Form 4361 Intake

Personal Information

Your identifying details for the IRS filing.

First Name *

First name is required.

Last Name *

Last name is required.

Date of Birth *

Date of birth is required.

Social Security Number * Required for IRS filings

SSN is required for IRS filings.

Mailing Address *

Address is required.

City *

State *

ZIP *

Email Address *

Valid email is required.

Phone Number *

Phone number is required.

Ministerial Credentials

Details about your ordination, licensing, or commissioning.

Credential Type *

Ordained Minister

Licensed Minister

Commissioned Minister

Please select your credential type.

Date of Ordination/Licensing/Commissioning * When you received your credential

Credential date is required.

Title or Position *

Title is required.

Church / Ministry Information

The organization that issued your credential.

Name of Ordaining/Licensing Church or Organization *

Church/organization name is required.

Church/Organization Address

Denomination or Affiliation

Important Filing Deadline: Form 4361 must be filed within 2 years of when you were ordained, licensed, or commissioned. If your credential date is more than 2 years ago, please contact our team before proceeding.

Income & Tax Information

Required for the Form 4361 application.

First Tax Year with Ministerial Income * First year you earned (or will earn) SE income as a minister

First tax year is required.

Second Tax Year with Ministerial Income * The following year

Second tax year is required.

Ecclesiastical Powers Description * Describe the difference in religious powers between ordained, licensed, and commissioned ministers in your church. If no difference, write "No difference."

This description is required for the IRS filing.

Supporting Details

Help us prepare your strongest application.

Describe Your Ministerial Duties Briefly outline the duties you perform in your ministerial role that relate to the factors above.

Do you have a copy of your ordination/licensing certificate? *

Yes -- I can provide a copy

No -- I need assistance obtaining one

Do your church bylaws define the ecclesiastical powers of ministers? *

Yes -- I can provide a copy of the relevant section

No -- I need help with this

Religious Objection Certification

Form 4361 requires a genuine religious objection to accepting Social Security benefits from ministerial income.

Please Read Carefully: By filing Form 4361, you are certifying that you have a religious objection to accepting Social Security, Medicare, and other public insurance benefits based on income from your ministerial services. You understand that by receiving this exemption, you will not earn Social Security credits on your ministerial income going forward.

I certify that I am conscientiously opposed to, or because of my religious principles I am opposed to, the acceptance 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.

You must certify your religious objection to proceed with Form 4361.

Third-Party Designee Authorization

Authorize Church Law & Strategy to file on your behalf.

I authorize VanSteenis Consulting Services, LLC (Church Law & Strategy) and any of its affiliates, employees, and agents as my third-party designee to prepare and submit IRS Form 4361 on my behalf. I affirm all information provided in this intake form is accurate and truthful.

Authorization is required to proceed.

Electronic Signature * Type your full legal name as your electronic signature

Signature is required.

Date *

How did you hear about us?

If someone referred you, please provide their name

Additional Notes or Questions

IRS Form 4361 Intake

Personal Information

Ministerial Credentials

Church / Ministry Information

Income & Tax Information

Five Factor Test

Factor 1: Ordained, Commissioned, or Licensed (REQUIRED)

Factor 2: Administer Sacraments

Factor 3: Conduct Worship Services

Factor 4: Management & Maintenance of Religious Organization

Factor 5: Considered a Spiritual Leader