Form Ftb 8633 - California E-File Program Participant Enrollment Form

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California e-file Program
Participant Enrollment Form
!
!
!
1
Application type
New
Update
Reinstate
Name of sole proprietor, partnership, or corporation, as shown on tax return
2
Participant name
Doing business as, if different from above
EFIN
Identification numbers
3
SSN/FEIN
ETIN
Street
4
Participant address
(Mailing address)
City
State
ZIP Code
Street
(Physical address, if different
3
from mailing address)
City
State
ZIP Code
3
First name
Middle initial
Last name
5
Contact information
(Primary contact)
6
Phone
Ext.
Fax
5
Email
5
!
6
About the participant
Certified Public Accountant (CPA or AICPA) #_____________________
(e.g., business owner or
!
Enrolled Agent # __________________
responsible official)
!
Attorney
!
CTEC # ______________ , surety bonding company________________
!
Other, specify__________________________________________
!
7
About the participant’s
Sole proprietorship
business
!
Partnership
(Check one)
V
!
Corporation, enter corporation number ________________________
3
!
Non-profit tax preparation service; Volunteer Income Tax Assistance
(VITA); or Tax Counseling for the Elderly (TCE)
!
Out-of-State (include a copy of your IRS acceptance letter)
!
Limited liability company (LLC)
!
8
Participant type
Electronic Return Originator
(Check all that apply)
!
3
Transmitter
!
Software Developer
Submit your
Fax:
(916) 845-0287
For more
Email:
e-file@ftb.ca.gov
application
information
Phone:
(916) 845-0353
Mail:
e-file Program MS A-1
Web:
Franchise Tax Board
PO Box 1468
Sacramento, CA 95812-1468
Online:
For Privacy Act Notice, get form FTB 1131.
FTB 8633 (REV 11-2003) Side 1

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