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Official form guide
Form SS-16: Certificate of Election of Coverage
IRS Form SS-16 is a Certificate of Election of Coverage used by religious orders whose members are required to take a vow of poverty. It certifies election of social security and Medicare coverage under section 3121(r). The due date for retroactive quarters depends on the filing quarter (e.g., filed in Q1 requires payment by April 30).
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IRS Form SS-16 - Certificate of Election of Coverage
IRS Form SS-16 is a Certificate of Election of Coverage used by religious orders whose members are required to take a vow of poverty. It certifies election of social security and Medicare coverage under section 3121(r). The due date for retroactive quarters depends on the filing quarter (e.g., filed in Q1 requires payment by April 30).
Risk Radar
Scan points- 1Failure to enter a correct or present effective date (quarter/year) in the space right of the address will cause Form SS-16 to be returned.
- 2Omitting the required effective date in the space to the right of the address.
- 3Filing without an authorized official signing the form on all necessary copies (A, B, and C).
- 4Not including the best daytime telephone number for IRS questions.
- 5Using a filing date that does not correspond with the selected effective quarter/year.
Plain English
This form allows religious orders to officially elect coverage under Social Security and Medicare laws. It confirms that the order's members are covered for services performed while carrying out their required duties. Filing this document establishes the proper dates for paying related federal taxes.
Submission Date
- Filing date: 2025-11-28 14:10:05
- 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 a religious order (or autonomous subdivision of a religious order) whose members are required to take a vow of poverty files it to certify election of social security and Medicare coverage under section 3121(r).
- Do not use it when the filer is not a religious order whose members are required to take a vow of poverty, as this form is specific to that entity type.
- Check Form 941-X (Adjusted Employer’s QUARTERLY Federal Tax Return or Claim for Refund) instead when claiming a refund or making an adjustment outside of the initial filing period.
Form selector
Use this form or another form?
Filing quarterly returns for adjustments or claims of refund
The source mentions this form specifically regarding election instructions.
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If notified to file an annual return instead of a standard quarterly return
Form SS-16 directs filers who were notified to file Form 944, Employer’s ANNUAL Federal Tax Return, to call the IRS for assistance.
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Filing the routine periodic federal tax return
The source provides specific rules on how filing Form SS-16 affects the due date of the Form 941.
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Deadline or filing window
The due date for filing returns and paying tax for retroactive quarters is determined by the date Form SS-16 is filed. If the form is filed during the 1st quarter (January, February, March), payment is due April 30; if filed during the 2nd quarter (April, May, June), it is due July 31; if filed during the 3rd quarter (July, August, September), it is due October 31; otherwise, it is due January 31 of next year.
Checklist
What you need before filling it out
Copies to file
Copies A, B, and C · Form p.1, p.3
Effective election date
Calendar quarter in which the certificate is filed, or after, or any one of the 20 calendar quarters before · Space to the right of the address
Filer Identification
Full name of religious order and Employer identification number · Top section of p.1/p.3
Required record retention
Keep Copy D for your records · How To File Form SS-16 (p.1), (p.3)
Quarterly Return Deadline Calculation
The deadline for Form 941 is the last day of the calendar month following the relevant quarter. · p.2, p.4
Before you submit
- 1Ensure an authorized official signs and provides their title, printed name, phone number, and date on the form.
- 2Verify that the Effective Date entered is one of three options: the quarter of filing, the quarter immediately following filing, or any one of the 20 calendar quarters before filing.
- 3Confirm that if the religious order already files Form 941, the same Employer Identification Number (EIN) is used on Form SS-16.
- 4Send Copies A, B, and C to the IRS address listed under Where To File Form SS-16; keep Copy D for record keeping.
- 5Review the definition of wages and confirm that any fair market value of benefits less than $100 a month is excluded from wage calculations.
- 6If providing a foreign address, ensure the information follows the order: city, province or state, and country, without abbreviating the country name.
- 7Check the Form SS-16 for the correct due date calculation for Forms 941 and 941-X based on whether the election is current, future, or retroactive.
How to file this form
- 1Complete Forms SS-16 Copies A, B, and C by having an authorized official sign and print their name, title, date, and telephone number on all copies.
- 2Determine the appropriate effective quarter and write that specific date in the space to the right of the address. If this is incorrect or missing, the form will be returned.
- 3Mail Copies A, B, and C together to the IRS mailing address designated under Where To File Form SS-16.
- 4After filing, retain Copy D for your records; wait for Copy C to be returned by the Internal Revenue Service (IRS) upon acceptance of the election.
Known limitations
- 1The term “wages” excludes any fair market value of board, lodging, clothing, or other benefits received if that amount is less than $100 a month.
- 2If the religious order was notified to file Form 944 (Employer’s ANNUAL Federal Tax Return) instead of Form 941, assistance must be obtained by calling the IRS at 800-829-4933 (toll free).
- 3When entering a foreign address, the information must follow the order: city, province or state, and country.
- 4The form cannot infer the purpose of filing; its purpose is specifically limited to religious orders whose members are required to take a vow of poverty.
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 date for Form SS-16 is December 2025. The source instructs filers to visit www.irs.gov/FormSS16 for the latest information, but does not specify any recent changes.
What changed or needs a fresh check
- Edition date — confirm the revision date reads December 2025.
- Fee — The official source does not mention any filing fee for Form SS-16.
- Mailing address — Confirming the specific mailing address is necessary, as instructions state sending copies to the IRS address listed under Where To File Form SS-16, but the actual street address is omitted from the provided text.
- Signature and Contact Information — Verify that an authorized official of the order signs, prints their name, title, and provides a best daytime telephone number on Copies A, B, and C.
Quick Facts
Downloads
After you file
- 1An authorized official must sign Form SS-16 and send Copies A, B, and C to the specified IRS address.
- 2The filer should keep Copy D for their records.
- 3Copy C will be returned by the Internal Revenue Service (IRS) after the form is accepted.
- 4If the effective date on Form SS-16 is incorrect or missing relative to the filing date, Form SS-16 will be returned.
Sources
- SRC[Form p.1] The form applies to religious orders (or autonomous subdivision of religious order) whose members are required to take a vow of poverty.
- SRC[Form p.1] Copies A and C contain general information for filing Form SS-16, while Copies B and D contain instructions specific to filing Form 941 and Form 941-X.
- SRC[Form p.1] The term “wages” also includes the fair market value of board, lodging, clothing, and other benefits a member receives in return for services from the order or from any person or organization under an agreement with the order or subdivision. If the fair market value of the items is less than $100 a month, that amount cannot be included as wages.
- SRC[Form p.1] The effective date can be the calendar quarter in which the certificate is filed, the quarter after filing, or any one of the 20 calendar quarters before the quarter in which the certificate is filed.
- SRC[Form p.1] An authorized official must sign and send Copies A, B, and C to the IRS address listed under Where To File Form SS-16; Copy D should be kept for records.
- SRC[Form p.2] If filing for retroactive quarters, an employer must enter “Form SS-16” and the date filed across the top margin of page 1 of each Form 941 being filed.
Common confusion points
Which copies of Form SS-16 should I send to the IRS?
The filer must send Copies A, B, and C.
→ Keep Copy D for your records.
What happens if my Effective Date is wrong or missing?
If the effective date is incorrect for the filing date or is missing, Form SS-16 will be returned by the Internal Revenue Service (IRS).
→ Enter one of the three specified dates in the space to the right of the address.
How do I calculate wages if benefits are provided in kind?
The term “wages” includes the fair market value of board, lodging, clothing, and other benefits; however, amounts less than $100 a month cannot be included.
→ Only include the fair market value of items that exceed $100 per month.
I need to file Form 944 instead of Form 941; who do I call?
If you were notified to file Form 944, Employer’s ANNUAL Federal Tax Return, instead of Form 941, call the IRS at 800-829-4933 (toll free).
→ Use this number for assistance with Forms 944 and 941.
What is the deadline if I elect coverage for a future quarter?
If Form SS-16 is made effective the first day of the calendar quarter immediately after the quarter in which it is filed, then Form 941 is due the last day of the calendar month following that quarter.
→ The deadline follows the quarter *after* your filing.
If I live outside the United States, what order should my address follow?
For a foreign address, enter the information in this specific order: city, province or state, and country, while following the country’s practice for entering the postal code.
→ Do not abbreviate the name of the country.
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Questions about IRS Form SS-16
What is IRS Form SS-16 used for?
This form allows religious orders to officially elect coverage under Social Security and Medicare laws. It confirms that the order's members are covered for services performed while carrying out their required duties. Filing this document establishes the proper dates for paying related federal taxes.
Who must file IRS Form SS-16?
Religious orders (or autonomous subdivision of religious order) whose members are required to take a vow of poverty must file Form SS-16.
What information does IRS Form SS-16 require?
The form collects identifying information for the religious order, including its full name and employer identification number. It certifies that the entity elects social security and Medicare coverage under section 3121(r).
When is IRS Form SS-16 due?
The filer must enter an effective date in the space to the right of the address. This date can be the calendar quarter in which the certificate is filed, the subsequent calendar quarter, or any one of the 20 calendar quarters before the filing quarter.
Where do I file IRS Form SS-16?
An authorized official must send Copies A, B, and C to the IRS address listed below under Where To File Form SS-16. Copy D should be kept for records.
How do I complete IRS Form SS-16?
An authorized official of the order must sign the form on both the front and back sections (Copies A, B, and C). The filer must also include the best daytime telephone number where the IRS can reach them. Copies A, B, and C are sent to the IRS; Copy D is kept by the filer.
What happens if IRS Form SS-16 is filed incorrectly?
If the entity files and pays by the applicable due date, it will not be subject to failure to file or failure to pay penalties or interest. If the effective date is incorrect or missing, Form SS-16 will be returned.
Which copies of Form SS-16 should I send to the IRS?
The filer must send Copies A, B, and C. Keep Copy D for your records.
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