SECTION 6. REQUIREMENTS FOR

A REQUEST FOR CONSENT AND REQUIREMENTS FOR AN EMPLOYEE CONSENT

.01 The request for consent must clearly inform the employee of the purpose of the employee consent. It must provide a name and contact information for any questions by the employee and must give a reasonable period of time to respond, which period shall not be less than 45 days from the date of the request. A request for consent may include an express presumption that if an employee’s response has not been received by the employer during this time period, the employee will be considered to have refused to provide the employee consent; however, a failure to respond may not be deemed consent. A request for consent may also include a request that the employee keep the employer informed about any change in the employee’s mailing address or email address. The request for consent must clearly state that the employer will repay or reimburse the employee share of the overpayment (plus any interest allocable to the employee share) to the extent the overpayment (plus allocable interest) is refunded by the IRS. Finally, all requests for consent must indicate that an employee cannot authorize the employer to claim a refund on the em

ployee’s behalf for any overpaid Additional Medicare Tax, regardless of whether Additional Medicare Tax was withheld from the employee; the following language may be used in any request for consent to meet this requirement:

“You cannot authorize us to claim a refund on your behalf for any overpaid Additional Medicare Tax, and our claim will not include a claim for Additional Medicare Tax withheld from employees. Additional Medicare Tax (0.9%) applies to wages, railroad retirement (RRTA) compensation, and self-employment income (together with that of your spouse if filing a joint return) that are more than:

$125,000 if married filing separately, $250,000 if married filing jointly, or $200,000 for any other filing status.

If, as a result of our refund claim, your wages are adjusted, you may also be able to claim a refund for Additional Medicare Tax. For more information on the Additional Medicare Tax, see the Instructions for Form 8959.”

.02 A request for consent may be solicited on paper or in an electronic format. The employer may furnish a paper request for consent by personal delivery or by mail to the employee’s last known address using the United States Postal Service or a designated delivery service under § 7502(f). An electronic request for consent may be sent to the employee’s email address in accordance with section 7 of this revenue procedure.

.03 An employee consent must meet the following requirements:

(1) Contain the name, address, and taxpayer identification number of the employee;

(2) Contain the name, address, and employer identification number of the employer;

(3) Contain the tax period(s), type of tax ( e.g ., social security and Medicare taxes), and the amount of tax for which the employee consent is provided;

(4) Affirmatively state that the employee authorizes the employer to claim a refund for the overpayment of the employee share of tax;

(5) For refund claims for employee tax overcollected in prior years, include the employee’s written statement;

(6) Identify the basis of the claim ( e.g ., request for refund of the social security and Medicare taxes withheld with regard to excess transit benefits provided in 2014 due to a retroactive legislative change); and

(7) Be dated and contain the employee’s signature under penalties of perjury. The penalties of perjury statement should be located immediately above the required signature.

.04 The employer may use a TTIN on an employee consent as the employee’s taxpayer identification number, in place of the complete SSN of the employee, if the employer prepares the consent for the employee to sign and prepopulates the employee’s taxpayer identification number with the TTIN. The use of a TTIN is not permitted if the employer requests that the employee provide an SSN as the employee’s taxpayer identification number or if the employee furnishes the number via the consent.

.05 An employer must retain all requests for consent, employee consents (including any required written statement), and employees’ responses (indicating that the employee does not authorize the employer to claim a refund of FICA taxes on his or her behalf), as long as their contents may be material in the administration of any internal revenue law, but in no event for less than four years after the date the claim is filed. These documents are not submitted with the claim for refund, but copies must be submitted to the IRS if requested.