Required Notification of Endowment Excise Tax Paid

Summary

A form titled Required Notification of Endowment Excise Tax Paid, issued under section 314(d)(6) of the Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (CRRSAA). It states that an institution required to remit payment to the Internal Revenue Service for the excise tax under section 4968 of the Internal Revenue Code of 1986 for tax year 2019 must notify the Department of Education within 30 days of making that determination. The acknowledgment certifies that the institution will not draw down more than 50% of the institution's total allocation under CRRSAA section 314 before any approved waiver request. The form has fields for institution name, authorized representative, DUNS Number, OPE ID and date, and gives instructions for (a)(1) supplemental awards and new CRRSAA awards.

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          Required Notification of Endowment Excise Tax Paid
Note: Only institutions subject to the tax described below are required to complete and submit
this form.
Pursuant to Coronavirus Response and Relief Supplemental Appropriations Act, 2021
(CRRSAA), Pub. L. 116-260, section 314(d)(6), any institution that was required or will be
required to remit payment to the Internal Revenue Service for the excise tax paid on investment
income of private colleges and universities under section 4968 of the Internal Revenue Code of
1986 for tax year 2019 must notify the U.S. Department of Education (Department) that it is
required to remit such payment, within 30 days of making such a determination.
Successfully completing and submitting this form to the Department constitutes the required
notice.
          By checking this box, I acknowledge on behalf of my recipient institution that the
 ☐        institution paid or will be required to pay excise tax on investment income of
          private colleges and universities under section 4968 of the Internal Revenue Code of
          1986 for tax year 2019.
          Pursuant to this acknowledgement, I further certify on behalf of my recipient
          institution that the institution will not draw down more than 50% of its total
          allocation (the “50% requirement”) under CRRSAA section 314, prior to any request
          and approval for a waiver under Section 314(d)(6)(B) of the CRRSAA my recipient
          institution may submit.
          I further certify my recipient institution will use (the “use requirement”) the
          remaining available funds for drawdown only to support students consistent with
          the allowable use of funds under CRRSAA section 314(c)(3) or for sanitation,
          personal protective equipment, or other expenses associated with the general
          health and safety of the campus environment related to the qualifying emergency
          under CRRSAA section 314(d)(6)(A) consistent with any other applicable
          requirements in section 314.


 Institution Name: _________________________________________
 Authorized Representative (typed name): ______________________________________
 Authorized Representative Title: _________________________________________
 DUNS Number: _________________________________________
 OPE ID: _________________________________________
 Date: _________________________________________
Waiver: For those institutions intending to request a waiver of the 50% and use requirements
described in the acknowledgment above pursuant to CRRSAA Section 314(d)(6)(B), the
Department intends to follow up with a process for requesting a waiver.
General Instructions: Institutions must only submit this form once for all HEERF grant
programs, and no action is required by institutions not subject to the endowment excise tax.
Institutions that have not yet determined if they are subject to the 2019 endowment excise tax
must submit this form within 30 calendar days of determining that they are subject to the tax.
Submission instructions if receiving an (a)(1) supplemental award: If receiving a supplemental
award under section 314(a)(1) of the CRRSAA, institutions must return this form as a completed
attachment via email to both HEERF@ed.gov and the email of your assigned education program
officer contact as indicated in Box 3 of your Grant Award Notification (GAN).
Submission instructions if receiving a new CRRSAA Award: Institutions applying for new awards
under CRRSAA must submit the form with their application for grant funds by uploading the
form to the “Other Attachments” section of Grants.gov.


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