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.
Official form guide
Form 13980: 13980
IRS Form 13980 is the Application for Certification of a Small Business Health Care Tax Credit. Use it when a small employer wants the IRS to certify eligibility for the credit under the Small Business Health Care Tax Credit program.
Need help with Form 13980?
Open it in the AI Editor for field guidance, checks, and PDF export.
Need help? AI Editor guides you through every field of Form 13980.
Start filling →Form Overview
IRS Form 13980 - 13980
IRS Form 13980 is the Application for Certification of a Small Business Health Care Tax Credit. Use it when a small employer wants the IRS to certify eligibility for the credit under the Small Business Health Care Tax Credit program.
Risk Radar
Scan points- 1A single missing signature can invalidate the entire application.
- 2Missing payroll or employee contribution data
- 3Incorrect employee count (full‑time equivalents)
- 4Failure to attach required health‑plan documentation
- 5Signature omitted or dated incorrectly
Plain English
If you run a small business and pay for employee health insurance, you can apply for a tax credit. This form asks the IRS to confirm that you qualify before you claim the credit on your tax return.
Submission Date
- Filing date: 2025-06-27 22:10:06
- 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.
What this form is for
- Use when you want IRS certification for the Small Business Health Care Tax Credit.
- Do not use if you are only reporting the credit on your tax return; use Form 8941 instead.
- Check Form 941 or Form 944 if you need to report payroll taxes alongside the credit.
Form selector
Use this form or another form?
Employer has 26+ employees
Credit is claimed directly on the return, no certification needed
✓ Verify employee count first
Employer only offers self‑insured plan
Certification only for fully insured or government‑sponsored plans
✓ Review plan type
Employer qualifies for the credit but wants to claim retroactively
Request a refund or adjustment
✓ Confirm the year is within the 3‑year look‑back period
Deadline or filing window
The application must be received by the due date of the employer’s income tax return for the year the credit is claimed, including any extensions. If the return is filed on time, the application should be mailed or e‑filed by that same date. No separate statutory deadline is published.
- —Total payroll for eligible employees | Sum of wages reported on Form W‑2 | Total payroll amount | Verify inclusion of only eligible wages
Checklist
What you need before filling it out
Employee count (Section 1)
Payroll records showing FTEs · Employer’s payroll system
Employer contribution amount (Section 2)
Health‑plan invoice or payroll deduction report · Accounting records
Health‑plan affordability (Section 3)
Plan summary document · Insurance carrier
Signature block (Section 5)
Authorized officer signature · Physical form
Before you submit
- 1Confirm form edition matches current IRS website
- 2Verify employee FTE count is between 1 and 25
- 3Calculate employer contribution correctly
- 4Attach health‑plan summary and payroll summary
- 5Check that all required fields are filled
- 6Sign and date the form
- 7Mail to the correct IRS address or upload via e‑services
- 8Retain a copy of the complete packet for records
- 9Record mailing date or e‑file confirmation number
- 10Cross‑check credit amount with Form 8941 calculations
How to file this form
- 1Gather payroll reports, health‑plan documents, and employee contribution data
- 2Download the latest Form 13980 PDF from IRS.gov
- 3Complete Sections 1‑4 with accurate numbers
- 4Attach required documentation (plan summary, payroll summary)
- 5Sign and date the form in Section 5
- 6Mail to the address in the instructions or submit electronically via e‑services
- 7Save tracking info (mail receipt or e‑file confirmation)
Known limitations
- 1Form does not calculate the credit; it only requests certification
- 2Only applicable to employers with 1‑25 FTEs and average employee wages ≤ $50,000
- 3IRS may request additional documentation after submission
- 4Electronic filing is limited to authorized e‑services users
Field map
Compact field-by-field guide
General Info
2 items
Full legal name and taxpayer identification number (SSN or EIN).
Current mailing address.
Details
2 items
Complete all applicable sections of this form according to the official IRS instructions.
Enter the relevant dollar amount if this form involves tax calculation.
Certification
1 items
Read and acknowledge any certifications required by this form.
Signatures
1 items
Sign and date. Unsigned forms cannot be processed.
Almost done reviewing the fields?
Fillable formOpen in Editor->Form 13980 is currently active for tax years 2022‑2025. The IRS updates the form periodically; verify the edition date before filing.
What changed or needs a fresh check
- Edition date – ensure the form is the latest version posted on IRS.gov
- Fee – no filing fee required
- Mailing address – use the address in the current instructions
- Electronic filing option – verify e‑services eligibility
- Signature line – include employer’s authorized signature and date
- Attachments – include payroll summary and health‑plan summary
Quick Facts
Downloads
After you file
- 1Keep the mailed copy and any delivery receipt
- 2Track the IRS certification response (mail or electronic notice)
- 3If approved, note the certified credit amount for use on Form 8941
- 4Store all supporting payroll and plan documents for at least three years
- 5Monitor for any IRS follow‑up requests
- 6Update your accounting system with the certified credit amount
Sources
- SRCForm 13980 title and purposeIRS official form header
- SRCEligibility criteriaIRS instructions for Form 13980
- SRCSubmission addressIRS Form 13980 instructions page
- SRCNo filing feeindicated in the form instructions
- SRCSignature requirementSection 5 of the form
- SRCEdition date locationtop of the form PDF
- SRCElectronic filing optionIRS e‑services documentation
- SRCDeadline relationshipIRS guidance linking certification to tax return due date
Common confusion points
FTE calculation
Employers often count part‑time workers incorrectly
→ Re‑calculate using IRS definition
Affordable coverage threshold
Misreading the 9.5% of household income rule
→ Verify employee share against IRS tables
Eligibility year vs. filing year
Credit applies to the year coverage was provided
→ Align form year with coverage year
Certification vs. claim
Certification is separate from the actual credit claim on Form 8941
→ File both forms as required
Electronic vs. paper submission
Not all employers have e‑services access
→ Use mail if e‑file not available
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- Form 843 (Claim for Refund) to request correction
Source transparency
Copyright & Licensing - US Government Forms
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.
Never sign without understanding every clause.
BrieflyGo reviews your contracts in plain English — instantly.