Instructions for Form 8928

Instructions for Form 8928

(Rev. December 2025)

For Use With Form 8928 (Rev. December 2025)

Return of Certain Excise Taxes Under Chapter 43

of the Internal Revenue Code

Section references are to the Internal Revenue Code unless

otherwise noted.

Future Developments

For the latest information about Form 8928 and its instructions,

such as legislation enacted after they were published, go to

IRS.gov/Form8928.

What’s New

Electronic payments. If you have access to U.S. banking

services or electronic payment systems, you should use direct

deposit for any refunds and pay electronically for any payments,

whenever possible.

Direct deposit. Direct deposit fields have been added onto the

form on lines 42b, 42c, and 42d. If there is an overpayment on

line 42a, enter your direct deposit information on lines 42b, 42c,

and 42d. See Line 42, later, for more information.

Making a payment. If there is a balance due on line 41, go to

IRS.gov/Payments for information on how to make a payment.

See Line 41, later, for more information.

Increased failure-to-file penalty. The minimum penalty under

section 6651(a) for the failure to file Form 8928 within 60 days of

the due date has increased to the smaller of the tax due or $525.

General Instructions

Purpose of Form

File Form 8928 to report the tax due on the following failures by

group health plans or employers.

• A failure to provide a level of coverage of the costs of pediatric

vaccines (as defined in section 2612 of the Public Health

Services Act) that is not below the coverage provided as of May

1, 1993.

• A failure to satisfy continuation coverage requirements under

section 4980B.

• A failure to meet portability, access, renewability, and market

reform requirements under sections 9801, 9802, 9803, 9811,

9812, 9813, 9815, 9816, 9817, 9818, 9819, 9820, 9822, 9823,

9824, and 9825.

• A failure to make comparable Archer medical savings account

(MSA) contributions under section 4980E.

• A failure to make comparable health savings account (HSA)

contributions under section 4980G.

Who Must File

Form 8928 must be filed by the following.

1. Any employer, group health plan, plan administrator, or

plan sponsor liable for the tax under section 4980B for failure to

provide the required level of pediatric vaccine coverage or to

offer continuation coverage to a qualified beneficiary.

2. Any employer or group health plan liable for the tax under

section 4980D for failure to meet portability, access, renewability,

and market reform requirements for group health plans under

Dec 29, 2025

sections 9801, 9802, 9803, 9811, 9812, 9813, 9815, 9816,

9817, 9818, 9819, 9820, 9822, 9823, 9824, and 9825.

3. Any employer liable for the tax under section 4980E for

failure to make comparable Archer MSA contributions for all

participating employees.

4. Any employer liable for the tax under section 4980G for

failure to make comparable HSA contributions for all

participating employees.

When To File

For a failure under section 4980B or section 4980D, if the failure

is by an employer or other person responsible for providing or

administering benefits under the plan (such as an insurer or

third-party administrator), file Form 8928 on or before the due

date for filing the person’s federal income tax return.

If the failure under section 4980B or section 4980D is by a

multiemployer or multiple employer plan, file Form 8928 on or

before the last day of the seventh month following the end of the

plan year.

For a failure under section 4980E or section 4980G, file Form

8928 on or before the 15th day of the 4th month following the

calendar year in which the noncomparable contributions were

made.

Extension. File Form 7004, Application for Automatic Extension

of Time to File Certain Business Income Tax, Information, and

Other Returns, to request an automatic extension of time to file

Form 8928. You must file Form 7004 on or before the regular due

date of Form 8928. See the Instructions for Form 7004 for more

information. Form 7004 does not extend the time to pay excise

taxes due under Form 8928.

Where To File

Send Form 8928 to the following address.

Department of the Treasury

Internal Revenue Service Center

Kansas City, MO 64999

Private delivery services (PDSs).

Filers can use certain PDSs designated by the IRS to meet the

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

payments. Go to IRS.gov/PDS, for the current list of PDSs.

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

date.

For the IRS mailing address to use if you’re using a PDS, go

to IRS.gov/PDSStreetAddresses.

Note: PDSs can’t 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.

Interest and Penalties

Interest. Interest is charged on taxes not paid by the due date

even if an extension of time to file is granted. Interest is also

Instructions for Form 8928 (Rev. 12-2025) Catalog Number 52470C

Department of the Treasury Internal Revenue Service www.irs.gov

charged on penalties imposed from the due date, including

extensions, to the date of payment for failure to file, negligence,

fraud, gross valuation overstatements, and substantial

understatements of tax. The interest rate is determined under

section 6621.

Penalty for late filing of return. If you do not file a return by

the due date, including extensions, you may have to pay a

penalty of 5% of the unpaid tax for each month or part of a month

the return is late, up to a maximum of 25% of the unpaid tax. The

minimum penalty for a return that is more than 60 days late is the

smaller of $525 or 100% of the tax due. This amount reflects the

annual inflation adjustment for tax year 2025. The penalty will not

be imposed if you can show that the failure to file on time was

due to reasonable cause. If you file late, you must attach a

statement to Form 8928 explaining the reasonable cause.

Penalty for late payment of tax. If you do not pay the tax when

due, you may have to pay a penalty of 1/2 of 1% of the unpaid tax

for each month or part of a month the tax is not paid, up to a

maximum of 25% of the unpaid tax. The penalty will not be

imposed if you can show that the failure to pay on time was due

to reasonable cause.

Interest and penalties for late filing and late payment will be

billed separately after the return is filed.

Claim for Refund or Credit/Amended

Return

File an amended Form 8928 for any of the following.

• To claim a refund of overpaid taxes reportable on Form 8928.

• To receive a credit for overpaid taxes.

• To report additional taxes due within the same tax year of the

filer if those taxes have the same due date as those previously

reported.

File an amended return by writing “Amended Return” at the

top of Form 8928 and completing the appropriate part.

If you file an amended return to claim a refund or credit, the

claim must state in detail the reasons for claiming the refund. In

order for the IRS to promptly consider your claim, you must

explain why you are filing the claim and provide the appropriate

supporting evidence. See Regulations section 301.6402-2 for

more details.

Specific Instructions

Filer tax year. Enter the tax year of the employer, entity, or

individual on whom the tax is imposed by using the plan year

beginning and ending dates entered in Part I of Form 5500 or by

using the tax year of the business return filed, if applicable.

Item A. Name and address of filer. Enter the name and

address of the employer, individual, or other entity who is liable

for the tax.

Include the suite, room, or other unit numbers after the street

number. If the post office does not deliver mail to the street

address and you have a P.O. box, show the box number instead

of the street address.

If the entity has a foreign address, enter the information in the

following order: city or town, state or province, and country.

Follow the country’s practice for entering the postal code. Do not

abbreviate the country name.

Item C. Name of plan. Enter the formal name of the plan, name

of the plan sponsor, or name of the insurance company or

financial institution of the direct filing entity (DFE). In the case of

a group insurance arrangement (GIA), enter the name of the

trust or other entity that holds the insurance contract. In the case

of a master trust investment account (MTIA), enter the name of

the sponsoring employers.

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If the plan covers only the employees of one employer, enter

the employer’s name or enough information to identify the plan.

This should be the same name indicated on the Form 5500

series return/report if that form is required to be filed for the plan.

Item D. Name and address of plan sponsor. The term “plan

sponsor” means:

1. The employer, for a group health plan established or

maintained by a single employer;

2. The employee organization, in the case of a plan of an

employee organization; or

3. The association, committee, joint board of trustees, or

other similar group of representatives of the parties who

establish or maintain the plan, if the group health plan is

established or maintained jointly by one or more employers and

one or more employee organizations, or by two or more

employers.

Include the suite, room, or other unit numbers after the street

number. If the post office does not deliver mail to the street

address and you have a P.O. box, show the box number instead

of the street address.

If the plan sponsor has a foreign address, enter the

information in the following order: city or town, state or province,

and country. Follow the country’s practice for entering the postal

code. Do not abbreviate the country name.

Item E. Plan sponsor’s EIN. Enter the nine-digit employer

identification number (EIN) assigned to the plan sponsor. This

should be the same number used to file the Form 5500 series

return/report.

Item F. Plan year ending. “Plan year” is defined in Regulations

section 54.9801-2. Enter eight digits in month/date/year order.

This number assists the IRS in properly identifying the plan and

time period for which the Form 8928 is being filed. For example,

a plan year ended March 31, 2025, should be shown as

03/31/2025.

Item G. Plan number. Enter the three-digit number that the

employer or plan administrator assigned to the plan. This

three-digit number is used with the EIN entered on line B and is

used by the IRS, the Department of Labor, and the Pension

Benefit Guaranty Corporation as a unique 12-digit number to

identify the plan.

Note: If the plan number is not provided, this will cause a delay

in processing your return.

Filer’s signature. To reduce the possibility of correspondence

and penalties, please sign and date the form. Also, enter a

daytime phone number where you can be reached.

Paid preparer use only. A paid preparer must sign Form 8928

and provide the information in the “Paid Preparer Use Only”

section at the end of the form if the preparer was paid to prepare

the form and is not an employee of the filing entity. The preparer

must give you a copy of the form in addition to the copy to be

filed with the IRS.

If you are a paid preparer, enter your Preparer Tax

Identification Number (PTIN) in the space provided. Include your

complete address. If you work for a firm, you also must enter the

firm’s name and the EIN of the firm. However, you cannot use the

PTIN of the tax preparation firm in place of your PTIN.

You can apply for a PTIN online or by filing Form W-12, IRS

Paid Preparer Tax Identification Number (PTIN) Application and

Renewal. For more information about applying for a PTIN online,

visit the IRS website at IRS.gov/PTIN.

Inst. for Form 8928 (Rev. 12-2025)

Part I. Tax on Failure To Satisfy

Continuation Coverage Requirements

Under Section 4980B

Complete a separate Part I, Section A, lines 1 through 6, for each

qualifying event for which one or more failures to satisfy

continuation coverage requirements occurred during the

reporting period as a result of failures due to reasonable cause

and not to willful neglect. If multiple qualifying events occurred

with different noncompliance periods, complete lines 1 through 6

on a separate Part I for each qualifying event. Then complete a

“summary” Form 8928 with items A through G and enter the total

amount of the excise tax on line 7 of that summary form and

complete lines 8 through 11 for all qualifying events as a result of

failures due to reasonable cause and not to willful neglect.

Complete a separate Part I, lines 12 through 14, for each

qualifying event for which one or more failures to satisfy

continuation coverage requirements occurred during the

reporting period as a result of failures due to willful neglect or

otherwise not due to reasonable cause. If multiple qualifying

events occurred with different noncompliance periods, complete

lines 12 through 14 on a separate Part I for each qualifying event.

Then complete a “summary” Form 8928 with items A through G

and enter the total amount of the excise tax on line 15 of that

summary form for all failures that were due to willful neglect or

otherwise not due to reasonable cause.

Write “Summary Form” at the top to indicate that this is a

summary form and attach all copies to it.

Note: You may report all failures on the same form if the failures

occurred during the same tax year.

For purposes of Part I, a qualifying event is any of the

following.

• Death of the covered employee.

• Termination or reduction of hours of the covered employee’s

employment (other than for employee gross misconduct).

• Divorce or legal separation of the covered employee from the

employee’s spouse.

• Covered employee becoming entitled to Medicare benefits.

• Dependent child of the covered employee ceasing to be a

covered child under the terms of the plan.

• Bankruptcy of the employer from whose employment the

covered employee retired.

Waiver of excise tax. The Secretary of the Treasury may waive

part or all of the excise tax under Part I, to the extent that

payment of the tax would be excessive relative to the failure

involved. This only applies to failures due to reasonable cause

and not due to willful neglect.

Note: The tax under Part I will not apply to the following.

• Any failure of a group health plan if the qualifying event

occurred during the calendar year immediately following a

calendar year during which all employers maintaining the plan

normally employed fewer than 20 employees on a typical

business day.

• Any governmental plan under section 414(d).

• Any church plan under section 414(e).

Section A. Failures Due to Reasonable Cause

and Not to Willful Neglect

If the failure or failures as a result of a particular qualifying event

were due to reasonable cause and not to willful neglect,

complete Part I, Section A, lines 1 through 11.

Line 1. Calculate the total number of days of noncompliance

within the reporting period beginning on the date the failure first

occurred and ending on the earlier of the date the failure is

Inst. for Form 8928 (Rev. 12-2025)

corrected or, at the latest, a date that is 6 months after the last

day of the maximum continuation coverage period under the

qualifying event that led to the failure.

Note: The noncompliance period may include portions of more

than 1 plan year (in the case of an employee benefit plan) or 1

tax year (in the case of an employer or third-party administrator).

In that case, only the portion of the noncompliance period falling

within that plan year or tax year would be used to calculate the

excise tax due for that year.

Line 4. No tax is due for any failure under Part I, Section A, if it

is established to the satisfaction of the Secretary of the Treasury

that no one liable for the tax knew, or exercising reasonable

diligence would have known, that the failure occurred.

Additionally, no tax is due if the failure under Part I, Section A,

was due to reasonable cause and not due to willful neglect and

the failure was corrected during the 30-day period beginning on

the first date anyone liable for the tax knew, or exercising

reasonable diligence should have known, that the failure existed.

For this purpose, a failure is treated as corrected if the failure

is retroactively undone to the extent possible and the qualified

beneficiary to whom the failure relates is placed in a financial

position which is as good as such beneficiary would have been

in had the failure not occurred.

Line 5. The minimum excise tax under Part I, Section A, is

$2,500 for each qualified beneficiary for whom one or more

failures occurred if the failure or failures were not corrected

before the date a notice of examination of income tax liability was

sent from the IRS, and the failure or failures continued during the

examination period. The minimum excise tax under Part I,

Section A, is $15,000 if the failure or failures are determined to

be more than de minimis.

Line 7. If you had more than one qualifying event during the

reporting period, complete lines 1 through 6 in a separate Part I,

Section A, for each qualifying event and enter the total from

line 6 from all copies of Part I, Section A, on line 7 of your

summary form. See the discussion under Part I earlier.

Line 8. For a single employer plan, enter on line 8 the aggregate

amount paid or incurred during the preceding tax year by the

employer (or a predecessor) for its group health plan. For a

multiemployer plan, enter on this line the amount paid or incurred

during the current tax year to provide medical care, directly or

through insurance or reimbursement.

Line 11. The maximum excise tax payable during a tax year by

third-party administrators, HMOs, and insurance companies

under Part I, Section A, is $2 million for all plans for failures due

to reasonable cause and not to willful neglect. For those entities,

do not enter more than $2 million on this line for such failures for

all plans even if the aggregate excise tax owed for all failures

under Part I, Section A, is more than $2 million.

Section B. Failures Due to Willful Neglect or

Otherwise Not Due to Reasonable Cause

If the failure or failures as a result of a particular qualifying event

were due to willful neglect or otherwise not due to reasonable

cause, complete Part I, Section B, lines 12 through 15.

Line 12. Calculate the total number of days of noncompliance

within the reporting period beginning on the date the failure first

occurred and ending on the earlier of the date the failure is

corrected or, at the latest, a date that is 6 months after the last

day of the maximum continuation coverage period under the

qualifying event that led to the failure.

Line 15. If you had more than one qualifying event during the

reporting period, complete lines 12 through 14 in a separate Part

I, Section B, for each qualifying event and enter the total from

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line 14 from all copies of Part I, Section B, on line 15 of your

summary form. See the discussion under Part I earlier.

Part II. Tax on Failure To Meet

Portability, Access, and Renewability

Requirements Under Section 4980D

Complete a separate Part II, Section A, lines 17 through 23, for

each failure to meet portability, access, and renewability

requirements that occurred during the reporting period that was

due to reasonable cause and not to willful neglect. If multiple

such failures occurred with different noncompliance periods,

complete lines 17 through 23 in a separate Part I, Section A, for

each failure. Then complete a “summary” Form 8928 with items

A through G and enter the total amount of the excise tax on

line 24 of that summary form and complete lines 25 through 28

for all failures due to reasonable cause and not to willful neglect.

Complete a separate Part II, Section B, lines 29 through 33,

for each failure to meet portability, access, and renewability

requirements that occurred during the reporting period that was

due to willful neglect or otherwise not due to reasonable cause. If

multiple failures occurred with different noncompliance periods,

complete lines 29 through 32 on a separate Part II, Section B, for

each failure. Then complete a “summary” Form 8928 with items

A through G and enter the total amount of the excise tax on

line 33 of that summary form for all such failures.

Write “Summary Form” at the top to indicate that this is a

summary form and attach all copies to it.

Waiver of excise tax. The Secretary of the Treasury may waive

part or all of the excise tax under Part II, to the extent that

payment of the tax would be excessive relative to the failure

involved. This only applies to failures due to reasonable cause

and not due to willful neglect.

Exception for certain insured small employer plans. If you

are a small employer who provides health insurance coverage

solely through a contract with a health insurance issuer, you will

not be liable for the excise tax under Part II for any failure (other

than a failure under section 9811) that is solely the result of the

health insurance coverage offered by the issuer.

“Small employer” is generally defined as an employer who

employed an average of at least 2 but not more than 50

employees on business days during the preceding calendar

year, and who employs at least 2 employees on the first day of

the current plan year. Special rules apply to employers not in

existence in the preceding year. See section 4980D(d)(2)(B).

Section A. Failures Due to Reasonable Cause

and Not to Willful Neglect

If the failure or failures were due to reasonable cause and not to

willful neglect, complete Part II, Section A, lines 17 through 28.

Line 17. Calculate the total number of days of noncompliance

within the reporting period beginning on the date the failure first

occurred and ending on the date the failure is corrected.

Note: The noncompliance period may include portions of more

than 1 plan year (in the case of an employee benefit plan) or 1

tax year (in the case of an employer or third-party administrator).

In that case, only the portion of the noncompliance period falling

within that plan year or tax year would be used to calculate the

excise tax due for that year.

Line 21. No tax is due for any failure under Part II, Section A, if it

is established to the satisfaction of the Secretary of the Treasury

that no one liable for the tax knew, or exercising reasonable

diligence would have known, that the failure occurred.

Additionally, no tax is due if the failure under Part II, Section A,

was due to reasonable cause and not due to willful neglect and

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the failure was corrected during the 30-day period beginning on

the first date anyone liable for the tax knew, or exercising

reasonable diligence would have known, that the failure existed.

For this purpose, a failure is treated as corrected if the failure

is retroactively undone to the extent possible and the person to

whom the failure relates is placed in a financial position which is

as good as such person would have been in had the failure not

occurred.

In the case of a church plan, the failure must be corrected

before the close of the correction period, as defined under

section 414(e)(4)(C).

Line 22. The minimum excise tax under Part II, Section A, is

$2,500 for each individual to whom the failure relates if the failure

or failures were not corrected before the date a notice of

examination of income tax liability was sent from the IRS and the

failure or failures continued during the examination period. The

minimum excise tax under Part II, Section A, is $15,000 if the

failure or failures are determined to be more than de minimis.

Exception for church plans. The $2,500 (or $15,000, if

applicable) minimum excise tax does not apply to a church plan,

as defined in section 414(e). If your plan meets the requirements

for a church plan, enter “-0-” on this line and go to line 23.

Line 24. If you had more than one failure during the reporting

period, complete lines 17 through 23 in a separate Part II,

Section A, for each failure and enter the total from line 23 from all

copies of Part II, Section A, on line 24 of your summary form.

See the discussion under Part I earlier.

Line 25. For a single employer plan, enter on this line the

aggregate amount paid or incurred during the preceding tax year

by the employer (or a predecessor) for its group health plan. For

a multiemployer plan, enter on this line the amount paid or

incurred during the current tax year to provide medical care,

directly or through insurance or reimbursement.

Section B. Failure Due to Willful Neglect or

Otherwise Not Due to Reasonable Cause

If the failure or failures were due to willful neglect or otherwise

not due to reasonable cause, complete Part II, Section B, lines

29 through 33.

Line 29. Calculate the total number of days of noncompliance

within the reporting period beginning on the date the failure first

occurred and ending on the date the failure is corrected.

Line 33. If you had more than one failure during the reporting

period, complete lines 29 through 32 in a separate Part II,

Section B, for each qualifying event and enter the total from

line 32 from all copies of Part II, Section B, on line 33 of your

summary form. See the discussion under Part I earlier.

Part III. Tax on Failure To Make

Comparable Archer MSA

Contributions Under Section 4980E

An employer is liable for tax under section 4980E if they fail to

make comparable contributions to the Archer MSAs of all

comparable participating employees for each coverage period

during the calendar year.

“Comparable contributions” are contributions which are the

same amount or which are the same percentage of the annual

deductible limit under the high deductible health plan covering

the employees.

“Comparable participating employees” are employees who

are eligible individuals covered under any high deductible health

plan of the employer, and who have the same category of

coverage.

Inst. for Form 8928 (Rev. 12-2025)

To determine whether contributions are comparable, see

Regulations sections 54.4980G-1 through 54.4980G-7.

Line 35. Enter the aggregate amount contributed to employees’

Archer MSAs for tax years ending with or within the calendar

year.

Waiver of excise tax. The Secretary of the Treasury may waive

part or all of the excise tax under this part, to the extent that

payment of the tax would be excessive relative to the failure

involved. This only applies to failures due to reasonable cause

and not to willful neglect.

Controlled group. For purposes of this part, all persons treated

as a single employer under section 414(b), (c), (m), or (o) will be

treated as one employer.

Part IV. Tax on Failure To Make

Comparable HSA Contributions

Under Section 4980G

An employer is liable for tax under section 4980G if they fail to

make comparable contributions to the HSAs of all comparable

participating employees for each coverage period during the

calendar year.

Line 37. Enter the aggregate amount contributed to employees’

HSAs for tax years ending with or within the calendar year.

Waiver of excise tax. The Secretary of the Treasury may waive

part or all of the excise tax under this part, to the extent that

payment of the tax would be excessive relative to the failure

involved. This only applies to failures due to reasonable cause

and not to willful neglect.

Controlled group. For purposes of this part, all persons treated

as a single employer under section 414(b), (c), (m), or (o) will be

treated as one employer.

Part V. Tax Due or Overpayment

Line 40—Tax Paid With Form 7004

If you filed Form 7004, enter the amount of tax paid, if any, when

you filed that form.

Line 41—Tax Due

You must pay the tax due in full when you file Form 8928. The

IRS recommends paying electronically whenever possible.

Options to pay electronically include any of the payment options

below. Go to IRS.gov/Payments to see all of your payment

options.

Electronic Federal Tax Payment Systems (EFTPS). Payment

of the tax due may be submitted electronically through EFTPS.

EFTPS is a free service of the Department of the Treasury. Go to

IRS.gov/EFTPS and EFTPS.gov for more information.

Same-day wire. Payment of the tax due shown on Form 8928

may be submitted electronically through same-day wire from

your financial institution. Contact your financial institution for

availability, cost, and time frames. Go to IRS.gov/SameDayWire

for more information.

Paying by check. Make the check payable to “United States

Treasury.” Write the entity’s name, address, employer

identification number (EIN), and “Form 8928” on the check to

assist us in posting it to the proper account. Go to IRS.gov/

PayByMail for more information.

Direct deposit is available for this form. If there is an

overpayment when filing your return, complete Part V, lines 42b,

42c, and 42d to input your direct deposit information.

Line 42a. If line 42a is under $1, we will send a refund only on

written request.

Line 42b. The routing number must be nine digits. The first two

digits must be 01 through 12 or 21 through 32. Ask your financial

institution for the correct routing number to enter on line 42b if:

• The routing number on a deposit slip is different from the

routing number on your checks,

• Your deposit is to a savings account that doesn’t allow you to

write checks, or

• Your checks state they are payable through a financial

institution different from the one at which you have your checking

account.

Line 42c. Check the appropriate box for the type of account.

Don’t check more than one box. You must check the correct box

to ensure your deposit is accepted.

Line 42d. The account number can be up to 17 characters

(both numbers and letters). Include hyphens but omit spaces

and special symbols. Enter the number from left to right and

leave any unused boxes blank. Don’t include the check number.

Privacy Act and Paperwork Reduction Act Notice. We ask

for the information on this form to carry out the Internal Revenue

laws of the United States. Taxpayers subject to the provisions of

sections 4980B, 4980D, 4980E, and 4980G are required to

provide the information requested on this form. Section 6109

requires you to provide your identifying number. If you fail to

provide this information in a timely manner, you may be liable for

penalties. Routine uses of this information include giving it to the

Department of Justice for civil and criminal litigation, to other

federal agencies as authorized by law, and to cities, states, the

District of Columbia, and U.S. commonwealths and possessions

for use in administering their tax laws. We may also disclose this

information to other countries under a tax treaty, to federal and

state agencies to enforce federal nontax criminal laws, or to

federal law enforcement and intelligence agencies to combat

terrorism.

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 . . . . . . . . . . . . . . . . . . . . . .

Learning about the law or the form . . . . . . . . . .

Preparing, copying, assembling, and sending the

form to the IRS . . . . . . . . . . . . . . . . . . . . . .

12 hr., 40 min.

4 hr., 0 min.

6 hr., 47 min.

If you have comments concerning the accuracy of the time

estimates or suggestions for making this form simpler, we would

be happy to hear from you. See the instructions for the tax return

with which this form is filed.

Line 42—Overpayment

If you have access to U.S. banking services, you should use

direct deposit for any refunds, whenever possible. Go to IRS.gov/

DirectDeposit for more information.

Inst. for Form 8928 (Rev. 12-2025)

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