IRS Form 14764 – ESRP Response – Applicable Large Employers (ALEs) who receive IRS Letter 226-J must act quickly to address a proposed Employer Shared Responsibility Payment (ESRP) under the Affordable Care Act (ACA). The key document for your response is IRS Form 14764, officially titled “ESRP Response.”
This guide, based exclusively on current official IRS.gov resources (updated through December 2025 and May 2025), explains exactly what Form 14764 is, who needs it, how to complete it correctly, deadlines, what happens next, and common pitfalls to avoid. Use it to respond accurately and protect your business from unnecessary penalties or collection actions.
What Is IRS Form 14764?
IRS Form 14764 (Revision Date: February 2018) is the official one- or two-page response form ALEs use to reply to IRS Letter 226-J. It allows you to formally:
- Agree with the IRS’s proposed ESRP calculation
- Disagree with all or part of it and provide corrections
The form is enclosed with every Letter 226-J along with Form 14765 (Employee Premium Tax Credit (PTC) Listing) and an ESRP summary table. You must return the completed Form 14764 (and any required attachments) by the response deadline printed on your Letter 226-J.
Official Download:
IRS Form 14764 PDF
Who Must Use Form 14764? (Applicable Large Employers & ESRP Basics)
Form 14764 applies only to Applicable Large Employers (ALEs) — employers who had an average of 50 or more full-time employees (including full-time equivalents) in the prior calendar year.
Under IRC Section 4980H, an ALE may owe an ESRP if:
- It did not offer affordable minimum-value health coverage to at least 95% of its full-time employees and dependents, and
- At least one full-time employee received a premium tax credit (PTC) for Marketplace coverage in one or more months.
The IRS determines potential liability by cross-referencing your filed Forms 1094-C and 1095-C with employees’ individual tax returns. Letter 226-J is the first formal notice proposing a specific ESRP amount (adjusted annually for inflation; for example, $2,880 per employee under 4980H(a) or $4,320 under 4980H(b) in recent years).
Understanding IRS Letter 226-J and Form 14765
Letter 226-J contains:
- Explanation of the proposed ESRP
- Monthly breakdown table showing 4980H(a) and/or 4980H(b) liability
- Form 14764 (your response form)
- Form 14765 — the detailed list of “assessable full-time employees” (those who received a PTC and for whom you did not claim an affordability safe harbor or other relief on Line 16 of their Form 1095-C)
Highlighted months on Form 14765 indicate non-assessable periods. You will use Form 14765 to mark corrections if you disagree.
Response deadline: Usually 30 days from the date of Letter 226-J (exact date is printed on page 1). Missing it typically results in automatic assessment.
Step-by-Step: How to Complete and Submit IRS Form 14764?
- Gather Documents
- Your Letter 226-J package
- Copies of the Forms 1094-C and 1095-C you filed for the year in question
- Form 14765 (PTC Listing)
- Payroll, coverage, and affordability records
- Decide: Agree or Disagree?
If you AGREE with the proposed ESRP:
- Complete and sign Form 14764 indicating agreement.
- Return it with full payment (check or money order) or note that you will pay later (IRS will send Notice CP 220J).
- No additional explanation needed.
If you DISAGREE (in whole or in part):
- Complete and sign Form 14764 indicating disagreement.
- Attach a signed written statement explaining why you disagree (include your EIN, name, and the tax year).
- Mark corrections directly on the enclosed Form 14765 using the exact indicator codes from the Instructions for Forms 1094-C and 1095-C (Line 14 and Line 16 codes).
- Do not file corrected Forms 1094-C or 1095-C solely for this response.
- Attach any supporting documentation (payroll records, plan documents, etc.).
- Recalculate the ESRP if applicable and explain the revised amount.
- Optional but Recommended: Authorize a representative (tax professional, attorney, or CPA) using Form 2848 (Power of Attorney) and specify “Section 4980H Shared Responsibility Payment” for the relevant year. Many ALEs include this with their Form 14764 submission.
- Mail Everything
Return the completed Form 14764 + attachments exactly as instructed in Letter 226-J (usually to a specific IRS address listed in the letter). Keep complete copies for your records.
Pro Tip: Contact the IRS employee named in the letter immediately if you need a short extension — they often grant one when requested promptly.
What Happens After You Submit Form 14764?
The IRS reviews your response and issues one of the Letter 227 series (acknowledgment letters):
| Letter 227 Type | What It Means | Next Steps Required? |
|---|---|---|
| 227-J | You agreed; ESRP will be assessed | None — case closed |
| 227-K | ESRP reduced to $0 | None — case closed |
| 227-L | ESRP revised (usually lower) | Agree, request manager meeting, or appeal |
| 227-M | No change to ESRP | Agree, request meeting, or appeal |
| 227-N | Appeals decision issued | None — final |
| 227-O | Revised for tax-exempt/government entities | Follow new Form 14764 if needed |
If you still disagree after Letter 227-L or 227-M, you can request a pre-assessment conference with IRS Appeals (instructions are in the letter; generally 30 days to respond). Publication 5 explains your appeal rights.
If you ignore both Letter 226-J and any follow-up Letter 227, the IRS will assess the full proposed ESRP and mail Notice CP 220J (bill). Collection actions may follow per Publication 594.
Common Mistakes to Avoid with Form 14764
- Missing the exact response deadline printed on your letter
- Forgetting to sign the form or the disagreement statement
- Submitting corrected 1094-C/1095-C instead of marking changes on Form 14765
- Failing to include a full written explanation when disagreeing
- Not keeping copies of everything sent to the IRS
- Ignoring the option to authorize a representative (Form 2848)
Helpful Resources (All Official IRS Links)
- Understanding Your Letter 226-J
- Understanding Your Letter 227
- Questions & Answers on Employer Shared Responsibility Provisions
- Form 14765: Employee PTC Listing
- Form 2848: Power of Attorney
- Publication 594: The IRS Collection Process
- Publication 5: Your Appeal Rights and How To Prepare a Protest
Frequently Asked Questions (FAQ)
- Do I have to pay immediately when I agree on Form 14764?
No. You can indicate payment will follow; the IRS will send a formal bill (CP 220J) with payment options, including installment agreements. - Can I still appeal after agreeing on Form 14764?
No — signing agreement on Form 14764 generally closes the case with assessment. Disagree and use the appeals process in Letter 227 if needed. - Is Form 14764 still current in 2026?
Yes. The February 2018 revision remains the active form referenced on all current IRS pages. - What if I never received Letter 226-J but think I might owe ESRP?
Contact the IRS ACA Employer Hotline or use the “Let us help you” option on IRS.gov. - Should I hire a professional?
For any disagreement or complex employee data issues, consulting a tax attorney or CPA experienced in ACA/ESRP matters is strongly recommended to avoid costly errors.
Responding correctly and promptly to IRS Letter 226-J using Form 14764 is the best way to resolve proposed ESRP assessments efficiently. Download the form today, review your records carefully, and submit on time.
Need more help? Visit the official IRS ACA Employer page or contact the IRS number listed on your Letter 226-J. Always rely on IRS.gov for the most current guidance.
This article is for informational purposes only and is not tax or legal advice. Consult a qualified professional for your specific situation.