Form Crf-Bulk - Tax Preparer Registration Form
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CRF-BULK (Rev. 1/13)
GEORGIA DEPARTMENT OF REVENUE
P. O. BOX 49512
ATLANTA, GEORGIA 30359-1512
NEED HELP? CALL 1-877-423-6711
TAX PREPARER REGISTRATION FORM
A Tax Preparer (or Service Provider) is a third party who, by agreement, files electronic tax
transactions, either in bulk or single entry online, on behalf of taxpayer clients.
Legal Name
Mailing Address
City
State
Zip Code
Federal ID Number
Social Security #
Contact Person
Contact Telephone #
Contact Fax #
Contact E-mail Address
Upon receipt of this form, the department will send a letter to you specifically for tax preparers. A
State Tax Identifier Number (STI) will also be provided by mail. If you already have an STI, a new
number will not be issued. However, we will advise you of your STI number. Additional information
for tax preparers may be found on our Web site at
.
As a third party tax preparer, you have the option to file a client’s transaction information
individually online at the Georgia Tax Center website
gtc.dor.ga.gov
or to submit an electronic file
containing transactions for multiple clients.
Note: One electronic payment cannot cover multiple transactions.
Name of Owner, Officer, Partner or Responsible Party
Signature of Owner, Officer, Partner or Responsible Party
Date
By submitting this registration form, the above party agrees to abide by the statutes and regulations of
the State of Georgia in the filing of returns on behalf of taxpayers. This registration form does not
grant power of attorney to the above party to act on behalf of the taxpayer regarding tax matters with
the Georgia Department of Revenue or allow the above party to act as an agent of the department.
Tax preparers may wish to have a Georgia Power of Attorney form on file with the department for
their clients. A Power of Attorney form is available at the Department’s Internet site under “Forms
and Publications.”
Mail Completed application to:
Georgia Department of Revenue
PO Box 49512
Atlanta GA 30359-1512
St-license@dor.ga.gov
E-Mail completed application to:
If you have any questions concerning this application, contact the Call Center at 1-877-423-6711.
.
For more information, visit our website at
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