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Form 4029 (Rev. 03-2011)
Page
General Instructions
How to show exemption from self-employment taxes on Form 1040. If
the IRS returned your copy of Form 4029 marked “Approved,” write “Form
4029” on the “Self-employment tax” line in the Other Taxes section of Form
Section references are to the Internal Revenue Code.
1040, page 2.
Purpose of form. Form 4029 is used by members of recognized religious
groups to apply for exemption from social security and Medicare taxes. The
Instructions to Employers
exemption is for individuals and partnerships (when all the partners have
approved certification).
Employees without Form 4029 approval. If you have employees who do
Note. The election to waive social security benefits, including Medicare
not have an approved Form 4029, you must withhold the employee’s share
benefits, applies to all wages and self-employment income earned before
of social security and Medicare taxes and pay the employer’s share.
and during the effective period of this exemption and is irrevocable for that
Reporting exempt wages. If you are a qualifying employer with one or more
period.
qualifying employees, you are not required to report wages that are exempt
Who may apply. You may apply for this exemption if you are a member of,
under section 3127. Do not include these wages for social security and
and follow the teachings of, a recognized religious group (as defined below).
Medicare tax purposes on Form 941, Employer’s QUARTERLY Federal Tax
If you already have approval for exemption from self-employment taxes, you
Return, Form 943, Employer’s Annual Tax Return for Agricultural Employees,
are considered to have met the requirements for exemption from social
or on Form 944, Employer’s ANNUAL Federal Tax Return. If you have
security and Medicare taxes on wages and do not need to file this form.
received an approved Form 4029, check the box on line 4 of Form 941 (line
3 of Form 944) and write “Form 4029” in the empty space below the check
You are not eligible for this exemption if you received social security
box. If you file Form 943 and have received an approved Form 4029, write
benefits or payments, or if anyone else received these benefits or payments
“Form 4029” to the left of the wage entry spaces for Total wages subject to
based on your wages or self-employment income. However, you can file
social security taxes and Total wages subject to Medicare taxes.
Form 4029 and be considered for approval if you paid back any benefits you
received.
Preparation of Form W-2. When you prepare Form W-2 for a qualifying
employee, enter “Form 4029” in the box marked “Other.” Do not make any
Recognized religious group. A recognized religious group must meet all the
entries in the boxes for Social security wages, Medicare wages and tips,
following requirements:
Social security tax withheld, or Medicare tax withheld for these employees.
• It is conscientiously opposed to accepting benefits of any private or public
insurance that makes payments in the event of death, disability, old age, or
Privacy Act and Paperwork Reduction Act Notice. We ask for the
retirement; makes payments for the cost of medical care; or provides
information on this form to carry out the Internal Revenue laws of the United
services for medical care (including social security and Medicare benefits).
States. We need this information to ensure that you are complying with these
• It has provided a reasonable level of living for its dependent members.
laws and to allow us to figure and to collect the right amount of tax. Applying
• It has existed continuously since December 31, 1950.
for an exemption from social security and Medicare taxes is voluntary.
Providing the requested information, however, is mandatory if you apply for
Certification. In order to complete the certification portion under Part I,
the exemption. Our legal right to ask for the information requested on this
you need to enter your religious group (on the first line) followed by the
form is Internal Revenue Code sections 6001, 6011, 6012(a) and 6109. Code
religious district or congregation (on the second line). For example, if you
section 6109 requires that you provide your social security number on what
enter “Old Order Amish” as your religious group, then you would enter
you file. If you fail to provide all or part of the information requested on Form
“Conewango Valley North District,” “Conewango Valley West District,” etc.,
4029, your application may be denied. If you provide false or fraudulent
on the second line as the district. However, if you are Anabaptist or
information, you may be subject to penalties.
Mennonite, enter the name of your religious group as “Unaffiliated Mennonite
Churches” or “Eastern Pennsylvania Mennonite Church,” etc., and the
Generally, tax returns and return information are confidential, as stated in
congregation as “Antrim Mennonite Church (Anabaptist)” or “Bethel
section 6103. However, section 6103 allows or requires the Internal Revenue
Mennonite Church (Mennonite),” on the second line.
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
When to file. File Form 4029 when you want to apply for exemption from
to the Department of Justice to enforce the tax laws, both civil and criminal,
social security and Medicare taxes. This is a one-time election. Keep your
to cities, states, the District of Columbia, U.S. commonwealths or
approved copy of Form 4029 for your permanent records.
possessions for use in administering their tax laws. We may also disclose
Where to file. Send the original and two copies of Form 4029 to:
this information to other countries under a tax treaty, to federal and state
Social Security Administration
agencies to enforce federal nontax criminal laws, or to federal law
Security Records Branch,
enforcement and intelligence agencies to combat terrorism.
Attn: Religious Exemption Unit
Please keep this notice with your records. It may help you if we ask for
P.O. Box 7
other information. If you have any questions about the rules for filing and
Boyers, PA 16020
giving information, please call or visit any Internal Revenue Service office.
If you are no longer a member or no longer follow the teachings of the
The time needed to complete and file this form will vary depending on
religious group, your exemption is no longer effective. Notify the Internal
individual circumstances. The estimated average time is: Recordkeeping, 6
Revenue Service by sending a letter to:
min.; Learning about the law or the form, 19 min.; Preparing the form, 18
Department of the Treasury
min.; Copying, assembling, and sending the form to the SSA, 16 min.
Internal Revenue Service Center
If you have comments concerning the accuracy of these time estimates or
Philadelphia, PA 19255-0733
suggestions for making this form simpler, we would be happy to hear from
you. You can write to the Internal Revenue Service, Tax Products
Social security number. Enter your social security number on line 2. If you
Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
do not have a social security number, file Form SS-5, Application for a Social
NW, IR-6526, Washington, DC 20224. Do not send the form to this address.
Security Card, at your local social security office. You can order Form SS-5
Instead, see Where to file on this page.
by calling 1-800-772-1213 or by visiting the website for Social Security at
.
Effective period of exemption. An approved exemption granted to
employers and employees is effective on the first day of the first quarter after
the quarter in which Form 4029 is filed. An approved exemption granted to
self-employed individuals is effective when granted and applies for all years
for which you satisfy the requirements. The exemption will continue as long
as you, or in the case of wage payments, both the employee and employer
continue to meet the exemption requirements.
Signature. The completed Form 4029 must be signed and dated by the
applicant in Part I and by the authorized representative of the religious group/
district/congregation in Part II.