Form Mi-8633 - Application To Participate In The Michigan E-File Program
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1MI-8633
Michigan Department of Treasury
Issued under authority of P.A. 281 of 1967. Filing is voluntary.
(Rev. 8-99)
APPLICATION TO PARTICIPATE IN THE MICHIGAN E-FILE PROGRAM
If you previously filed form MI-8633 with Treasury and the information has not
changed, you do not need to file again this year. If you need to update your
information, you should file a revised form and check the box in the lower left corner.
Please type or print.
Firm's Legal Name as shown on the firm's tax return
Electronic Filing ID Number from IRS Acceptance Letter (6 digits)
FEIN and/or Social Security Number
Doing Business As (DBA) if other than the name above
S
Mailing Address (Street, P.O. Box)
T
Office Use
(City, State, ZIP Code)
A
Alternate Contact
T
Contact
E
Daytime Telephone Number
FAX Number
Daytime Telephone Number
FAX Number
(
)
(
)
(
)
(
)
E-mail Address
E-mail Address
O
Please answer the following questions by checking the appropriate boxes:
F
YES
NO
Do you want the above address published on Michigan Treasury's web site?
A.
If no, what address would you like published (if any)?
M
I
C
YES
NO
IMPORTANT!
B.
H
Will you develop electronic filing software?
If "Yes" enter your ten-character software developer ID number here. __ __ __ __ __ __ __ __ __ __
I
If "No" indicate which software package you plan to use. _______________________________________
G
How will you transmit returns?
Direct to IRS
C.
A
If direct, what is your acknowledgement mailbox ID? __ __ __
Using your tax preparation software
N
Third party transmitter
(Using software other than your tax preparation software.)
YES
NO
Do you or your firm have any unfiled personal or business tax returns or unpaid tax
D.
liabilities due in the past three years?
APPLICANT AGREEMENT
Under the penalties of perjury, I affirm that I have examined this application and any accompanying information, and to the best of my
knowledge and belief it is true, correct, and complete. This firm and its employees will comply with all provisions of the Internal Revenue
Service Publication 1345, Handbook for Electronic Filers of Individual Income Tax Returns, and any requirements specified by the Michigan
Department of Treasury for the years of participation. I understand that if this firm is sold or its organizational structure is changed, acceptance
for participation is not transferable; a new application must be filed. I further understand that noncompliance will result in the firm no longer
being allowed to participate in the program. I am aware that I must be accepted by the Internal Revenue Service to enable my participation in
the Federal/State Electronic Filing Program. I am authorized to make and sign this statement on behalf of the firm.
Name and Title of Firm Official and/or Principal Owner (please type or print)
Signature of Firm Official and/or Principal Owner
Date
Mail or fax completed form to:
Check here if this form contains
Electronic Filing Office
If you have questions, please call the
revised information and replaces
Michigan Department of Treasury
Electronic Filing Office at (517) 373-0614.
the form you currently have on file
P.O. Box 30058
Deaf, hearing or speech impaired persons
with the Michigan Department of
Lansing, MI 48909
call (517) 373-9419 (TTY).
Treasury.
Fax: (517) 241-2727
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