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Form 14417: Reimbursable Agreement - Non-Federal Entities (State and Local Governments, Foreign Governments, Commercial Organizations, and Private Businesses)
IRS Form 14417 is a Reimbursable Agreement form for Non-Federal Entities (State and Local Governments, Foreign Governments, Commercial Organizations, and Private Businesses). The agreement operates on a fiscal year basis.
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IRS Form 14417 - Reimbursable Agreement - Non-Federal Entities (State and Local Governments, Foreign Governments, Commercial Organizations, and Private Businesses)
IRS Form 14417 is a Reimbursable Agreement form for Non-Federal Entities (State and Local Governments, Foreign Governments, Commercial Organizations, and Private Businesses). The agreement operates on a fiscal year basis.
Risk Radar
Scan points- 1Work on the project cannot begin until final signatures have been obtained.
- 2Failing to enter the estimated completion (End) date in MM-DD-YYYY format.
- 3Starting project work before the agreement is fully signed by both Seller and Buyer.
- 4Omitting necessary contact details for the Buyer's Program Representative official on Page 4.
- 5Not selecting or describing a payment method in Section 9 (e.g., Paper Check, Money Order).
Plain English
This form establishes an official agreement where one entity pays another for goods or services. It details what is being purchased and sets the expected end date for that support. By signing it, both parties confirm the terms of the financial arrangement with the IRS.
Submission Date
- Filing date: 2024-03-06 12:13:28
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when an agreement requires reimbursement for services or products between non-federal entities (State/Local Governments, Foreign Governments, Commercial Organizations, Private Businesses).
- Do not use it when the transaction is solely internal to a federal agency and does not require external reimbursable authorization.
- Check Form 14417 instead when you are filing this specific Reimbursable Agreement.
Form selector
Use this form or another form?
When dealing with Foreign Government reimbursement
The source confirms its use for Foreign Governments specifically.
✓ Check the 'Seller' section on Page 2.
When a Buyer requires multiple approvals
This allows for additional official signatures from the Buyer beyond the primary signatory listed in Section 11.
✓ Confirm all required signers are documented on Page 3/6.
When providing advance payment inquiries only
The mailing address provided on Page 2 is designated specifically for 'Advance Payment Inquiries Only'.
✓ Ensure you use the correct address listed on Page 2.
Deadline or filing window
The agreement itself requires an estimated completion (End) date in MM-DD-YYYY format; IRS agreements operate on a fiscal year basis and do not cross fiscal years. The form does not specify a filing deadline, but work should not start before all signatures are secured.
Checklist
What you need before filling it out
Advance Payment Mailing Address
IRS - Beckley P.O. Box 9002, Beckley, WV 25802-9002 · Form p.2
Payment Method Selection (Page 6)
Must select one: Paper Check, Electronic check via Pay.gov, Money order, or Other · Form p.6
CFO Authorizing Official Info (Seller)
Name, Title, Phone, Email (Page 6, Section 10) · Form p.6
IRS Budget Office Coordinator Info
Name, Title, Phone, Email (Page 5, Section 2) · Form p.5
Work Commencement Trigger
Work cannot begin until the agreement is fully signed (Page 6) · Form p.6
Before you submit
- 1Verify that one payment method option on Page 6 has been checked.
- 2Confirm the Buyer's Finance Office Representative details (Name, Title) are listed on Page 2.
- 3Ensure the Seller's organization name and its GPRS section information are present on Page 2.
- 4Check that the Corporate Budget authorizing official (Seller) signature/date is present on Page 6.
- 5Verify that the Buyer's primary Authorizing Official details (Name, Title) are listed in Section 11 of Page 6.
- 6If applicable, confirm all required Co-Signature details for the Buyer are completed in Section 11a.
- 7Confirm the address entered on Page 4 pertains to the Buyer's Program Representative official.
How to file this form
- 1Complete all fields related to the Seller (organization) and the Buyer organization, including contact information for both parties.
- 2Enter the specific mailing address details of the Buyer's Program Representative official on Page 4.
- 3Select and document the Payment method on Page 6, ensuring one box is checked.
- 4Obtain all necessary signatures: Seller CFO (Page 6), Buyer Authorizing Official (Page 6/11.e), and any required Co-Signatures (Page 3/11a).
- 5Submit advance payment to the IRS at P.O. Box 9002, Beckley, WV 25802-9002 (if mailing a paper check).
- 6Keep a copy of the fully executed Form 14417 for your records before or immediately after submission.
Known limitations
- 1The agreement operates on a fiscal year basis and does not cross fiscal years.
- 2Legal Terms and Conditions are incorporated by reference on pages 3 and 4 of Form 14417.
- 3If the organization is not one of the specified Non-Federal Entities (State and Local Governments, Foreign Governments, Commercial Organizations, or Private Businesses), this form may not apply.
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.
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Fillable formOpen in Editor->The current edition is Revision 3-2023, and it is associated with Catalog Number 59893X; the source does not point to a specific 'latest information' page.
What changed or needs a fresh check
- Edition date — confirm Revision 3-2023.
- Catalog Number — confirm 59893X.
- Mailing address (to IRS) — confirm P.O. Box 9002, Beckley, WV 25802-9002.
- Payment method options — confirm Paper check, Electronic check via Pay.gov, Money order, or Other are listed on Page 6.
- Statutory authority — confirm the Internal Revenue Code section references box is pre-populated on Page 5.
Quick Facts
Downloads
After you file
- 1Keep a copy of Form 14417.
- 2Retain books or records relating to Form 14417 for as long as the contents may become material in the administration of any Internal Revenue law.
- 3Ensure all information is typed into Form 14417, except for Authorizing/Approving Officials' Signatures.
- 4If an error occurs, one must correct it, referencing the specific field number and name.
Sources
- SRCInstructions p.1 — The official title is Reimbursable Agreement - Non-Federal Entities (State and Local Governments, Foreign Governments, Commercial Organizations, and Private Businesses).
- SRCForm p.1 — The revision date on file for Form 14417 is March 2023.
- SRCInstructions p.1 — Field 5 requires entering the estimated completion (End) date; IRS agreements operate on a fiscal year basis.
- SRCInstructions p.3 — Section 6103(p)(4) of the IRC provides specific requirements for Federal, state, and local organizations to safeguard Federal tax returns as a condition of receiving information.
- SRCForm p.3 — Unauthorized disclosure under Section 7213 of the IRC is punishable by a fine up to $5,000 or imprisonment of not more than 5 years, or both.
- SRCInstructions p.4 — Field 1.a requires entering the IRS-assigned agreement tracking number in the format RA + fiscal year + project number.
Common confusion points
What does 'Agreement action' mean?
This refers to what is happening with the agreement.
→ Check if you are filing a New Amendment (increase or decrease), Cancellation, or simply entering into a new Agreement.
'End date' vs. 'Cancellation date'?
The End date is the estimated completion date for support under the agreement; the Cancellation date is when the agreement officially ends.
→ Verify that the End date reflects the expected end of service/support.
Who needs to sign?
Both Seller and Buyer must provide authorizing/approving official information, though a Co-Signature may be required.
→ Check if your organization requires more than one approving official for ratification (see Form 14417, p.3).
What is the IRS agreement tracking number format?
It follows the structure: RA + fiscal year + project number.
→ Confirm the numbering scheme uses 'RA' as the prefix and your specific fiscal year.
When must I use this form?
The title indicates it applies to Non-Federal Entities, but the statutory authority covers various situations.
→ Check Section 3 for specific IRC sections that apply to your agreement type.
Is there a deadline to file Form 14417?
Not stated in the official source — verify on the agency site.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- The filing of Form 14417 itself is the primary action; errors are corrected on the form, not necessarily by a separate follow-up form.
Questions about IRS Form 14417
What is IRS Form 14417 used for?
This form establishes an official agreement where one entity pays another for goods or services. It details what is being purchased and sets the expected end date for that support. By signing it, both parties confirm the terms of the financial arrangement with the IRS.
Who must file IRS Form 14417?
The filer category includes State and Local Governments, Foreign Governments, Commercial Organizations, and Private Businesses seeking reimbursement from the IRS.
What information does IRS Form 14417 require?
The form collects details such as the description of requested products/services (Section 6), contact information for both the Seller and Buyer (Sections 10 & 11), and payment method details (Section 9).
When is IRS Form 14417 due?
The agreement must include an estimated completion (End) date, which should be entered in MM-DD-YYYY format on Page 1.
Where do I file IRS Form 14417?
The form requires the address of the Buyer's Program Representative official to be entered on Page 4. The IRS Budget Office Reimbursables Coordinator details are also required on Page 5.
How do I complete IRS Form 14417?
Work on the project cannot begin until the agreement is fully signed. The Seller (Corporate Budget) must review and sign first, followed by the Buyer's Authorizing/Approving official signing to authorize the purchase. Final signatures from both Seller and Buyer must be obtained before work starts.
What happens if IRS Form 14417 is filed incorrectly?
Section 7431 states that persons who knowingly or negligently make an unauthorized disclosure of a return or return information are liable for civil damages.
What does 'Agreement action' mean?
This refers to what is happening with the agreement. Check if you are filing a New Amendment (increase or decrease), Cancellation, or simply entering into a new Agreement.
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