0925 Form 15662 (PDF)

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f15662.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

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(September 2025)

Department of the Treasury - Internal Revenue Service

OMB Number

1545-1520

Review the below instructions and Revenue Procedure (Rev. Proc.) 2025-4, I.R.B. 2025-1 I.R.B. 158, updated annually, before completing this application.

1a . Taxpayer name

b . Taxpayer address

For internal use only

c . City d . State e . ZIP code

f . Taxpayer identification number (TIN) g . Telephone number h . Fax number i . Taxpayer’s tax year end (MM)

Complete lines 1j–1m only for a foreign address.

j . City or town k . Country name

l . Province/Country m . Foreign postal code

2 . Taxpayer contact, if applicable. If a Form 2848 or Form 8821 is attached, mark box, and do not complete lines 2a–2k for that individual

a . Contact person’s name

b . Contact person’s address

c . City d . State e . ZIP code

f . Telephone number g . Fax number

Complete lines 2h–2k only for a foreign address.

h . City or town i . Country name

j . Province/Country k . Foreign postal code

3a . Name of plan (if applicable)

b . 3-digit plan number (if applicable)

If more space is needed for any item, attach additional sheets the same size as this form. Identify each additional sheet with the taxpayer’s name and TIN and identify each item.

Under penalties of perjury, I declare that I have examined this request, including accompanying documents, and, to the best of my knowledge and belief, the request contains all the relevant facts relating to the request, and such facts are true, correct, and complete.

Sign here Date

Name (type or print) Title (type or print)

Catalog Number 95555C www.irs.gov Form 15662 (9-2025)

Page 2

4 . Select one ruling request type and review the requirements of the listed revenue procedures associated with the request to make certain your submission is complete

a . Computation of the exclusion ratio under § 72(b) (Rev. Proc. 2025-4, updated annually)

b . Changes in funding method(s) under § 412(d)(1) or § 433(c)(5)(B) (Rev. Proc. 2025-4, updated annually; Rev. Proc. 2017-57)

c . Changes in actuarial assumption(s) under § 430(h)(5)(A) or § 433(c)(5)(C)(i) (Rev. Proc. 2025-4, updated annually)

d . Waiver of the liquidity shortfall excise tax under § 4971(f)(4) (Rev. Proc. 2025-4, updated annually)

e . 5-year amortization extension under § 431(d)(1) (Rev. Proc. 2025-4, updated annually; Rev. Proc. 2010-52)

f . Alternate amortization extension under § 431(d)(2) (Rev. Proc. 2025-4, updated annually; Rev. Proc. 2010-52)

g . Whether a plan amendment is reasonable and provides for only de minimis increases in plan liabilities in connection with an

extension of an amortization period under § 412(c)(7)(B) (Rev. Proc. 2025-4, updated annually)

h . Return to the employer of certain nondeductible contributions (Rev. Proc. 2025-4, updated annually; Rev. Proc. 90-49)

i . Use of substitute mortality table(s) under § 430(h)(3)(C) (Rev. Proc. 2025-4, updated annually; Rev. Proc. 2017-55)

j . Nonbank trustee approval letter (Rev. Proc. 2025-4, updated annually)

k . Waiver of the 60-day rollover requirement under §§ 402(c)(3) and 408(d)(3) (Rev. Proc. 2025-4, updated annually)

l . Requests for relief under § 301.9100 to recharacterize contributions to a Roth IRA (Rev. Proc. 2025-4, updated annually)

m . Request for change in plan/trust year ( submit Form 5308, Request for Change in Plan/Trust Year)

n. Changes in the selection of data elements under section 4.03 of Rev. Proc 2017-56

5 . Enter amount of user fee submitted. See specific instructions

6 . IRS Secure Messaging provides a safe means for exchanging information with IRS online. Secure messaging information is available at www.irs.gov/TEGEconnect. See Publication 5295, Secure Messaging for Tax Exempt and Government Entities, which provides additional information about secure messaging. To use IRS Secure Messaging, submit a completed Form 15314 with this application and mark the box

Catalog Number 95555C www.irs.gov Form 15662 (9-2025)

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Instructions for Form 15662, Application for Private Letter Rulings

General Instructions Who may file: See Rev. Proc. 2025-4, updated annually, for submission procedures.

What to submit: See Rev. Proc. 2025-4, updated annually, for submission procedures.

Where to file: File Form 15662 at this address:

• Internal Revenue Service, Attention: EP Letter Rulings P.O. Box 12192, TE/GE Stop 31A Team 105 Covington, KY 41012-0192

• For private delivery services, see address and additional instructions in 31.01(3) of Rev. Proc. 2025-4, updated annually.

Specific Instructions Taxpayer identification number: If the taxpayer is an individual, this will generally be their Social Security Number. If the taxpayer is not an individual, this will generally be their Employer Identification Number.

Foreign Address(es): If applicable, for lines 1j–1m or 2h–2k, follow the country's practice for entering the name of the city or town, province/country, and the postal code.

Taxpayer contact: The taxpayer contact listed on line 2 will be sent all taxpayer correspondence. If the taxpayer is an individual, this section should be left blank. A properly completed Form 2848 or Form 8821 should be submitted with this application if you want to authorize another person to be contacted concerning this application.

User Fee: All applications must be accompanied by the appropriate user fee. Applications submitted without the proper user fee will not be processed and will be returned to the taxpayer. To find the proper user fee, see Rev. Proc. 2025-4, updated annually. Send the user fee with this application when you file it.

To determine the appropriate user fee for each ruling listed on line 4, refer to the schedule for user fees set forth in Appendix A of Rev. Proc. 2025-4, (updated annually), available at www.irs.gov. Check the appropriate box and enter the user fee in line 5. Attach to the left side of the form a check or money order payable to “United States Treasury” for the full amount of the user fee to Form 15662, if applicable. If payment was made through www.pay.gov, a copy of the payment confirmation must also be submitted. If you don't include the full amount, your application may be returned. Attach Form 15662 to your ruling request.

Signature: If the taxpayer is an individual, the individual (or another person authorized under a power of attorney) must sign this application. If the taxpayer is not an individual, an officer, owner, trustee, general partner or member-manager (or another person authorized under a power of attorney) must sign this application. If an authorized power of attorney signs this application:

• Send the properly completed Form 2848 with this application when you file it, and

• The taxpayer must also submit a signed penalties of perjury statement, as required by Section 6.02(14) of Rev. Proc. 2025-4.

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. If you want to submit a ruling request, you are required to provide this information. We need it to determine whether the fact pattern described in your ruling request complies with these laws. You aren’t required to request a Private Letter Ruling; however, if you do so, sections 6001, 6011, 6058(a) and 6109 of the Internal Revenue Code require you to provide the information requested. Failure to provide this information in a timely manner or providing false or fraudulent information, may subject you to penalties. Section 7528 authorizes us to charge a user fee.

An agency may not conduct nor sponsor, and a person is not required to respond to, a collection of information unless it displays a valid control number assigned by OMB. The valid OMB control number for this information collection is 1545-1520. The estimated burden associated with this collection of information is 6 hours per response. The time needed to complete and file this form will vary depending on individual circumstances. 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 of the Internal Revenue Code. However, section 6104(b) makes certain information contained in this form publicly available. We may also give this information to the Department of Labor or the Pension Benefit Guaranty Corporation (PBGC) for administration of ERISA; the Department of Justice for civil and criminal litigation; and 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 treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.

Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Internal Revenue Service:

Internal Revenue Service Tax Forms and Publications 1111 Constitution Ave. NW, IR-6526 Washington, DC 20224

Don’t send Form 15662 to this address. Instead, see Where To File, earlier.

Catalog Number 95555C www.irs.gov Form 15662 (9-2025)