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Form 23 - Application For Enrollment To Practicebefore The Internal Revenue Service - 2000 Page 4

Position Title and Nature of

Address and Telephone Number

Employment Dates

Worked Performed.

of District Office. If POD was

Include Supervisor’s Name

the National Office, state your

From

and Post of Duty.

office/organization.

SCHEDULE B

Instructions:

If you answered YES to any one of the questions 8a through 8f or 9a on page 2, or Schedule A questions 2a through 2e on page 3, you must explain in detail.

If you answered NO to question 9b on page 2 you must explain in detail. Enter question number and the appropriate explanation below.

Item

Explanation

PRIVACY ACT STATEMENT

Section 330 of title 31, United States Code, authorizes collection of this information. The primary use of this information is for the Director of Practice to act

upon applications for enrollment to practice before the Internal Revenue Service and to maintain rosters of enrolled agents. Additional disclosures of the

information may be made to Federal, state, or foreign agencies if relevant for their use in investigations of violations of laws or regulations, for hiring and

retaining an individual, or granting a security clearance, license, contract, grant or other benefit. Furnishing the information on this form is voluntary but failure

to do so may result in failure to grant you enrollment.

Paperwork Reduction Act Notice

We are requesting the information on this form to determine if you are qualified for enrollment to practice before the Internal Revenue Service pursuant to 31 CFR

Part 10. The information is required for those who desire to practice as an enrolled agent.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control

number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal

Revenue law. Generally, tax returns and return information are confidential, as required by Code section 6103.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is: 1 hour.

If you have any comments concerning the accuracy of this time estimate or suggestions for making this form simpler, we would be happy to hear from

you. You can write to the Tax Forms committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. DO NOT send the form to this office.

Instead, mail it to the address shown at the top of the form.

Page 4

Catalog Number 16233B

Form 23 (Rev. 9-2000)

Form 23 - Application For Enrollment To Practicebefore The Internal Revenue Service - 2000 Page 4

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