Independent form guide. BrieflyGo is not affiliated with or endorsed by IRS, USCIS, SSA, DOL, or any U.S. government agency. Official forms are sourced from public government websites.

IRSOther IRS Forms (4000–6999)

Official form guide

Form 4670: Request for Relief of Payment of Certain Withholding Taxes

Internal Revenue Service Form 4670 is a request to be relieved from liability for payment of certain withholding taxes. Employers or other withholding agents file it, and it notes the 0.9% Additional Medicare Tax on wages over $200,000.

Fillable formOpen in Editor->Download blank PDF

Need help with Form 4670?

Open it in the AI Editor for field guidance, checks, and PDF export.

Fillable formOpen in Editor->

Form Overview

IRS Form 4670 - Request for Relief of Payment of Certain Withholding Taxes

Internal Revenue Service Form 4670 is a request to be relieved from liability for payment of certain withholding taxes. Employers or other withholding agents file it, and it notes the 0.9% Additional Medicare Tax on wages over $200,000.

Form 4670 collects the employer identification number, legal name, trade name, address, the tax return type (e.g., Form 941), the tax year, and the number of Form 4669 statements attached, plus the requester’s signature.

Risk Radar

Scan points
  • 1Submitting Form 4670 without a signature results in immediate return.
  • 2Failing to attach the required Form 4669 statements for each payee.
  • 3Including more than one tax form type or tax year on a single Form 4670.
  • 4Omitting the examination report for payments subject to Income Tax Withholding, Backup Withholding, or Additional Medicare Tax.
  • 5Not attaching a copy of Form 4549/4549-A for payments to foreign persons.

Plain English

Form 4670 lets a payor ask the IRS to excuse it from paying taxes it was required to withhold. You attach the payee's Form 4669 showing the tax was paid, then sign and send it. The form is used for income tax, backup withholding, or Additional Medicare Tax relief.

Submission Date

  • Filing date: 2015-08-24 00:00:00
  • Preparation window: collect IDs, supporting records, and signatures in advance.
  • Final review: verify names, dates, and required fields before submission.

AI co-pilot

Fill it faster. Catch mistakes before you file.

Explains confusing fields in plain English
Flags missing signatures, dates, IDs, and attachments
Keeps the PDF ready for editor, send, and proof flows
Open AI workspace->

Glossary Terms

identificationincome taxwithholdincome

Hover a term to preview the meaning.

What this form is for

  • Use this form when you are a payor seeking relief from liability for taxes that were required to be withheld and you are attaching the required Forms 4669 and any examination reports or amended returns.
  • Do not use it when you need to request relief for multiple tax years or multiple tax forms on a single submission; a separate Form 4670 is required for each.
  • Check Form 941‑X instead when the tax for which relief is requested has already been paid and you must file an adjusted return.

Form selector

Use this form or another form?

Requesting relief for income tax withholding on wages

Shows the payee has reported the payments and paid the tax

✓ Confirm a completed Form 4669 is attached for each payee

Form 4669

Tax has already been paid and an adjustment is needed

Adjusted return documents the corrected tax amount

✓ Verify the appropriate adjusted return (e.g., Form 941‑X) is included

Form 941‑X

Payments to foreign persons subject to withholding tax

Provides examination changes for foreign withholding

✓ Ensure the foreign withholding examination report is attached

Form 4549‑A

Deadline or filing window

Not stated in the official source.

Checklist

What you need before filling it out

1

Employer identification number (EIN)

Business legal name and EIN · Form header area

⚠ Using SSN/ITIN instead of EIN✕ High
2

Tax return (check one)

Check box for appropriate form (e.g., Form 941) · Box list on Form 4670

⚠ Selecting more than one box✕ Medium
3

Number of Forms 4669 attached

Count of attached Forms 4669 · Attachment section

⚠ Leaving count blank or incorrect✕ Medium
4

Signature block

Authorized officer signature and printed name · Signature area

⚠ Missing signature✕ High
5

Tax year field

Four‑digit year for relief request · Tax year space

⚠ Entering wrong format (e.g., yy)✕ Low

Before you submit

  1. 1Check the correct tax form box (e.g., Form 941) is selected
  2. 2Enter the four‑digit tax year for the relief request
  3. 3Enter the exact number of Forms 4669 attached
  4. 4Attach the required examination report for income tax, backup withholding, or Additional Medicare Tax
  5. 5If tax was already paid, attach the appropriate adjusted return (Form 941‑X, Form 943‑X, Form 944‑X, Form 945‑X, or Form CT‑1X)
  6. 6Attach Form 4549‑A when the payment is to a foreign person
  7. 7Sign the form with the authorized individual’s signature
  8. 8Print the signer’s name in the designated field
  9. 9Provide a daytime phone number
  10. 10Date the form

How to file this form

  1. 1Gather a completed Form 4669 from each payee for the tax year
  2. 2Attach the Form 4669(s), any examination reports, and any amended returns to Form 4670
  3. 3Complete the required fields on Form 4670 and sign it
  4. 4Mail the signed Form 4670 with attachments to the appropriate IRS examiner or filing address
  5. 5Retain a copy of the entire submission for your records

Known limitations

  1. 1Form 4670 cannot be used for multiple tax years or multiple tax forms on a single submission; separate forms are required
  2. 2Relief cannot be requested without first obtaining a Form 4669 from each payee
  3. 3The form must not be filed using a Social Security Number or ITIN; only the business EIN is allowed
  4. 4For foreign person payments, relief requires attaching Form 4549‑A; without it the request is incomplete

Field map

Compact field-by-field guide

6 fields

General Info

2 items

Taxpayer Name and TIN

Full legal name and taxpayer identification number (SSN or EIN).

Requiredtext
Address

Current mailing address.

Requiredtext

Details

2 items

Required Information

Complete all applicable sections of this form according to the official IRS instructions.

Requiredtext
Amount (if applicable)

Enter the relevant dollar amount if this form involves tax calculation.

amount

Certification

1 items

Certification Statement

Read and acknowledge any certifications required by this form.

Requiredcheckbox

Signatures

1 items

Signature

Sign and date. Unsigned forms cannot be processed.

Requiredsignature
This compact map shows typical fields for this form type. The AI Editor gives precise field guidance after you open the PDF.

Almost done reviewing the fields?

Fillable formOpen in Editor->
Current form status
IRS

Form 4670 (Rev. 8‑2015) is the current edition; the source does not indicate a newer version or changes since that revision.

What changed or needs a fresh check

  • Edition date — confirm the form revision reads 8‑2015
  • Fee — Not stated in the official source — verify on the agency site
  • Mailing address — Not stated in the official source — verify on the agency site
  • Signature — confirm the form is signed by an authorized officer as described
  • EIN field — confirm the employer identification number is entered correctly

Form Preview

Form 4670 page 1

Page 1

Form 4670 page 2

Page 2

Open in AI Editor →

Quick Facts

Any employer or other withholding agent that seeks relief from liability for taxes withheld must file IRS Form 4670.
Form 4670 collects the employer identification number, legal name, trade name, address, the tax return type (e.g., Form 941), the tax year, and the number of Form 4669 statements attached, plus the requester’s signature.
Not stated in the official source.
If the form relates to an examination that is still ongoing or ended within the past 30 days, send it to the IRS Examiner handling the case. If the examination concluded more than 30 days ago or is unrelated, send it to the address provided for exempt organizations, governmental entities, and Indian tribal entities.
If the form is not signed, the IRS will return it for signature, and the payor remains liable for any penalty or addition to tax for failure to deduct and withhold.
First, obtain a separate Form 4669 from each payee for each year relief is requested. Then complete Form 4670 by entering the EIN, name, address, checking the appropriate tax return box, entering the tax year, and noting the number of Form 4669s attached. Attach the required Form 4669s, any examination reports, and any amended returns. Finally, have an authorized officer sign the form before mailing it to the proper IRS address.

Downloads

Blank Form 4670↗

Fill Form 4670

AI-powered guidance for every field

Fillable formOpen in Editor->

Free to start / No account required

After you file

  1. 1Retain copies of Form 4670 and all attachments for your records
  2. 2Keep the signed original for your records
  3. 3Verify that the filing address used matches the one appropriate for your entity type
  4. 4Monitor mail for any IRS correspondence regarding the request

Sources

  • SRCForm p.1 — revision date is 8‑2015
  • SRCForm p.1 — purpose stated as request for relief from liability for taxes required to be withheld
  • SRCForm p.1 — requirement to attach Forms 4669, examination reports, and amended returns
  • SRCForm p.1 — attach examination report for Income Tax Withholding, Backup Withholding, or Additional Medicare Tax
  • SRCForm p.1 — attach Form 4549/4549‑A for payments to foreign persons
  • SRCForm p.1 — do not use SSN or ITIN; use business legal name and EIN
  • SRCForm p.2 — submit to IRS examiner if examination ended within past 30 days, otherwise to address provided
  • SRCForm p.2 — signature must be by authorized individual (sole proprietor, corporation officer, partnership member)

Common confusion points

Can I check more than one tax form box?

Only one tax form box may be selected per Form 4670

→ Ensure only one tax form box is selected

Do I need a Form 4669 for each payee?

A separate Form 4669 is required for each payee

→ Verify a Form 4669 is attached for each payee

May I use my SSN instead of an EIN?

The form requires the business EIN, not an SSN or ITIN

→ Enter the employer identification number, not an SSN

Do I file one Form 4670 for all years?

Each tax year and form type requires its own Form 4670

→ File a distinct Form 4670 for each tax year and form type

Is an examination report required for all payments?

Examination reports are required only for payments subject to income tax withholding, backup withholding, or Additional Medicare Tax

→ Attach the examination report only for those payment types

What if the tax was already paid?

An adjusted return (e.g., Form 941‑X) must be attached

→ Include the appropriate adjusted return form

Workflow map

Related forms and next steps

5 signals

Before

Form 4669 — provides the statement of payments received from the payee

Current

4670

After

None listed

Often used with

Form 941‑X — adjusted return for employment taxes when tax has been paidForm 943‑X — adjusted return for agricultural employment taxesForm 944‑X — adjusted return for small employer annual employment taxes

⚠ If something goes wrong

  • Form 4549‑A — examination changes for foreign person withholding

Questions about IRS Form 4670

What is IRS Form 4670 used for?

Form 4670 lets a payor ask the IRS to excuse it from paying taxes it was required to withhold. You attach the payee's Form 4669 showing the tax was paid, then sign and send it. The form is used for income tax, backup withholding, or Additional Medicare Tax relief.

Who must file IRS Form 4670?

Any employer or other withholding agent that seeks relief from liability for taxes withheld must file IRS Form 4670.

What information does IRS Form 4670 require?

Form 4670 collects the employer identification number, legal name, trade name, address, the tax return type (e.g., Form 941), the tax year, and the number of Form 4669 statements attached, plus the requester’s signature.

Where do I file IRS Form 4670?

If the form relates to an examination that is still ongoing or ended within the past 30 days, send it to the IRS Examiner handling the case. If the examination concluded more than 30 days ago or is unrelated, send it to the address provided for exempt organizations, governmental entities, and Indian tribal entities.

How do I complete IRS Form 4670?

First, obtain a separate Form 4669 from each payee for each year relief is requested. Then complete Form 4670 by entering the EIN, name, address, checking the appropriate tax return box, entering the tax year, and noting the number of Form 4669s attached. Attach the required Form 4669s, any examination reports, and any amended returns. Finally, have an authorized officer sign the form before mailing it to the proper IRS address.

What happens if IRS Form 4670 is filed incorrectly?

If the form is not signed, the IRS will return it for signature, and the payor remains liable for any penalty or addition to tax for failure to deduct and withhold.

Can I check more than one tax form box?

Only one tax form box may be selected per Form 4670 Ensure only one tax form box is selected

Do I need a Form 4669 for each payee?

A separate Form 4669 is required for each payee Verify a Form 4669 is attached for each payee

Ready to get started?

Upload the form or open it in the AI Editor for intelligent guidance

Fillable formOpen in Editor->

Source transparency

Copyright & Licensing - US Government Forms

Independent guide

BrieflyGo links to and explains official public form sources. We are not a government agency, and this page is for general form guidance, not legal advice.

Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Public DomainCreated by the U.S. federal government. Not subject to copyright (17 USC § 105). Freely copyable without restriction.
Verify current license terms with the source agency before reuse outside this platform.

Understand the agreement before you sign it.

Review risky clauses in plain English, fix the document, and keep it moving toward signature.

Review a contract free →