Form 13803 - Lncome Verification Express Service (Ives) Application
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1
2Department of the Treasury–Internal Revenue Service
13803
Form
OMB Number
lncome Verification Express Service (IVES)
(July 2011)
1545-2032
Application
Please check the box(es) below that apply to this application.
New
Revised
Add New Location
Cancellation
Official Business Name (required)
Doing Business As (required)
Business ElN/SSN (required)
If your firm is a partnership,
(Remains the same when adding
(Remains the same when adding
corporation or sole
new locations).
new locations).
proprietorship with employees,
provide the employee
identification number. If you do
not have employees, provide
your social security number.
(Remains the same when
adding new locations).
Business Location Address (required)
Billing Address (required, if different
Fax (required)
A new application should be prepared for
than above)
each business location. A Post Office Box
will not be accepted.
Business Telephone Number (required)
Business E-mail address
DUNN and Bradstreet Number
(optional)
By marking this box, you acknowledge that you have read Publication 4557, Safeguarding Taxpayer
Data, and will abide by the guidelines of the publication. In addition, you agree to use the taxpayer
information you receive only for the purpose(s) the taxpayer/requestor intended on the Form 4506-T.
Failure to complete this box will result in the application being rejected and returned.
13803
Form
(Rev. 7-2011)
Catalog Number 48547A
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