8038-R Request for Recovery of Overpayments Under Arbitrage Reb

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TREASURY/IRS AND OMB USE ONLY DRAFT
Form

8038-R

(Rev. November 2025)
Department of the Treasury
Internal Revenue Service

Part I

OMB No. 1545-0047

File a separate form for each issue.
See instructions.
Go to www.irs.gov/Form8038R for the latest information.

Reporting Authority

1

Issuer’s name

3

Number and street (or P.O. box if mail is not delivered to street address)

5a City, town, or post office

5b State

2

Issuer’s employer identification number (EIN)

Room/suite

4

Report number (For IRS Use Only)

5c ZIP code

6

Date of issue
CUSIP number

7

Name of issue

8

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 on line 12) that are required to be paid under section
148 as of the date the recovery is requested . . . . . . . . . . .
14
15
Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
16a Overpayment. Subtract line 15 from line 12 . . . . . . . . . . . . . . . . . . .
16a
To elect direct deposit for this amount, complete lines 16b, 16c, and 16d.
b Routing number
c Type:
Checking
Savings
d Account number
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
19
20
21

22

Other Information (see instructions)

Yes No
Check the “Yes” or “No” box for each question below.
Was the overpayment paid as penalty in lieu of rebate under section 148(f)(4)(C)(vii)? . . . . . . . .
19
Has the final computation date for the issue occurred? . . . . . . . . . . . . . . . . . .
20
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
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

Paid
Preparer
Use Only

Preparer’s name

Date

Name and title of issuer’s authorized representative

Preparer’s signature

Date

Firm’s name

Firm’s EIN

Firm’s address

For Paperwork Reduction Act Notice, see the instructions.

Check
if PTIN
self-employed

Phone no.
Cat. No. 57334H

Form 8038-R (Rev. 11-2025) Created 4/17/25

DRAFT — DO NOT FILE

DRAFT — DO NOT FILE

Request for Recovery of Overpayments
Under Arbitrage Rebate Provisions