Application for Voluntary 
Form  8952                         Classification Settlement Program (VCSP)                                         OMB No. 1545-2215
(Rev. November 2023)
Department of the Treasury                         Do not send payment with Form 8952.  
Internal Revenue Service          Go to www.irs.gov/Form8952 for instructions and the latest information. 
Caution: Taxpayer must make certain representations in order to be eligible to participate in the VCSP. These representations can be 
found in Part V on page 2.
Part I   Taxpayer Information
1      Taxpayer’s name                                                                  2  Employer identification number (EIN)

3      Number and street (or P.O. box number if mail is not delivered to a street address)                          Room/Suite

4      City, town or post office, state, and ZIP code

5      Telephone number                                 6  Website address (optional)

7      Fax number (optional)                            8  Email address (optional)

9       Type of entity. Check the applicable box:
         Sole proprietorship              Cooperative organization described in section 1381 of the Internal Revenue Code
         Joint venture                    Tax-exempt organization
         Partnership                      State or local government (for worker class or position not covered under a section 218 agreement)
         C corporation                    Other (specify here)
         S corporation
10      Are you a member of an affiliated group?
         Yes                No
        If “Yes,” complete the common parent information on lines 11–14.
        If “No,” skip to Part II.
11      Name of common parent of the affiliated group                                   12  EIN of common parent

13      Number and street (or P.O. box number if mail is not delivered to a street address) of common parent

14      City, town or post office, state, and ZIP code of common parent

Part II  Contact Person
Attach a properly completed Form 2848, Power of Attorney and Declaration of Representative, if applicable. Also see Special 
instructions for Form 2848 in the instructions. 
• Name and title of contact person
• Contact person’s number and street (or P.O. box number if mail is not delivered to a street address)

• Contact person’s city, town or post office, state, and ZIP code
• Contact person’s telephone number
• Contact person’s fax number (optional)
• Contact person’s email address (optional)
Part III General Information About Workers To Be Reclassified
15      Enter the total number of workers from all       16  Enter a description of the class or classes of workers to be reclassified. 
        classes to be reclassified. A class of workers       If more space is needed, attach separate sheets. See instructions
        includes all workers who perform the same 
        or similar services.

17      Enter the beginning date of the employment 
        tax period (calendar year or quarter) for which 
        you want to begin treating the class or classes 
        of workers as employees. This date should be 
        at least 120 days after the date you file Form 
        8952. See instructions
              /            /

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.          Cat. No. 37772H     Form 8952 (Rev. 11-2023)

Form 8952 (Rev. 11-2023)                                                                                                              Page 2
Taxpayer’s name                                                                                 Employer identification number (EIN)

Part IV     Payment Calculation Using Section 3509(a) Rates (see instructions)
18    Enter total compensation paid in the most recently completed calendar year to 
      all workers to be reclassified. See instructions . . . . .                    . . . . . .   18
19    Multiply line 18 by 3.24% (0.0324) .  .   . . .    . . . .                    . . . . . . . . . . . . .    . 19
20    Enter any compensation included on line 18 that exceeded the social security 
      wage  base  for  any  worker  or  workers  for  the  most  recently  completed
      calendar year. See instructions .   . .   . . .    . . . .                    . . . . . .   20
21    Subtract line 20 from line 18   .   . .   . . .    . . . .                    . . . . . .   21
22    Multiply line 21 by 7.44% (0.0744) .  .   . . .    . . . .                    . . . . . . . . . . . . .    . 22
23    Add lines 19 and 22  .  .     . .   . .   . . .    . . . .                    . . . . . . . . . . . . .    . 23
24    Multiply line 23 by 10% (0.10). This is the VCSP payment you will submit with your signed closing 
      agreement. See instructions .   .   . .   . . .    . . . .                    . . . . . . . . . . . . .    . 24
Part V      Taxpayer Representations
Caution: Since the representations include the penalty of perjury statement, the representations under Part V must be signed by the 
taxpayer, not the taxpayer’s representative.
A     Treatment of Workers
  1   Taxpayer wants to voluntarily reclassify certain workers as employees for federal income tax withholding, Federal Insurance 
      Contributions Act, and Federal Unemployment Tax Act taxes (collectively, federal employment taxes) for future tax periods.
  2   Taxpayer is presently treating the workers as nonemployees.
  3   Taxpayer has filed all required Forms 1099 for each of the workers to be reclassified for the 3 preceding calendar years ending 
      before the date of this application.
  4   Taxpayer has consistently treated the workers as nonemployees.
  5   There is no current dispute between the taxpayer and the IRS as to whether the class or classes of workers are nonemployees 
      or employees for federal employment tax purposes.
B     Examination
  1   Taxpayer or, if applicable, any member of the taxpayer’s affiliated group, is not under employment tax examination by the IRS.
  2   Taxpayer is not under examination by the Department of Labor or any state agency concerning the proper classification of the 
      class or classes of workers.
  3 a Taxpayer has not been examined previously by the IRS or the Department of Labor concerning the proper classification of the 
      class or classes of workers; or
  b   Taxpayer has been examined previously by the IRS or the Department of Labor concerning the proper classification of the 
      class or classes of workers and the taxpayer has complied with the results of the prior examination.
Caution: Do not send payment with Form 8952. You will submit payment later with your signed closing agreement. If you submit payment 
with Form 8952, it may cause a processing delay.
         Under penalties of perjury, I declare that I have examined this submission, including any accompanying documents, and to the best of my knowledge and 
         belief, all of the facts contained herein are true, correct, and complete. 
Sign     Taxpayer’s signature                                                                                      Date
Here

         Print/Type preparer’s name               Preparer’s signature                            Date
Paid                                                                                                          Check          if  PTIN 
                                                                                                              self-employed
Preparer 
Use Only Firm’s name                                                                                    Firm’s EIN
         Firm’s address                                                                                 Phone no.
                                                                                                                   Form 8952 (Rev. 11-2023)