments if 

needed. 

Generally, this information will be sufficient to determine whether a 

refund is appropriate. For refund claim rejections where there is a 

procedural deficiency or where an issuer has failed to provide sufficient 

information to enable a determination that an overpayment occurred, the 

IRS will contact the issuer or its representative to resolve the deficiency. 

If all the requested information is not timely received, a letter will be sent 

explaining that the request for recovery is deficient and that its 

processing is rejected. 

For refund claim denials, in full or in part, if the IRS makes a 

preliminary determination to deny a refund claim, the IRS will notify the 

issuer in writing that it may submit additional information or participate 

in a conference, or both. Additional information must be submitted 

within 21 days of the request for additional information or the 

conference. If the issuer fails to submit additional information or if the 

IRS disagrees that an overpayment occurred, the IRS will send the 

issuer a registered or certified letter denying the claim, subject to the 

issuer's appeal rights. 

The procedures for processing a request for refund are detailed in 

Rev. Proc. 2008-37 which is on page 137 of Internal Revenue Bulletin 

2008-29 at www.irs.gov/pub/irs-irbs/irb08-29.pdf. 

An issuer is entitled to appeal a refund claim denial. See Rev. Proc. 

2006-40 which is on page 694 of Internal Revenue Bulletin 2006-42 at 

www.irs.gov/pub/irs-irbs/irb06-42.pdf, for details.

Where To File 

File Form 8038-R, and attachments, with the Internal Revenue Service, 

Ogden Submission Processing Center, Ogden, UT 84201. 

Private delivery services. You can use certain private delivery services 

designated by the IRS to meet the “timely mailing as timely filing/

paying” rule for tax returns and payments. These private delivery 

services include only the following:

• DHL Express (DHL): DHL Same Day Service.

• Federal Express (FedEx): FedEx Priority Overnight, FedEx Standard 

Overnight, FedEx 2Day, FedEx International Priority, and FedEx 

International First.

• United Parcel Service (UPS): UPS Next Day Air, UPS Next Day Air 

Saver, UPS 2nd Day Air, UPS 2nd Day Air A.M., UPS Worldwide 

Express Plus, and UPS Worldwide Express.

The private delivery service can tell you how to get written proof of the 

mailing date.

▲!

CAUTION

Private delivery services cannot deliver items to P.O. boxes. 

You must use the U.S. Postal Service to mail any item to an 

IRS P.O. box address. 

Specific Instructions 

Line 1. Enter the name of the governmental entity that issued the 

bonds, not the name of the entity receiving the benefit of the financing. 

Part I. Reporting Authority 

Line 6. Enter the date of issue. This date should be identical to the date 

on the corresponding Form 8038-T, Part I, line 6. This is generally the 

first date on which there is a physical exchange of the bonds for the 

purchase price. 

Line 7. Enter the name of the issue. This name should be identical to the 

name listed on the corresponding Form 8038-T, Part I, line 7. If there is 

no name, please provide other identification of the issue. 

Line 8. Enter the CUSIP (Committee on Uniform Securities 

Identification Procedures) number of the bond with the latest maturity. 

The CUSIP should be identical to the CUSIP listed on the corresponding 

Form 8038-T, Part I, line 8. Enter “None” if the issue does not have a 

CUSIP number. 
Form 8038-R (Rev. 4-2011) Page 3 

Lines 9 and 10. Enter the name, title, and telephone number of the 

officer of the issuer whom the IRS may call for more information. If the 

issuer designates a person other than an officer of the issuer (including 

a legal representative or paid preparer) whom the IRS may call for more 

information with respect to this return, enter the name, title, and 

telephone number of such person here.

Note. By authorizing a person other than an authorized officer of the 

issuer to communicate with the IRS and whom the IRS may call for 

more information with respect to this return, the issuer authorizes the 

IRS to communicate directly with the individual listed in line 9 and 

consents to the disclosure of the issuer's return information to that 

individual, as necessary, in order to process this return.

Part II. Request for Refund 

Line 11. Current Regulations sections 1.148-1 through 1.148-11 apply 

to issues outstanding after June 30, 1993. If the issue was outstanding 

prior to July 1, 1993, the 1992 regulations apply (that is, Regulations 

sections 1.148-1 through 1.148-12 effective May 18, 1992 (T.D. 8418, 

1992-1 C.B. 29)). However, check the box if the issue was outstanding 

prior to July 1, 1993, and the issuer has elected not to apply the 1992 

regulations; the current Regulations sections 1.148-1 through 1.148-11 

apply. 

Line 17. Provide the computations of the overpayment paid as part of a 

rebate payment, penalty in lieu of rebate, or to terminate the penalty in 

lieu of rebate. Also, include the computations for interest (if any). A 

description of the facts that led to the overpayment must be included on 

this form. 

Line 18. Provide a schedule showing amounts and dates that payments 

were made to the United States for the issue. Attach copies of Form(s) 

8038-T that accompanied payments to the United States. 

Part III. Other Information 

Line 20. The final computation date is the date the issue is discharged. 

For details, see Regulations section 1.148-3(e)(2). 

Line 21. Enter the name and EIN of an entity, other than a governmental 

entity, that is to use proceeds of these obligations. If more than one, 

attach a schedule.

Line 22. If the issuer wishes to authorize the IRS to communicate 

directly with a person who is a representative of the entity listed on line 

21, check the box and enter the name and telephone number of such 

person. 

Note. By authorizing a person other than an authorized officer of the 

issuer to communicate with the IRS and whom the IRS may contact with 

respect to this return, the issuer authorizes the IRS to communicate 

directly with the individual entered in line 22 and consents to disclose 

the issuer's return information to that individual, as necessary, in order 

to process this return.

Signature and Consent

An authorized representative of the issuer must sign Form 8038-R and 

any applicable certification. Also print the name and title of the person 

signing Form 8038-R. 

The authorized representative of the issuer signing this form must 

have the authority to consent to the disclosure of the issuer's return 

information, including information provided on the issuer's 

corresponding Form 8038-T, as necessary to process this return, to the 

person(s) that have been designated in Form 8038-R.

Note. If authority is granted in line 9 or line 22 for the IRS to 

communicate with a person other than an officer of the issuer, by 

signing this form, the issuer's authorized representative consents to the 

disclosure of issuer's return information, as necessary to process this 

return, to such person.

Paid Preparer 

If an authorized representative of the issuer filled in its return, the paid 

preparer's space should remain blank. 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 issuer, 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.

The paid preparer must:

• Sign the return in the space provided for the preparer's signature (a 

facsimile signature is acceptable),

• Enter the preparer information, and 

• Give a copy of the return to the issuer.

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. 

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. 

The time needed to complete and file this form will vary depending 

on individual circumstances. The estimated average time is: 

Recordkeeping, 5 hr., 44 min.; Learning about the law or the form, 

3 hr., 10 min.; Preparing, copying, assembling, and sending the form 

to the IRS, 3 hr., 24 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 Internal Revenue Service, 

Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 

Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the 

form to this address. Instead, see Where To File earlier.