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Form 4029 Application for Exemption From Social Security ...

form 4029 Application for Exemption From Social Security and Medicare Taxes and Waiver of Benefits(Rev. November 2018) Department of the Treasury Internal Revenue Service Go to for the latest information. Before you file this form , see the instructions under Who may apply on page 2. This Exemption is granted only if the IRS returns a copy to you marked Approved. OMB No. 1545-0064 File Three CopiesCaution: Approval of form 4029 exempts you from Social Security and Medicare taxes only. The Exemption does not apply to federal income tax. Ministers, members of religious orders, and Christian Science practitioners, see form 4361, Application for Exemption From Self-Employment Tax for Use by Ministers, Members of Religious Orders, and Christian Science Practitioners. Part I To Be Completed by ApplicantPrint or type 1 Name of taxpayer Address (number, street, or box) City or town, state, and ZIP code 2 Social Security number 3 Date of birth 4 Contact phone number (optional)5 Do not send me my Social Security Statement.

Approval of Form 4029 exempts you from social security and Medicare taxes only. The exemption does not apply to federal income tax. Ministers, members of religious orders, and Christian Science practitioners, see Form 4361, Application for Exemption From Self-Employment Tax for

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