Form 56 - Notice Concerning Fiduciary Relationship Page 2
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Form 56 (Rev. 12-2015)
Page
Revocation or Termination of Notice
Part II
Section A—Total Revocation or Termination
Check this box if you are revoking or terminating all prior notices concerning fiduciary relationships on file with the Internal
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Revenue Service for the same tax matters and years or periods covered by this notice concerning fiduciary relationship
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Reason for termination of fiduciary relationship. Check applicable box:
a
Court order revoking fiduciary authority
b
Certificate of dissolution or termination of a business entity
c
Other. Describe
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Section B—Partial Revocation
8a Check this box if you are revoking earlier notices concerning fiduciary relationships on file with the Internal Revenue Service
for the same tax matters and years or periods covered by this notice concerning fiduciary relationship .
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b Specify to whom granted, date, and address, including ZIP code.
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Section C—Substitute Fiduciary
Check this box if a new fiduciary or fiduciaries have been or will be substituted for the revoking or terminating fiduciary and
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specify the name(s) and address(es), including ZIP code(s), of the new fiduciary(ies)
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Court and Administrative Proceedings
Part III
Name of court (if other than a court proceeding, identify the type of proceeding and name of agency)
Date proceeding initiated
Address of court
Docket number of proceeding
City or town, state, and ZIP code
Date
Time
Place of other proceedings
a.m.
p.m.
Signature
Part IV
I certify that I have the authority to execute this notice concerning fiduciary relationship on behalf of the taxpayer.
Please
Sign
Here
Fiduciary’s signature
Title, if applicable
Date
56
Form
(Rev. 12-2015)
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