Form 23 - Application For Enrollment To Practice Before The Internal Revenue Service Page 2
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Form 23 (Rev. 4-2017)
Page
7
Do you have a Centralized Authorization File (CAF) number?
Yes
No
If “Yes”, enter all CAF numbers assigned to you (attach additional pages, if necessary):
8
Are you current with your individual and business taxes, including any
corporate and employment tax obligations?
Yes
No
If "NO", provide explanation.
9
Yes
No
Have you been sanctioned by a federal or state licensing authority?
Has any application you filed with a court, government department,
10
commission, or agency for admission to practice ever been denied?
Yes
No
11
Have you been convicted of a tax crime or any felony?
Yes
No
Have you been permanently enjoined from preparing tax returns, or
12
representing others before the IRS?
Yes
No
NOTE: If you answered “Yes” to question 9, 10, 11 or 12, please describe on a separate page, the matter, including the date
of when the matter occurred, and provide any additional information about the matter that you would like us to consider.
13
Are you a CPA?
If “Yes”, enter the states where you are licensed to practice.
Yes
No
14
Are you an Attorney?
If “Yes”, enter the states where you are licensed to practice.
Yes
No
Part 2. Sign here
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and
complete.
Signature
Date
23
Form
(Rev. 4-2017)
Filling out this form:
It is important to answer all questions on the form. Failure to answer any questions or sign the form could result in processing delays.
An intentionally false statement or omission identified with your application is a violation of Circular 230 10.51(a)(4) and 18 U.S.C. 1001
and may be grounds for suspension or disbarment from practice.
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