Form 13551 - Application To Participate In The Irs Acceptance Agent Program - 2011

Download a blank fillable Form 13551 - Application To Participate In The Irs Acceptance Agent Program - 2011 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 13551 - Application To Participate In The Irs Acceptance Agent Program - 2011 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

For Official Use Only
Application to Participate in the
13551
Control Number:
Form
IRS Acceptance Agent Program
(Rev. 11-2011)
(Please read the instructions carefully before completing this Form.)
OMB Number 1545-1896
Please check the type of acceptance agent for which you are applying:
New
Renewal
Amended
Acceptance Agent
Certifying Acceptance Agent
Please check the box that best describes Organization status:
1
Professional Status of Authorized
Financial Institution
Corporation
Representative
(Individual Listed on Line 5)
Educational Institution
LLC
Tax Preparer
CPA*
Attorney*
Government Agency or
Sole Proprietorship
Enrolled Agent*: Enter No.
Military Organization
ERO
Casino
(Specify)
Other
Partnership
Other
*See instructions for proof requirements
Legal Name of Business
(If an entity, also enter location where organized or created.)
3 Business EFIN:
4
Business Employer Identification
2
Number (EIN)
and Name and PTIN of Principal Partner or Owner of the Business
(See Instructions)
5 Name and email of Authorized Representative of the
7 Social Security Number (SSN) or
6 Date of birth
Business (first, middle, last)
(month, day, year)
Taxpayer Identification Number (ITIN)
8 Home address (street, city/county, state/country, and ZIP
9 Check the
10 Have you ever been assessed any
code/foreign postal code) of individual listed on Line 5.
preparer penalties, been convicted of
appropriate box
a crime, failed to file personal tax
U.S. Citizen
returns, or pay tax liabilities, or been
convicted of any criminal offense
U.S. Resident Alien*
under the U.S. Internal Revenue laws?
Nonresident Alien*
No
Yes
*Attach copy of green
(Please attach an explanation for a “Yes”
card or visa if residing
in the U.S.
response.)
11 Doing Business As (DBA) Name (Complete only if the business is operating under a name which is different than the business name listed on Line 2)
12 Business location address*
Street
City/County
State/Country
ZIP Code/Foreign Postal Code
*If more than one location, attach a separate sheet listing all locations.
Fax Number:
Email:
13 Business Telephone: Number:
(
)
(
)
14 Mailing address of the Business if different from the location address on line 12
Number and Street
City/County
State/Country
ZIP Code/Foreign Postal Code
If “No,” provide a brief explanation why.
15 Does the Business provide tax related services year round?
Yes
No
15a How many Form W-7 applications does the Business plan to submit within a 12-month calendar period?
Complete the following information for Primary Contact if different than the authorized representative on Line 5.
(See instructions)
16
Title:
Email Address:
(
)
(
)
Primary Contact Name (first, middle initial, last)
Phone Number:
Fax Number:
17 Complete the following information for Alternate Contact if different than the individual listed on Line 5.
(See instructions)
Title:
Email Address:
(
)
(
)
Alternate Contact Name (first, middle initial, last)
Phone Number:
Fax Number:
18
Identify the activities performed by you or your organization (tax preparation, University, etc.) as well as the type of customers that you
will service (foreign investors, foreign students, etc.) to validate your request for Acceptance Agent status.
(See instructions)
19 If you would like to be included on the published list of Acceptance Agents located on the IRS website, check here.
Note: the business must perform tax preparation to be included on the list.
Under the penalties of Perjury, I declare that I have examined this application and read all accompanying information, and to the best of my knowledge and belief, the information being provided is true,
correct, and complete. I or my institution and its employees acting on behalf of the institution will comply with all of the provisions of the Revenue Procedure for Acceptance Agents and related
publications each year of our participation. Acceptance for participation is not transferable. I understand that if this institution is sold or its organizational structure changes, a new application must be filed.
I further understand that noncompliance will result in the institution and/or the individuals listed on this application, being suspended from participation in the IRS Acceptance Agent Program. I am
authorized to make and sign this statement on behalf of the institution.
21
22
20
Signature of Authorized Representative
Date
Name and title of Authorized Representative (type or print)
Date
Name and title of Principal, Partner or Owner (type or print)
Signature of Principal, Partner or Owner
Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. Your response is voluntary. You are not required to provide the information requested on a form that is
subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any
Internal Revenue law. Generally, tax returns and return information are confidential, as required by code section 6103. The estimated average time to complete this form is 30 minutes. If you have comments concerning the accuracy of this time
estimate or suggestions for making this form simpler, we will be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, Washington,
DC 20224. Do NOT send this form to this address. Instead, enclose it with the magnetic tape and send it to the Service Center to which you submit your tapes or send it to the transmission reception site that received your transmitted returns.
13551
Catalog Number 38262Q
Department of the Treasury–Internal Revenue Service
Form
(Rev. 11-2011)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 4