Form 8633 - Application To Participate In The Irs E-File Program - 1998

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For Official Use Only

8633

Form

EFIN:

ETIN:

Application to Participate in the

(Rev. May 1998)

IRS e-file Program

Department of the Treasury

OMB Number 1545-0991

Internal Revenue Service

PLEASE CHECK BELOW WHICH BOX(S) APPLY TO THIS APPLICATION:

NEW

FOREIGN FILER

ON-LINE FILING

REVISED (INCLUDE EFIN: _________________ )

REAPPLYING

Firm’s legal name as shown on firm’s tax return

b Firm’s employer identification number and/or social security

number (EIN/SSN)

Doing Business As (DBA) (If other than the name in item 1a)

d Is the firm controlled or owned by another electronic filer?

Yes, complete all controlling office information and Section 9 on

page 2. Do not complete section 8.

No, skip to question 1k and

Controlling Office Name

complete section 8 and 9 on page 2.

Controlling Office Business address

g ETIN of Controlling Office

h EFIN of Controlling Office

i Signature of responsible officer of the controlling office.

j Date

City

State ZIP Code

County

Sole Proprietorship

Check the box

l Check this box if you will be providing electronic filing and/or tax prepara-

tion as a benefit not for profit and are not using the services to attract

at the right that

Partnership (Number of Partners)

______

indicates your form

customers who will pay for tax preparation or transmission services.

Corporation

of organization.

Eligible entities include employers offering IRS e-file as a benefit to their

Other (Specify)

____________________

(see page 3 of this

employees, government agencies, VITA sites, etc. Attach to this form an

form)

explanation of how you will process returns for IRS e-file . . . . . . .

Name of contact representative (first, middle, last)

n Daytime telephone number (include area code) FAX number

p Daytime telephone number (include area code) FAX number

Name of alternate contact representative (first, middle, last)

r Business address (location of business)

FAX number

Mailing address (street or P.O. Box)

City

State ZIP Code

County

City

State ZIP Code

County

2 List all previous Electronic Filer Identification Number(s) (EFIN) and Electronic Transmitter Identification Number(s) (ETIN) assigned to you or your firm.

3 Please answer the following questions by checking the appropriate

I expect to transmit to or accept returns for transmission to the

Yes No

box(es). Do not check if using third-party transmitter.

following service centers. (Software Developers: Also indicate

service centers in whose areas you expect to market your

a Will you transmit tax return data directly to IRS? (Transmitter) . . .

1 2 3 4 5 6 7 8 9 0 1 2

software). (See page 4 for service center chart.).

1 2 3 4 5 6 7 8 9 0 1 2

If “Yes,” will you:

1 2 3 4 5 6 7 8 9 0 1 2

Andover

Austin

Cincinnati

Memphis

Ogden

Transmit using IBM 3780 bi-synchronous communication

1 2 3 4 5 6 7 8 9 0 1 2

protocol. OR

4 Has the firm or any corporate officer, partner, owner

1 2 3 4 5 6 7 8 9 0 1 2

Transmit using asynchronous communication protocol.

or responsible official: (Explain “Yes” responses)

Yes No

1 2 3 4 5 6 7 8 9 0 1 2

If you will be using asynchronous, indicate the file transfer protocol

a been assessed any preparer penalties? . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2

you will be using (mark only one):

1 2 3 4 5 6 7 8 9 0 1 2

b been convicted of a monetary crime? . . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

XMODEM - Checksum

YMODEM - G

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

c failed to file personal or business tax returns, or

1 2 3 4 5 6 7 8 9 0 1 2

XMODEM - CRC

YMODEM -Batch

unpaid tax liabilities? . . . . . . . . . . . . . . . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

XMODEM - 1K

ZMODEM

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

d been convicted of any criminal offense under the U.S.

1 2 3 4 5 6 7 8 9 0 1 2

Internal Revenue laws? . . . . . . . . . . . . . . . . . . . . . . . . .

b Will you write electronic filing software? (Software Developer) . . .

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

5 Do you intend to file Federal/State returns electronically? . . .

c Will you prepare tax returns, including Forms 8453, or collect

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

1 2 3 4 5 6 7 8 9 0 1 2

(If “Yes” see page 3 of this form)

1 2 3 4 5 6 7 8 9 0 1

completed returns, including Form 8453, for the purpose of filing

1 2 3 4 5 6 7 8 9 0 1 2

1 2 3 4 5 6 7 8 9 0 1

forms electronically? (Electronic Return Originator) . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2

6 Do you intend to file Forms 2555/2555EZ? . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2

d Will you receive tax return information from other electronic

1 2 3 4 5 6 7 8 9 0 1 2

7 Is the Firm open 12 months a year?. . . . . . . . . . . . . . . . .

1 2 3 4 5 6 7 8 9 0 1 2

filers, format return information and send returns to a transmitter?

If you answer “No” to question 7, give address and telephone number

(Service Bureau) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

available 12 months per year. (include area code) . . . . . . . .

e Do you intend to file Form 4868 and/or Form 9465? . . . . . . . . . . . .

8 Principals of Your Firm or Organization (continued on page 2) Complete only if line 1d is “No”

Do not complete this section if you checked the box in item 1d “Yes” or checked box 1l on page 1 of this form. If you are a sole proprietor, list your name, home

address, and social security number, and response to each question. If your firm is a partnership, list the name, home address, social security number, and respond

to each question for each partner who has a five percent (5%) or more interest in the partnership. If your firm is a corporation, list the name, title, home address, social

security number, and respond to each question for the President, Vice-President, Secretary, and Treasurer of the corporation. If you are a for-profit entity and checked

“Other,” on line 1k or you are a partnership and no partners have at least 5% interest in the partnership, list the name, title, home address, social security number, and

respond to each question for at least one individual authorized to act for the firm in legal and/or tax matters. (You may use continuation sheets.) The signature of each

person listed authorizes the Internal Revenue Service to conduct a credit check on that individual.

8633

See Paperwork Reduction Act Notice and Privacy Act Notice on page 4.

Catalog No. 64225N

Form

(Rev. 5-98)