HOUSING ALLOWANCE FORM
A housing allowance is designed to be a portion of clergy’s compensation. This portion of income can be excluded from gross income reported for federal income tax purposes but is not excluded for state or social security taxes. All housing allowance amounts will be approved by the Board of Directors prior to going into effect. Per the IRS, only licensed and approved clergy (pastors) are eligible for housing allowance. The housing allowance can only be designated for the clergy's primary residence.
I am a licensed pastor, registered with a county in Arkansas as a pastor, and am eligible for housing allowance in 2025.
*
Yes (please proceed)
No (please do not proceed. Reach out to HR@newlifechurch.tv if you have questions)
I'm not sure (please reach out to HR@newlifechurch.tv to seek clarity)
What is today's date?
*
-
Month
-
Day
Year
Date
What is your name?
*
First Name
Last Name
What is your work email?
*
example@example.com
What is your home address?
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Enter the annual amount of rent or house payment you anticipate paying for 2025.
*
Cannot be retroactively claimed
Enter the annual amount of real estate and/or personal property taxes (related to the contents of your home), not included in your house payment, you anticipate paying in 2025. If the amount is included in your house payment, enter zero.
*
Cannot be retroactively claimed
Enter the annual amount of homeowners and/or umbrella liability insurance (related to the contents of your home), not included in your house payment, you anticipate paying in 2025. If the amount is included in your house payment, enter zero.
*
Cannot be retroactively claimed
Enter the annual amount of any Home Equity Loan Payments you anticipate paying for housing expenses in 2025. If none, then enter zero.
*
Cannot be retroactively claimed
Enter the annual amount of any refinancing costs or down payments you anticipate paying in 2025. If none, then enter zero.
*
Cannot be retroactively claimed
Enter the annual amount for mowing, landscaping, and gardening you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for home maintenance you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for home pest control you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for home furnishings or furnishing repair costs you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for utility costs (electricity, gas, water, and garbage) you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for telephone, cable, satellite, internet, and/or other streaming services for your home you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for homeowner's association dues or condo fees you anticipate paying in 2025.
*
Cannot be retroactively claimed
Enter the annual amount for any other expense, related to your home, you anticipate paying in 2025.
*
Cannot be retroactively claimed
Total annual housing expenses for the year (total of all preceding answers).
Enter the amount of your officially designated housing allowance for 2025.
*
This amount must be less than your annual salary, but should not be greater than the total above.
I affirm that the above amounts are true and correct estimates of the requested expenses to the best of my knowledge and information. I also understand that the amount of my housing allowance excluded for federal income taxes is the least of the amounts calculated as my estimated housing expenses, my actual housing expenses or the fair rental value of a fully furnished similarly situated home.
*
Yes
No
I understand and agree that if my actual expenses become less than my designated housing amount, then I am responsible for reporting the excess amount to the IRS on 1h of form 1040 at the time I file my taxes (in which I will have to pay the due amount of taxes on the excess amount).
*
Yes
No
I understand and agree the church will not designate a portion of my compensation as housing allowance until this form is completed in its entirety. I also understand that retroactive designations of housing expenses are NOT allowed. If my housing expenses change after my designation has been approved for the year, I will notify HR and fill out another form to be approved before an adjustment will be made to my housing allowance.
*
Yes
No
I understand and agree that the amount of my housing allowance is excluded from my taxable income for federal tax purposes only and that I must include my housing allowance in my income for purposes of calculating my federal self-employment social security taxes unless I am exempt (IRS Form 4361) from self-employment social security taxes.
*
Yes
No
I understand and agree that I have the opportunity to consult with a tax professional of my choice for assistance in determining issues regarding my taxation as a Minister. I also agree that any instructions or assistance provided in completion of this form by New Life Church of Arkansas, Inc or its representatives is not tax advice and I release them from any damages real or perceived from their assistance.
*
Yes
No
Please sign this document expressing the truth of the preceding answers, amounts, and affirmations.
Continue
Continue
Should be Empty: