Reissue Savings Bonds PDF Details

Understanding the FS Form 4000, also known as the Request To Reissue United States Savings Bonds form, is vital for bond owners navigating through changes that necessitate the reissue of their savings bonds in the United States. Whether due to personal changes like a name change, adding or removing co-owners, or updating beneficiary information, this form serves as a crucial step in ensuring your savings bonds reflect your current circumstances accurately. It's imperative to follow the detailed instructions provided to avoid any fraudulent claims, which are taken seriously by the United States government and may lead to prosecution. Transitioning from paper bonds to electronic forms in TreasuryDirect for Series EE or Series I savings bonds marks a significant shift, aiming to streamline the management of your bonds. The form caters to various situations like changes in ownership due to life events — marriages, divorces, or death — requiring specific parts of the form to be completed along with evidence supporting the request. Additionally, legal representatives, trustees, and others in fiduciary roles may find this form necessary when managing bonds due to estate or trust matters. Proper completion includes disclosing the reason for reissue, tax responsibilities, and, critically, ensuring all parties involved consent and certify the information provided under the penalty of perjury, ultimately safeguarding both the bond owner's and the government's interests.

QuestionAnswer
Form NameReissue Savings Bonds
Form Length8 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min
Other namespublic debt form 4000, pd f 4000, pdf 4000 form, united states savings

Form Preview Example

 

 

 

RESET

 

 

 

 

For official use only:

Customer Name

Case or SR#

Customer No

 

 

 

 

FS Form 4000 (Revised November 2021)

 

 

OMB No. 1530-0025

Request To Reissue United States Savings Bonds

IMPORTANT: Follow instructions in filling out this form. Making any false, fictitious, or fraudulent claim or statement to the United States is a crime and may be prosecuted. Print in ink or type all information.

NOTE: When we reissue Series EE or Series I savings bonds, we no longer provide paper bonds. The reissued bonds are in electronic form, in our online system TreasuryDirect. For information on TreasuryDirect, go to www.treasurydirect.gov.

 

and are

 

for EE or I bonds,

for HH bonds,

 

Who must sign

 

 

 

 

 

If you are the …

requesting

 

complete parts

 

 

 

 

 

 

 

complete parts …

 

& what evidence is needed

 

reissue to …

 

…

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owner

Change name

 

A & C

B & C

 

Series EE and I

 

 

Series HH

 

 

 

Bond owner and

 

Owner

 

 

 

 

 

 

 

 

account owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owner

Trust

 

Use FS Form 1851

Use FS Form 1851

 

Use FS

Form 1851

 

 

rather than this form

 

 

 

 

 

 

 

 

Owner named on the bonds

Add a coowner or

 

Form not applicable*

B & C

 

Owner

 

 

 

 

 

beneficiary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owner named on the bonds

Change or remove

 

Form not applicable*

B & C

 

Owner

 

 

 

 

 

beneficiary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Series EE

 

Series I

 

 

Series EE and I

 

 

Series HH

 

 

Remove living

 

 

 

A & C, but

 

 

 

 

 

Owner

Owner named on the bonds

 

 

 

B & C

 

 

 

 

 

 

 

 

 

owner to name new

 

 

 

only if

 

Owner and new

 

(New owner must

– single owner

 

A & C

 

 

 

 

 

 

directed by

 

 

 

 

owner

 

 

 

 

owner

 

give direct-deposit

 

 

 

 

 

judicial

 

 

 

 

 

information on FS

 

 

 

 

 

proceedings

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form 5396)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Series EE and I

 

 

Series HH

 

 

 

 

 

 

 

 

 

 

 

 

Owner whose

 

 

 

 

 

 

 

 

 

 

 

name is being

 

 

 

 

 

 

 

 

 

 

 

removed if

 

 

 

 

 

 

 

 

 

 

 

another coowner

Owner of bonds in

Remove living

 

 

 

 

 

 

 

 

 

or beneficiary is

 

A & C

B & C

 

 

 

 

not to be named.

coownership form

coowner

 

 

 

 

 

 

Both coowners

 

Otherwise, both

 

 

 

 

 

 

 

 

 

 

 

coowners must

 

 

 

 

 

 

 

 

 

 

 

sign.

 

 

 

 

 

 

 

 

 

 

 

(New owner must

 

 

 

 

 

 

 

 

 

 

 

give direct-deposit

 

 

 

 

 

 

 

 

 

 

 

information on FS

 

 

 

 

 

 

 

 

 

 

 

Form 5396)

 

 

 

 

 

 

 

 

Living registrant.

Send certified copy

 

Remove deceased

 

 

 

 

 

 

of death certificate for decedent.

Surviving registrant

 

Form not applicable*

B & C

 

(For Series HH, owner must give

registrant

 

 

 

 

 

 

 

 

 

direct-deposit information on FS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form 5396)

 

 

 

 

 

 

 

 

 

 

 

 

 

Series EE and I

 

 

 

Series HH

 

 

 

 

 

 

 

 

 

Purchaser

 

 

 

 

 

 

 

 

 

 

 

 

 

(If the purchaser

 

 

 

 

 

 

Correct the

 

 

 

 

 

 

doesn’t wish to open a

 

Purchaser

registration of bonds

 

A & C

B & C

 

TreasuryDirect

 

 

 

Purchaser

in single owner or

 

 

account, the owner

 

 

 

 

beneficiary form

 

 

 

 

 

 

must provide the

 

 

 

 

 

 

 

 

 

 

 

 

 

TreasuryDirect account

 

 

 

 

 

 

 

 

 

information in part A

 

 

 

 

 

 

 

 

 

and join the purchaser

 

 

 

 

 

 

 

 

 

in signing in part C)

 

 

Correct the

 

 

 

 

 

 

Series EE and I

 

 

Series HH

 

Purchaser

registration of bonds

 

A & C

B & C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

in coownership

 

 

Purchaser and

 

Purchaser

 

 

 

 

 

 

 

 

 

form

 

 

 

 

 

 

both coowners

 

 

 

 

 

 

FS Form 4000

Department of the Treasury | Bureau of the Fiscal Service

1

 

 

 

 

 

 

 

 

 

 

 

Entitled person. Send certified copy

Entitled person due to a

Change ownership

 

 

 

of divorce decree.

 

 

 

 

 

 

 

divorce, legal separation or

and remove name of

A & C

B & C

 

(For Series HH, new first-named

annulment

living owner

 

 

 

 

 

 

owner must give direct-deposit

 

 

 

 

 

 

 

 

 

 

information on FS Form 5396)

 

 

 

 

 

 

 

 

 

 

 

 

 

Series EE and I

 

Series HH

 

 

 

 

 

 

 

 

 

 

 

 

 

Legal guardian.

 

Legal guardian.

 

 

 

 

 

Send certified

 

Send certified

 

 

 

 

 

copy of letters

 

copy of letters of

 

Show legal

 

 

 

of appointment.

 

appointment.

 

 

 

 

(The coowner

 

(For Series HH,

Legal guardian

guardianship

A & C

B & C

 

 

 

registration

 

 

 

must also sign

 

legal guardian

 

 

 

 

 

in part C)

 

must give direct-

 

 

 

 

 

 

 

deposit

 

 

 

 

 

 

 

information on FS

 

 

 

 

 

 

 

Form 5396, and, if

 

 

 

 

 

 

 

TIN is changing,

 

 

 

 

 

 

 

complete W-9)

 

 

 

 

 

 

 

 

 

 

 

 

 

Entitled person

 

Entitled person through

Name a new owner

A & C

B & C

 

(For Series HH, new owner must give

estate or trust

 

 

 

 

 

direct-deposit information on FS

 

 

 

 

 

 

 

 

 

 

Form 5396)

 

 

 

 

 

 

 

 

 

 

 

 

Current legal representative. Send

 

 

 

 

 

certified copy of letters of

 

 

 

 

 

appointment and death certificate(s)

Legal representative of an

 

 

 

 

for decedent(s) named in the

The estate

A & C

B & C

 

registration of the bonds.

estate

 

 

 

 

 

 

 

 

(For Series HH, legal representative

 

 

 

 

 

 

 

 

 

 

must give direct-deposit information

 

 

 

 

 

on FS Form 5396, and, if TIN is

 

 

 

 

 

changing, complete W-9)

 

 

 

 

 

 

 

 

 

 

 

Successor legal representative.

 

 

 

 

 

Current letters of appointment.

Successor legal

Show successor

A & C

B & C

 

(For Series HH, successor legal

representative of an estate

legal representative

 

representative must give direct-

 

 

 

 

 

 

 

 

deposit information on FS Form

 

 

 

 

 

5396, and, if TIN is changing,

 

 

 

 

 

complete W-9)

 

 

 

 

 

 

 

 

 

 

 

 

Successor trustee. Send resignation

 

 

 

 

 

letter, death certificate, or court order

 

 

 

 

 

showing why original trustee is no

 

 

 

 

 

longer acting. Also, send a

 

Show new

 

 

 

Certification of Trust or the complete

Successor trustee

A & C

B & C

 

trust agreement including any

successor trustee

 

amendments.

 

 

 

 

 

 

 

 

 

 

 

(For Series HH, successor trustee

 

 

 

 

 

must give direct-deposit information

 

 

 

 

 

on FS Form 5396, and, if TIN is

 

 

 

 

 

changing, complete W-9)

 

 

 

 

 

 

 

 

*A savings bond is reissued in electronic form and can be in only one name.

FS Form 4000

Department of the Treasury | Bureau of the Fiscal Service

2

PART A – REISSUES OF SERIES EE AND SERIES I BONDS

NOTES: 1) When we reissue Series EE or Series I savings bonds, we no longer provide paper bonds. The reissued bonds are in electronic form, in our online system TreasuryDirect. For information on opening an account in TreasuryDirect, go to www.treasurydirect.gov. 2) Series EE and Series I bonds may not be reissued within one month of final maturity.

1. DESCRIPTION OF BONDS

I/We request reissue of the savings bonds described below, in the amount of $ _________________ total face amount.

ISSUE DATE

 

 

INSCRIPTION

(Specific month

FACE

BOND NUMBER

(Provide complete Social Security Number [for example, 123-45-6789], names, including

and year of

AMOUNT

 

middle names or initials, and addresses [street, city, state] on the bonds.)

purchase)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(If you need more space, attach either FS Form 3500 [see www.treasurydirect.gov] or a plain sheet of paper.)

2. I/WE AGREE to reissue the bonds in electronic form in the following TreasuryDirect account:

Account Number __________________ Social Security Number or Employer Identification No. ______________________

Account Name: _____________________________________________________________________________________

NOTE: You may add a secondary owner or beneficiary once bonds have been reissued in electronic form in your TreasuryDirect account. For instructions, access your account and click “How do I” at the top of the page.

TAX LIABILITY: If the name of a living owner or principal coowner of the bonds is eliminated from the registration, the owner or principal coowner must include the interest earned and previously unreported on the bonds to the date of the transaction on his or her Federal income tax return for the year of the reissue. (Both registrants are considered to be coowners when bonds are registered in the form: "A" or "B.") The principal coowner is the coowner who (1) purchased the bonds with his or her own funds, or (2) received them as a gift, inheritance, or legacy, or as a result of judicial proceedings, and had them reissued in coownership form, provided he or she has received no contribution in money or money's worth for designating the other coowner on the bonds. If the reissue is a reportable event, the interest earned on the bonds to the date of the reissue will be reported to the Internal Revenue Service (IRS) by a Federal Reserve Bank or the Bureau of the Fiscal Service under the Tax Equity and Fiscal Responsibility Act of 1982. THE OBLIGATION TO REPORT THE INTEREST CANNOT BE TRANSFERRED TO SOMEONE ELSE THROUGH A REISSUE TRANSACTION. If you have questions concerning the tax consequences, consult the IRS, or write to the Commissioner of Internal Revenue, Washington, DC 20224. Unless we are otherwise informed, the first- named coowner will be considered the principal coowner for the purpose of this transaction.

3.DESCRIBE THE REASON FOR THE REISSUE ________________________________________________________

__________________________________________________________________________________________________

a. If the reason shown above is to correct an error in registration, provide the following information.

(1)Who purchased the bonds? ________________________________ (2) Whose funds were used? ____________________________

(3)How did the error occur? ______________________________________________________________________________________

(4)How should the bonds have been registered originally?

(a)Social Security Number or Employer Identification Number ____________________________________________________

(b)___________________________________________________________________________________________________

(Full name of owner/first named coowner or fiduciary inscription)

(c) Name of

coowner

beneficiary _________________________________________________________________

b. If the bonds will be held in the purchaser’s TreasuryDirect account as gifts please provide:

Name of recipient: _________________________________________ Social Security Number of recipient ________________________

FS Form 4000

Department of the Treasury | Bureau of the Fiscal Service

3

PART B – REISSUES OF SERIES HH BONDS, RETIREMENT PLAN BONDS, AND INDIVIDUAL RETIREMENT BONDS

NOTES: Savings bonds within one month of final maturity cannot be reissued. When reissuing Series HH savings bonds, the owner should also submit FS Form 5396, providing direct-deposit instructions for semi-annual interest payments (see www.treasurydirect.gov to download the form).

1. DESCRIPTION OF BONDS

I/We request reissue of the savings bonds described below, in the amount of $ _________________ total face amount.

ISSUE DATE

 

 

INSCRIPTION

(Specific month

FACE

BOND NUMBER

(Provide complete Social Security Number [for example, 123-45-6789], names, including

and year of

AMOUNT

 

middle names or initials, and addresses [street, city, state] on the bonds.)

purchase)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(If you need more space, attach either FS Form 3500 [see www.treasurydirect.gov] or a plain sheet of paper.)

2. REQUESTED REGISTRATION

a. Taxpayer Identification Number ________________________________________________________________________________

(Social Security Number or Employer Identification Number)

b. Registration ________________________________________________________________________________________________

(Full name of owner/first named coowner or fiduciary inscription)

c. Mailing Address ____________________________________________________________________________________________

(Number and Street or Rural Route)

(City)

(State)

(ZIP Code)

d. To name a coowner or beneficiary select the appropriate box and enter a name:

coowner

beneficiary (POD)

________________________________________________________________

(Full name of coowner or beneficiary)

(If a name is shown and neither box is marked, coownership will be assumed.)

TAX LIABILITY: If the name of a living owner or principal coowner of the bonds is eliminated from the registration, the owner or principal coowner must include the interest earned and previously unreported on the bonds to the date of the transaction on his or her Federal income tax return for the year of the reissue. (Both registrants are considered to be coowners when bonds are registered in the form: "A" or "B.") The principal coowner is the coowner who

(1)purchased the bonds with his or her own funds, or (2) received them as a gift, inheritance, or legacy, or as a result of judicial proceedings, and had them reissued in coownership form, provided he or she has received no contribution in money or money's worth for designating the other coowner on the bonds. If the reissue is a reportable event, the interest earned on the bonds to the date of the reissue will be reported to the Internal Revenue Service (IRS) by a Federal Reserve Bank or the Bureau of the Fiscal Service under the Tax Equity and Fiscal Responsibility Act of 1982. THE OBLIGATION TO REPORT THE INTEREST CANNOT BE TRANSFERRED TO SOMEONE ELSE THROUGH A REISSUE TRANSACTION. If you have questions concerning the tax consequences, consult the IRS, or write to the Commissioner of Internal Revenue, Washington, DC 20224. Unless we are otherwise informed, the first-named coowner will be considered the principal coowner for the purpose of this transaction.

3.DESCRIBE THE REASON FOR THE REISSUE ________________________________________________________

__________________________________________________________________________________________________

If the reason shown above is to correct an error in registration, provide the following information:

a. Who purchased the bonds? ________________________________________________________________________

b. Whose funds were used? __________________________________________________________________________

c. How did the error occur? __________________________________________________________________________

FS Form 4000

Department of the Treasury | Bureau of the Fiscal Service

4

PART C – SIGNATURES AND CERTIFICATIONS

I/We certify under penalty of perjury that the information provided herein is true and correct to the best of my/our knowledge and belief. I/We agree to reissue of the bonds as indicated and certify that the reissue is authorized.

I/We hereby bind ourselves, our heirs, legatees, successors, and assigns, jointly and severally, to hold the United States harmless on account of the reissue requested herein, to indemnify unconditionally and promptly repay the United States in the event of any loss which results from this request, including interest, administrative costs, and penalties. I/We consent to the release of any information regarding this transaction, including information contained in this application, to any party having an ownership or entitlement interest in the bonds.

Persons named on the bonds as well as the TreasuryDirect Account owner or Account Manager (if not the same person) must sign the form.

Sign in ink in the presence of a notary or certifying officer and provide the requested information.

Sign

Here: __________________________________________________________________________________________________

 

(Applicant's Signature)

 

(Applicant’s title)

_____________________________________________________

______________________________________________

(Print Name)

 

 

(Social Security Number)

Home Address ________________________________________

______________________________________________

(Number and Street or Rural Route)

 

(Daytime Telephone Number)

_____________________________________________________

______________________________________________

(City)

(State)

(ZIP Code)

(E-mail Address)

Sign

Here: __________________________________________________________________________________________________

 

(Applicant's Signature)

 

(Applicant’s title)

_____________________________________________________

______________________________________________

(Print Name)

 

 

(Social Security Number)

Home Address ________________________________________

______________________________________________

(Number and Street or Rural Route)

 

(Daytime Telephone Number)

_____________________________________________________

______________________________________________

(City)

(State)

(ZIP Code)

(E-mail Address)

Sign

Here: __________________________________________________________________________________________________

 

(Applicant's Signature)

 

(Applicant’s title)

_____________________________________________________

______________________________________________

(Print Name)

 

 

(Social Security Number)

Home Address ________________________________________

______________________________________________

(Number and Street or Rural Route)

 

(Daytime Telephone Number)

_____________________________________________________

______________________________________________

(City)

(State)

(ZIP Code)

(E-mail Address)

Instructions to Notary or Certifying Officer:

1.Name(s) of the person(s) who appeared and date of appearance MUST be completed.

2.If a Medallion stamp is used an original signature is required.

3.Person(s) must sign in your presence.

FS Form 4000

Department of the Treasury | Bureau of the Fiscal Service

5

How to Edit Reissue Savings Bonds Online for Free

It won't be hard to fill out treasury department form 4000 making use of our PDF editor. This is how it is possible to rapidly develop your form.

Step 1: Locate the button "Get Form Here" and click it.

Step 2: When you have accessed the treasury department form 4000 editing page you'll be able to see all the options you'll be able to undertake with regards to your template at the top menu.

Type in the requested content in each one area to fill out the PDF treasury department form 4000

example of gaps in fs form 4000

Type in the necessary particulars in DESCRIPTION OF BONDS, IWe request reissue of the savings, ISSUE DATE Specific month and year, FACE AMOUNT, BOND NUMBER, INSCRIPTION Provide complete, If you need more space attach, IWE AGREE to reissue the bonds in, Account Number Social Security, and Account Name section.

Completing fs form 4000 stage 2

You will have to put down particular particulars inside the area DESCRIBE THE REASON FOR THE, a If the reason shown above is to, Who purchased the bonds Whose, How did the error occur, How should the bonds have been, a Social Security Number or, Full name of ownerfirst named, c Name of coowner beneficiary, b If the bonds will be held in the, Name of recipient Social Security, FS Form, and Department of the Treasury Bureau.

fs form 4000 DESCRIBE THE REASON FOR THE, a If the reason shown above is to, Who purchased the bonds Whose, How did the error occur, How should the bonds have been, a Social Security Number or, Full name of ownerfirst named, c Name of coowner beneficiary, b If the bonds will be held in the, Name of recipient Social Security, FS Form, and Department of the Treasury Bureau blanks to complete

The DESCRIPTION OF BONDS, IWe request reissue of the savings, ISSUE DATE Specific month and year, FACE AMOUNT, BOND NUMBER, INSCRIPTION Provide complete, If you need more space attach, REQUESTED REGISTRATION, a Taxpayer Identification Number, Social Security Number or Employer, b Registration, and Full name of ownerfirst named box is the place to indicate the rights and responsibilities of both parties.

Finishing fs form 4000 part 4

Finish by reviewing these sections and filling out the pertinent information: d To name a coowner or beneficiary, coowner beneficiary POD, Full name of coowner or beneficiary, If a name is shown and neither box, TAX LIABILITY If the name of a, DESCRIBE THE REASON FOR THE, If the reason shown above is to, and a Who purchased the bonds.

stage 5 to finishing fs form 4000

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