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                                                        Application for Exemption From Self-Employment Tax                                                       OMB No. 1545-0074
Form    4361
(Rev. January 2011)                                     for Use by Ministers, Members of Religious Orders                                                        File Original 
Department of the Treasury                                                        and Christian Science Practitioners                                            and Two Copies 
Internal Revenue Service 
File original and two copies and attach supporting documents. This exemption is granted only if the IRS returns a copy to you marked “approved.” 
                                          1   Name of taxpayer applying for exemption (as shown on Form 1040)                                                Social security number

                                           Number and street (including apt. no.)                                                                            Telephone number (optional)

                                           City or town, state, and ZIP code
                     Please type or print 
2  Check one box:                                       Christian Science practitioner                        Ordained minister, priest, rabbi               3  Date ordained, licensed, etc. 
                                           Member of religious order not under a vow of poverty               Commissioned or licensed minister (see line 6)     (Attach supporting document. 
                                                                                                                                                                 See instructions.)
4   Legal name of ordaining, licensing, or commissioning body or religious order

                                          Number, street, and room or suite no.                                                                              Employer identification number

                                          City or town, state, and ZIP code

5                                         Enter the first 2 years after the date shown on line 3 that you had net self-employment earnings of $400 or 
                                          more, any of which came from services as a minister, priest, rabbi, etc.; member of a religious order; or 
                                          Christian Science practitioner    . .   . . . .       . . .         . . . .    . .  . .   .          . . . .  ▶
6                                         If you apply for the exemption as a licensed or commissioned minister and your denomination also ordains ministers, please indicate how your 
                                          ecclesiastical powers differ from those of an ordained minister of your denomination. Attach a copy of your denomination’s bylaws relating to the 
                                          powers of ordained, commissioned, and licensed ministers. 

7  I certify that I am conscientiously opposed to, or because of my religious principles I am opposed to, the acceptance (for services I perform as a 
                                          minister, member of a religious order not under a vow of poverty, or Christian Science practitioner) of any public insurance that makes payments in 
                                          the event of death, disability, old age, or retirement; or that makes payments toward the cost of, or provides services for, medical care. (Public 
                                          insurance includes insurance systems established by the Social Security Act.) 
    I certify that as a duly ordained, commissioned, or licensed minister of a church or a member of a religious order not under a vow of poverty, I have 
                                          informed the ordaining, commissioning, or licensing body of my church or order that I am conscientiously opposed to, or because of religious 
                                          principles I am opposed to, the acceptance (for services I perform as a minister or as a member of a religious order) of any public insurance that 
                                          makes payments in the event of death, disability, old age, or retirement; or that makes payments toward the cost of, or provides services for, 
                                          medical care, including the benefits of any insurance system established by the Social Security Act. 
    I certify that I have never filed Form 2031 to revoke a previous exemption from social security coverage on earnings as a minister, member of a 
                                          religious order not under a vow of poverty, or Christian Science practitioner. 
    I request to be exempted from paying self-employment tax on my earnings from services as a minister, member of a religious order not under a 
                                          vow of poverty, or Christian Science practitioner, under section 1402(e) of the Internal Revenue Code. I understand that the exemption, if granted, 
                                          will apply only to these earnings. Under penalties of perjury, I declare that I have examined this application and to the best of my knowledge and 
                                          belief, it is true and correct. 
Signature ▶                                                                                                                                          Date ▶
Caution:                                   Form 4361 is not proof         of the right to an exemption from federal income tax withholding or social security tax, the right to a parsonage 
allowance exclusion (section 107 of the Internal Revenue Code), assignment by your religious superiors to a particular job, or the exemption or church 
status of the ordaining, licensing, or commissioning body, or religious order. 
                                                                                        For Internal Revenue Service Use 
                                          Approved for exemption from self-employment tax on ministerial earnings 
                                          Disapproved for exemption from self-employment tax on ministerial earnings 
By 
                                                                                      (Director’s signature)                                                     (Date) 
                                                                                      Note. If you are a commissioned or licensed                  death, disability, old age, or retirement; or that 
General Instructions                                                                  minister of a religious denomination or church               makes payments for the cost of, or provides 
Section references are to the Internal  Revenue                                       that ordains its ministers, you may be treated in            services for, medical care, including any 
Code unless otherwise noted.                                                          the same manner as an ordained minister if you               insurance benefits established by the Social 
Purpose of form.File Form 4361 to apply for  an                                       perform substantially all the religious functions            Security Act. 
exemption from self-employment tax if you have                                        within the scope of the tenets and practices of                If you are a duly ordained, commissioned, or 
ministerial earnings (defined later) and are:                                         your religious denomination or church.                       licensed minister of a church or a member of a 
• An ordained, commissioned, or licensed                                                This application must be based on your                     religious order not under a vow of poverty, prior 
minister of a church;                                                                 religious or conscientious opposition to the                 to filing this form you must inform the ordaining, 
• A member of a religious order who has not                                           acceptance (for services performed as a                      commissioning, or licensing body of your church 
taken a vow of poverty; or                                                            minister, member of a religious order not under a            or order that, on religious or conscientious 
                                                                                      vow of poverty, or Christian Science  practitioner)          grounds, you are opposed to the acceptance of 
• A Christian Science practitioner.                                                   of any public insurance that makes payments for              public insurance benefits based on ministerial  
                                                                                                                                                   service. 
For Privacy Act and Paperwork Reduction Act Notice, see page 2                                                                  Cat. No. 41586H                  Form 4361 (Rev. 1-2011) 



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Form 4361 (Rev. 1-2011)                                                                                                                            Page 2 
Ministerial service, in general, is the service     societies, and other agencies integral to these     available, you can attach a letter signed by an 
you perform in the exercise of your ministry, in    organizations) under the authority of a church or   individual authorized to act for the organization 
the exercise of the duties required by your         church denomination.                                stating that the organization meets both of the 
religious order, or in the exercise of your         If your church assigns or designates you to         above requirements. 
profession as a Christian Science pracitioner.      perform services for an organization that is  
Ministerial earnings are the self-employment        neither a religious organization nor an integral    Privacy Act and Paperwork Reduction Act  
earnings that result from such service. See Pub.    agency of a religious organization, you are         Notice. We ask for the information on this form 
517 for details.                                    performing ministerial services even though they    to carry out the Internal Revenue laws of the 
Do not file Form 4361 if:                           may not involve conducting religious worship or     United States. We need this information to 
• You ever filed Form 2031, Revocation of           ministering sacerdotal functions. Your services     ensure that you are complying with these laws 
Exemption From Self-Employment Tax for Use          are ordinarily not considered assigned or           and to allow us to figure and collect the right 
by Ministers, Members of Religious Orders, and      designated by your church if any of the following   amount of tax. Applying for an exemption from 
Christian Science Practitioners; or                 is true.                                            self-employment tax is voluntary. However, 
                                                                                                        providing the requested information is mandatory 
• You belong to a religious order and took a vow    • The organization for which you perform the        if you apply for the exemption. Our legal right to 
of poverty. You are automatically exempt from       services did not arrange with your church for       ask for the information requested on this form is 
self-employment tax on earnings for services you    your services.                                      Internal Revenue Code sections 1402(e), 6001, 
perform for your church or its agencies. No tax     • You perform the same services for the             6011, 6012(a), and 6109 and their regulations. 
exemption applies to earnings for services you      organization as other employees not designated      Code section 6109 requires that you provide 
perform for any other organization.                 as you were.                                        your social security number on what you file. If 
Additional information. See Pub. 517, Social        • You perform the same services before and          you fail to provide all or part of the information  
Security and Other Information for Members  of      after the designation.                              requested on Form 4361, your application may 
                                                                                                        be denied. If you provide false or fraudulent 
the Clergy and Religious Workers.                   Nonexempt earnings. Exemption from self-            information, you may be subject to penalties. 
When to file. File Form 4361 by the due date,       employment tax does not apply to earnings from 
including extensions, of your tax return for the    services that are not ministerial.                  You are not required to provide the information 
                                                                                                        requested on a form that is subject to the 
second tax year in which you had at least $400      Earnings from the following entities are not        Paperwork Reduction Act unless the form 
of net earnings from self-employment, any of        exempt even if religious services are conducted     displays a valid OMB control number. Books or 
which came from ministerial services.               or sacerdotal functions are ministered: the United  records relating to a form or its instructions must 
Effective date of exemption. An exemption           States; a state, territory, or possession of the    be retained as long as their contents may 
from self-employment tax is effective for all tax   United States; the District of Columbia; a foreign  become material in the administration of any 
years ending after 1967 in which you have net       government; or a subdivision of any of these        Internal Revenue law. 
self-employment earnings of $400 or more if you     bodies. For example, chaplains in the U.S.  
receive any of it from ministerial services. For    Armed Forces are considered commissioned            Generally, tax returns and return information 
example, if you had qualified net earnings of       officers, not ministers. Similarly, chaplains in    are confidential, as stated in section 6103. 
$400 or more in 2008 and not again until 2010, a    state prisons or universities are considered civil  However, section 6103 allows or requires the 
valid Form 4361 filed by April 15, 2011, would      servants.                                           Internal Revenue Service to disclose or give the 
                                                                                                        information shown on your tax return to others as 
apply to 2008 and all later years. See Pub. 517 to  Indicating exemption on Form 1040. If the IRS       described in the Code. We may disclose this 
find out if you are entitled to a refund of self-   returns your application marked “approved” and      information to the Social Security Administration 
employment tax paid in earlier years.               your only self-employment income was from           for administration of the exemption, to the 
Where to file. Mail the original and two copies of  ministerial services, enter “Exempt—Form 4361”      Department of Justice to enforce civil and 
this form to: Department of the Treasury, Internal  on the self-employment tax line in the Other        criminal tax laws, and to cities, states, the 
Revenue Service Center, Philadelphia, PA            Taxes section of Form 1040. If you had other        District of Columbia, and U.S. commonwealths 
19255-0733.                                         self-employment income, see Schedule SE             or possessions to administer their tax laws. We 
Approval of application. Before your application    (Form 1040).                                        may also disclose this information to other 
can be approved, the IRS must verify that you                                                           countries under a tax treaty, to federal and state 
are aware of the grounds for exemption and that     Specific Instructions                               agencies to enforce federal nontax criminal laws, 
you want the exemption on that basis. When          Line 3. Enter the date you were ordained,           and to federal law enforcement and intelligence 
your completed Form 4361 is received, the IRS       commissioned, or licensed as a minister of a        agencies to combat terrorism. 
will mail you a statement that describes the        church; became a member of a religious order;       Please keep this notice with your records. It  
grounds for receiving an exemption under            or began practice as a Christian Science            may help you if we ask you for other information. 
section 1402(e). You must certify that you have     practitioner. Do not file Form 4361 before this     If you have any questions about the rules for 
read the statement and seek exemption on the        date. Attach a copy of the certificate (or, if you  filing and giving information, please call or visit 
grounds listed on the statement. The certification  did not receive one, a letter from the governing    any Internal Revenue Service office. 
must be made by signing a copy of the               body of your church) that establishes your status   The average time and expenses required to  
statement under penalties of perjury and mailing    as an ordained, commissioned, or licensed           complete and file this form will vary depending 
it to the IRS not later than 90 days after the date minister; a member of a religious order; or a       on individual circumstances. For the estimated 
the statement was mailed to you. If it is not       Christian Science practitioner.                     averages, see the instructions for your income 
mailed by that time, your exemption will not be 
effective until the date the signed copy is         Line 4. If you are a minister or belong to a        tax return. 
received by the IRS.                                religious order, enter the legal name, address,     If you have suggestions for making this form 
If your application is approved, a copy of          and employer identification number of the           simpler, we would be happy to hear from you. 
Form 4361 will be returned to you marked            denomination that ordained, commissioned, or        You can write to the Internal Revenue Service, 
“approved.” Keep this copy of Form 4361 for         licensed you, or the order to which you belong.     Tax Products Coordinating Committee, 
your permanent records. Once the exemption is       Get the employer identification number from your    SE:W:CAR:MP:T:T:SP, 1111 Constitution 
approved, you cannot revoke it.                     church or order.                                    Avenue, NW, IR-6526, Washington, DC 20224. 
Exempt earnings. Only earnings from                 You must be able to show that the body that         Do not send the form to this address. Instead, 
ministerial services (ministerial earnings) are     ordained, commissioned, or licensed you, or your    see Where to file on this page. 
exempt from self-employment tax.                    religious order, is exempt from federal income 
                                                    tax under section 501(a) as a religious 
Conducting religious worship services or            organization described in section 501(c)(3). You 
ministering sacerdotal functions are ministerial    must also be able to show that the body is a 
services whether or not performed for a religious   church (or convention or association of churches) 
organization.                                       described in section 170(b)(1)(A)(i). To assist the 
Ministerial services also include controlling,      IRS in processing your application, you can 
conducting, and maintaining religious               attach a copy of the exemption letter issued to 
organizations (including religious boards,          the organization by the IRS. If that is not   






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