Form 13551 - Application To Participate In The Irs Acceptance Agent Program - 2017

Download a blank fillable Form 13551 - Application To Participate In The Irs Acceptance Agent Program - 2017 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 - 2017 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.

For Official Use Only

Department of the Treasury - Internal Revenue Service

13551

Application to Participate in the

Control number

Form

IRS Acceptance Agent Program

(Rev. August 2014)

OMB Number 1545-1896

(Read the instructions carefully before completing this Form)

Check the type of acceptance agent for

Application Type:

If you are amending your application, select the reason below:

which you are applying:

New

Authorized Representative

Business Location

Acceptance Agent

Renewal

Acceptance Agent Type

Certifying Acceptance Agent

Amended

Other

1. Check the box that best describes Organization status

Professional Status of Authorized Representative (Individual

Listed on Line 5)

Financial Institution

Corporation

Educational Institution

LLC

Tax Preparer

CPA*

ERO

Attorney*

Casino

Sole Proprietorship

Enrolled Agent* (Enter number)

Partnership

Other

(Specify)

Government Agency or Military Organization

*See instructions for proof requirements

2. Legal Name of Business (If an entity, also enter location where organized or created)

3. Business Electronic Filing Identification Number (EFIN)

and Name and PTIN of Principal Partner or Owner of the Business (See Instructions)

4. Business Employer Identification Number (EIN)

5. Name and PTIN of Authorized Representative of the Business

6. Date of birth

7. Social Security Number (SSN) or Individual Taxpayer

(first, middle, last, PTIN)

(month, day, year)

Identification Number (ITIN)

8. Home address (street, city/county, state/country, and ZIP code/

9. Check the appropriate box

10. Have you ever been assessed any preparer penalties,

foreign postal code) of individual listed on Line 5

been convicted of a crime, failed to file personal tax

U.S. Citizen

returns, or pay tax liabilities, or been convicted of any

U.S. Resident Alien*

criminal offense under the U.S. Internal Revenue laws

Nonresident Alien*

Yes

*Attach copy of green card

(Please attach an explanation for a “Yes” response.)

or visa if residing in the U.S.

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 continuation sheets for each location and authorized representative(s) with required information.

13. Business telephone number

Fax 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

15. Does the Business provide tax related services year round

Yes

If “No,” provide a brief explanation why.

15a. How many Form W-7 applications does the Business plan to submit within a 12-month calendar period

16. Complete the following information for Primary Contact if different than the authorized representative on Line 5 (see instructions)

Primary Contact name (first, middle initial, last)

Title

Email address

Phone number

(

)

Fax number

(

)

17. Complete the following information for Alternate Contact if different than the individual listed on Line 5 (see instructions)

Alternate Contact name (first, middle initial, last)

Title

Email address

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. Signature of Authorized Representative

20. Name and title of Authorized Representative from line 5 (type or print)

22. Date

Signature of Principal, Partner or Owner

Name and title of Principal, Partner or Owner from line 2 (type or print)

Date

Privacy Act and 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

Form

(Rev. 8-2014)