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Also see: IRS Provides Penalty Relief to Taxpayers Affected by Erroneous Forms 1095-A.

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CPA Sample Statement: Statement Requesting Waiver of Estimated Tax Penalty under Notice 2015-30 Due to Incorrect or Delayed Form 1095-A

(Parker Tax Publishing April 27, 2015)

 

To request a waiver of the Code Sec. 6654(a) penalty as provided Notice 2015-30, taxpayers should check box A in Part II of Form 2210, complete page 1 of the form, and include the form with their return, along with the statement: "Received an incorrect or delayed Form 1095-A."

Taxpayers DO NOT need to attach documentation from the Marketplace, explain the circumstances under which they received an incorrect or delayed Form 1095-A, or complete any page other than page 1 of the Form 2210. Taxpayers also do not need to figure the amount of penalty for the penalty to be waived.

For additional information on relief of penalties relating incorrect or delayed Forms 1095-A for the 2014 tax year, see Notice 2015-30.

Sample Waiver Request Statement (to be attached to tax return when filed)

Received an incorrect or delayed Form 1095-A.


Disclaimer: This publication does not, and is not intended to, provide legal, tax or accounting advice, and readers should consult their tax advisors concerning the application of tax laws to their particular situations. This analysis is not tax advice and is not intended or written to be used, and cannot be used, for purposes of avoiding tax penalties that may be imposed on any taxpayer. The information contained herein is general in nature and based on authorities that are subject to change. Parker Tax Publishing guarantees neither the accuracy nor completeness of any information and is not responsible for any errors or omissions, or for results obtained by others as a result of reliance upon such information. Parker Tax Publishing assumes no obligation to inform the reader of any changes in tax laws or other factors that could affect information contained herein.

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