Skip to content
ChatProjectCodes

Federal housing law

Form 6069 — Return of Certain Excise Taxes on Mine Operators, Black Lung Trusts, and Other Persons Under Sections 4951, 4952, and 4953

Federal housing law as enacted — verbatim and citable.

Edition
2026-10-03
Last updated
2026-10-04
Jurisdiction
United States
Ask AI about this codeSearch the library

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f6069.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

Form

6069

(Rev. December 2025)

Return of Certain Excise Taxes on Mine Operators, Black Lung Trusts, and Other Persons Under Sections 4951, 4952, and 4953

OMB No. 1545-0047

NOT Open for Public Inspection

Department of the Treasury Internal Revenue Service Go to www.irs.gov/Form6069 for instructions and the latest information.

A For calendar year or other tax year beginning , and ending B Filer is: (1) Section 501(c)(21) Trust

1 Initial tax on the trust under section 4952(a)(1) (Part III, line 4b) . . . . . . . . . . . . . 1
2 Tax on mine operator under section 4953 (Part IV, line 8) . . . . . . . . . . . . . . . 2
3a Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) . . . . . 3a
b Self-dealer’s ratable share of liability (see instructions) . . . . . . . . 3b %
c Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b . . . . . . 3c
4a Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) . . . . . . 4a
b Filing trustee’s ratable share of liability (see instructions) . . . . . . . 4b %
c Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b . . . . . . . 4c
5a Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c) . . . . 5a
b Filing trustee’s ratable share of liability (see instructions) . . . . . . . 5b %
c Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b . . . . . . . 5c
6 Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c . . . . . . . . 6
7 Total payments, including amount paid with Form 8868 (see instructions) . . . . . . . . . . 7
8 Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to www.irs.gov/Payments or see the instructions . . . . . . . . . . . 8
9a Overpayment. If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d . . . . . . . . . . . . . . . . . . . . 9a
b Routing number c Type: Checking Savings
d Account number		 1
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 **1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 **1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 2
1 Initial tax on the trust under section 4952(a)(1) (Part III, line 4b) . . . . . . . . . . . . . 1
2 Tax on mine operator under section 4953 (Part IV, line 8) . . . . . . . . . . . . . . . 2
3a Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) . . . . . 3a
b Self-dealer’s ratable share of liability (see instructions) . . . . . . . . 3b %
c Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b . . . . . . 3c
4a Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) . . . . . . 4a
b Filing trustee’s ratable share of liability (see instructions) . . . . . . . 4b %
c Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b . . . . . . . 4c
5a Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c) . . . . 5a
b Filing trustee’s ratable share of liability (see instructions) . . . . . . . 5b %
c Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b . . . . . . . 5c
6 Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c . . . . . . . . 6
7 Total payments, including amount paid with Form 8868 (see instructions) . . . . . . . . . . 7
8 Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to www.irs.gov/Payments or see the instructions . . . . . . . . . . . 8
9a Overpayment. If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d . . . . . . . . . . . . . . . . . . . . 9a
b Routing number c Type: Checking Savings
d Account number		 1
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 **1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 **1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number
1 Initial tax on the trust under section 4952(a)(1) (Part III, line 4b) . . . . . . . . . . . . . 1
2 Tax on mine operator under section 4953 (Part IV, line 8) . . . . . . . . . . . . . . . 2
3a Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) . . . . . 3a
b Self-dealer’s ratable share of liability (see instructions) . . . . . . . . 3b %
c Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b . . . . . . 3c
4a Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) . . . . . . 4a
b Filing trustee’s ratable share of liability (see instructions) . . . . . . . 4b %
c Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b . . . . . . . 4c
5a Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c) . . . . 5a
b Filing trustee’s ratable share of liability (see instructions) . . . . . . . 5b %
c Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b . . . . . . . 5c
6 Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c . . . . . . . . 6
7 Total payments, including amount paid with Form 8868 (see instructions) . . . . . . . . . . 7
8 Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to www.irs.gov/Payments or see the instructions . . . . . . . . . . . 8
9a Overpayment. If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d . . . . . . . . . . . . . . . . . . . . 9a
b Routing number c Type: Checking Savings
d Account number		 1
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 3b % % %
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 3b % 3c
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 3b %
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 4b % % %
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 4b % 4c
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 4b %
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 5b % % %
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 5b % 5c
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 5b % 6
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 5b % 7
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 5b % 8
**1 **
Initial tax on the trust under section 4952(a)(1) (Part III, line 4b)
.
.
.
.
.
.
.
.
.
.
.
.
.
1
2
Tax on mine operator under section 4953 (Part IV, line 8)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2
3a
Initial tax on self-dealer under section 4951(a)(1) (Part II, line 3d) .
.
.
.
.
3a
b
Self-dealer’s ratable share of liability (see instructions) .
.
.
.
.
.
.
.
3b
%
c
Filing self-dealer’s liability. Multiply line 3a by percentage share reported on line 3b
.
.
.
.
.
.
3c
4a
Initial tax on trustee under section 4951(a)(2) (Part II, line 3e) .
.
.
.
.
.
4a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
4b
%
c
Filing trustee’s liability. Multiply line 4a by percentage share reported on line 4b
.
.
.
.
.
.
.
4c
5a
Initial tax on the trustee under section 4952(a)(2) (Part III, line 4c)
.
.
.
.
5a
b
Filing trustee’s ratable share of liability (see instructions)
.
.
.
.
.
.
.
5b
%
c
Filing trustee’s liability. Multiply line 5a by percentage share reported on line 5b
.
.
.
.
.
.
.
5c
6
Total tax. Enter the amount from line 1, or the sum of lines 2, 3c, 4c, and 5c
.
.
.
.
.
.
.
.
6
7
Total payments, including amount paid with Form 8868 (see instructions) .
.
.
.
.
.
.
.
.
.
7
8
Tax due. If line 6 is larger than line 7, subtract line 7 from line 6 and enter amount owed. For details
on how to pay, go to_www.irs.gov/Payments_ or see the instructions
.
.
.
.
.
.
.
.
.
.
.
8
9a
**Overpayment.**If line 6 is smaller than line 7, subtract line 6 from line 7 and enter the amount
overpaid. Complete lines 9b, 9c, and 9d
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9a
b
Routing number
c
Type:
Checking
Savings
d
Account number		 5b % 9a

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 12145E Form 6069 (Rev. 12-2025) Created 5/2/25

Form 6069 (Rev. 12-2025) Page 2 Part II Initial Taxes on Self-Dealing (Section 4951) 1 Acts of self-dealing (a) Act (b) Date (c) Description of act number of act (see instructions)

(b) Date

(c) Description of act

of act

(see instructions)

(1) (2) 2 Computation of initial tax on self-dealing disqualified person or trustee

(e) Tax on trustee, if applicable

(2.5% (0.025) of col. (c))

(see instructions)

(a) Act (b) Self-dealer(s) (c) Amount involved number

(d) Initial tax on self-dealer

(10% (0.10) of col. (c))

(see instructions)

(1) (2) 3 Totals . . . . . . . . . . . . . . . . . 4 Corrective action. Attach a detailed statement to describe corrective action taken or to explain why corrective action has not been taken. See instructions.

(b) Has corrective

(a) Act

action been taken? (c) FMV of amount recovered

number

Yes No (1) (2) Part III Initial Taxes on Taxable Expenditures and Tax Computation (Section 4952) 1 Taxable expenditures (a) Item (b) Name and address of recipient (c) Description of expenditure and purposes for which made number

(1)

(2)

2 Taxable expenditures by section 501(c)(21) Trust (section 4952(a)) (a) Item (b) Date paid or incurred (c) Amount (d) Trustees number

(1) (2) 3 Computation of initial tax (sections 4952(a)(1) and (2))

(c) Tax imposed on Trustee (2.5% (0.025) of line 2, col. (c))

(see instructions)

(a) Item number

(b) Tax imposed on section 501(c)(21) Trust

(10% (0.10) of line 2, col. (c))

(see instructions)

(1) (2) 4 Totals 5 Corrective action. Attach a detailed statement to describe corrective action taken or to explain why corrective action has not been taken. See instructions.

(b) Has corrective

(a) Act

action been taken? (c) FMV of amount recovered

number

Yes No (1) (2) Part IV Tax on Coal Mine Operators Under Section 4953. Computation of Section 4953 Tax by the Person Making Excess Contributions Under Section 192 to a Section 501(c)(21) Trust (see instructions)

Form 6069 (Rev. 12-2025)

Form 6069 (Rev. 12-2025) Page 3 Part IV Tax on Coal Mine Operators Under Section 4953. Computation of Section 4953 Tax by the Person Making Excess Contributions Under Section 192 to a Section 501(c)(21) Trust (see instructions) (continued)

Exceptions & meaning →

GoCodebook provides public access, search, citation, multilingual explanation, and practical interpretation of legally adopted building regulations. It is not a substitute for the official ICC or California code publications.