Form 56 - Notice Concerning Fiduciary Relationship Page 2

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Form 56 (Rev. 12-2011)
Page
Court and Administrative Proceedings
Part II
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 III
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. 12-2011)

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