Form 8027 Employers Annual Information Return of Tip Income and Al

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I.R.S. SPECIFICATIONS

1

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 8027, PAGE 1 of 2 (PAGE 2 IS BLANK)
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20.
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: NONE

Date

PRINTS: FACE ONLY
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form

8027

Action

Date

O.K. to print
Revised proofs
requested

Employer’s Annual Information Return of
Tip Income and Allocated Tips

Department of the Treasury
Internal Revenue Service

Signature

OMB No. 1545-0714

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2008

See separate instructions.

Employer identification number

Name of establishment

Type of establishment (check
only one box)

Number and street (see instructions)

City or town, state, and ZIP code

Employer’s name (same name as on Form 941)

Number and street (P.O. box, if applicable)

1

Evening meals only

2

Evening and other
meals

3

Meals other than
evening meals

4

Alcoholic beverages

Establishment number
(see instructions)

Apt. or suite no.

City, state, and ZIP code (if a foreign address, see instructions)

Does this establishment accept credit
Yes (lines 1 and 2 must be completed)
No
cards, debit cards, or other charges?
Attributed Tip Income Program (ATIP). See Revenue Procedure 2006-30

Check if: Amended Return
Final Return

1

Total charged tips for calendar year 2008

1

2

Total charge receipts showing charged tips (see instructions)

2

3

Total amount of service charges of less than 10% paid as wages to employees

3

4a Total tips reported by indirectly tipped employees

4a

b Total tips reported by directly tipped employees

4b

Note. Complete the Employer’s Optional Worksheet for Tipped Employees on page 6
of the instructions to determine potential unreported tips of your employees.
c Total tips reported (add lines 4a and 4b)

4c

5
6

7

Gross receipts from food or beverage operations (not less than line 2—see instructions)
Multiply line 5 by 8% (.08) or the lower rate shown here ©
granted by the IRS.
(Attach a copy of the IRS determination letter to this return.)
Note. If you have allocated tips using other than the calendar year (semimonthly, biweekly,
quarterly, etc.), mark an “X” on line 6 and enter the amount of allocated tips from your
records on line 7.
Allocation of tips. If line 6 is more than line 4c, enter the excess here

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5
6

7

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This amount must be allocated as tips to tipped employees working in this establishment.
Check the box below that shows the method used for the allocation. (Show the portion, if
any, attributable to each employee in box 8 of the employee’s Form W-2.)
a Allocation based on hours-worked method (see instructions for restriction)
Note. If you marked the checkbox in line 7a, enter the average number of employee hours
worked per business day during the payroll period. (see instructions)

b Allocation based on gross receipts method
c Allocation based on good-faith agreement (Attach a copy of the agreement.)
8

Enter the total number of directly tipped employees at this establishment during 2008

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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct, and complete.

Signature

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Title

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For Privacy Act and Paperwork Reduction Act Notice, see page 6 of the separate instructions.
Printed on recycled paper

Date

©

Cat. No. 49989U

Form

8027

(2008)