Employer/Payer Appointment of Agent

Form 2678, Employer/Payer Appointment of Agent
(Rev. April 2007)
Purpose: This is the first circulated draft of Form 2678, Employer/Payer
Appointment of Agent (Rev. April 2007).
TPCC Meeting: None scheduled.
Prior Revision: The prior revision is available at
http://publish.no.irs.gov/FORMS/PUBLIC/PDF/18770F02.PDF.
Other Products: Circulations of draft tax forms and instructions are posted at:
http://taxforms.web.irs.gov/Draft_products.html.
Comments: Please submit any comments by April 18, 2007. Phone
comments must be followed up with mail, fax, or e-mail.
Ron Gamble
Tax Law Specialist, SE:W:CAR:MP:T:T:SB
Phone: (202) 622-3841
Fax: (202) 622-8210
Email: [email protected]

Major Changes
Form 2678, Employer/Payer Appointment of Agent
(Rev. April 2007)
We extensively revised Form 2678 to provide:
•

Plain language instructions;

•

Signature lines for both the employer/payer and the agent to request and
confirm the agent’s authority, eliminating the need for any additional
authorization requests;

•

Easier revocation, with only one signature – either the employer’s/payer’s or
the agent’s – required to revoke authority;

•

Check boxes that clearly establish which form(s) the agent is authorized to file
on the employer’s/payer’s behalf;

•

A check box for the agent to indicate whether the employer is a disabled
individual or other welfare recipient receiving home-care services through a
state or local program;

•

Disclosure language, authorizing the IRS to disclose confidential tax
information to the agent and any third party the agent may contract with, such
as a reporting agent or CPA.

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Date

6
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 2678, PAGE 1 of 2
MARGINS: TOP 13 mm (1⁄ 2 ") CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20
FLAT SIZE: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

2678:

Date

Signature

O.K. to print

PRINTS: HEAD TO HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form
(Rev. April 2007)

Action

Revised proofs
requested

950107

Employer/Payer Appointment of Agent

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Department of the Treasury — Internal Revenue Service

OMB No. 1545-0029

Use this form if you want to request approval to have an agent pay compensation
(including wages), file returns, and make deposits of employment or other withholding
taxes or if you want to revoke an existing appointment.

For IRS use:

● If you are an employer or payer who wants to request approval, fill out Part 1 and sign it.
Then give it to the agent. Have the agent fill out Part 2 and sign it.
Note: This appointment is not effective until we approve your request. See the instructions
for your reporting requirements while we are processing your request. We will send a
letter to the agent after we approve your request.
● If you are an employer, payer, or agent who wants to revoke an existing appointment, fill
out both parts. In this case, only one signature is required. We will send a letter after we
process your request for revocation.
Why you are filing this form ... (Check one)
You want to appoint an agent for tax reporting and paying.
You want to revoke an existing appointment.

Part 1: Employer or Payer Information: If you want to appoint an agent, fill out this part.
1 Employer identification number (EIN)

—

2 Employer’s or payer’s name (not your trade name)
3 Trade name (if any)
4 Address

Number

Street

Suite or room number

City

State

5 Forms for which you want to appoint an agent or revoke the agent’s appointment to file.
(Check all that apply.)

Form
Form
Form
Form
Form
Form
Form

ZIP code

For ALL
employees/
payees

For SOME
employees/
payees

941, 941-PR, 941-SS (Employer’s QUARTERLY Federal Tax Return)
943, 943-PR (Employer’s ANNUAL Federal Tax Return for Agricultural Employees)
944, 944-PR, 944-SS (Employer’s Annual Federal Tax Return)
945 (Annual Return of Withheld Federal Income Tax)
1042 (Annual Withholding Tax Return for U.S. Source Income of Foreign Persons)
CT-1 (Employer’s Annual Railroad Retirement Tax Return)
CT-2 (Employee Representative’s Quarterly Railroad Retirement Tax Return)

Note: You may NOT appoint an agent to report and pay taxes reported on Form 940, Employer’s Annual Federal
Unemployment (FUTA) Tax Return.

I am authorizing the IRS to disclose otherwise confidential tax information to the agent relating to the authority granted
under this appointment, including disclosures required to process Form 2678. The agent may contract with a third party,
such as a reporting agent or certified public accountant, to prepare or file the returns covered by this appointment, or to
make any required payments. Such contract may authorize the IRS to disclose confidential tax information of the
employer/payer and agent to such third party. If a third party fails to file the returns or make the payments, the agent
and employer/payer remain liable.

✗

Print your name here

Sign your
name here
Date

Print your title here
/

/

Best daytime phone

(

)

–

Now give this form to the agent to fill out.
Cat. No. 18770D

Form

2678

©

(Rev. 4-2007)

6
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 2678, PAGE 2 of 2
MARGINS: TOP 13 mm (1⁄ 2 ") CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20
FLAT SIZE: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

PRINTS: HEAD TO HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

950207
Part 2: Agent Information: If you will be an agent for an employer or payer, fill out this part.
—

6 Agent’s employer identification number (EIN)
7 Name (not trade name)
8 Address

Check here if the employer is a disabled
Number
Street
Suite or room number
individual or other welfare recipient
receiving home-care services through a
state or local program
City
State
ZIP code
Under penalties of perjury, I declare that I have examined this form and any attachments, and to the best of my knowledge and
belief, it is true, correct, and complete.

✗

Print your name here

Sign your
name here
Date

Print your title here
/

/

Instructions

Best daytime phone

(

)

–

associated tax payments while this appointment is in effect. If an
agent contracts with a third party, such as a reporting agent or
certified public accountant, to prepare or file the returns covered
by this appointment or to make any required payments and the
third party fails to do so, the agent, employer, and payer remain
liable.

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This form allows employers and payers to request that an agent
be appointed to pay wages, file returns, and make deposits and
payments of employment or other withholding taxes under
Internal Revenue Code section 3504. You cannot use a prior
revision of this form. All prior revisions are obsolete and will not
be accepted.
● If you want to appoint an agent, check the box above Part 1
that says, “You want to appoint an agent for tax reporting and
paying,” and fill out Part 1.
● If you are an agent and you want to accept an appointment,
fill out Part 2.
● If you are an employer, payer, or agent and you want to
revoke an existing appointment of an agent, check the box
above Part 1 that says, “You want to revoke an existing
appointment,” and fill out Parts 1 and 2. However, only one
signature is required. If an existing appointment is revoked, the
IRS can no longer disclose confidential tax information to anyone
other than the employer/payee.

What are your reporting and payment requirements
while we are processing your request?

Send Form 2678 to us about 30 days before the date when you
want the appointment to become effective. This appointment is
not effective until we approve your request.
We will send a letter with the effective date to the agent after
we have approved the request. You should keep a copy of this
form and our approval for your records.
Until we approve the request, the employer/payer must still file
all appropriate tax returns and make all associated tax deposits
and payments. The employer/payer must continue to file all
appropriate tax returns and deposit or pay any taxes attributable
to any payments not covered by the appointment.

What are your reporting and payment requirements
after the IRS approves your appointment?
Agents must follow the procedures in Revenue Procedure 70-6
for employment taxes (unless you are a sub-agent for a state
agent under Notice 2003-70) and Revenue Procedure 84-33 for
backup withholding. Agents for employers who are receiving
home-care services through a state or local program are often
referred to as “fiscal intermediaries”. All agents, employers, and
payers remain liable for filing all returns and making all

Page

2

Where to send this form

Send your
form to ...

If you live in ...
Connecticut
Delaware
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Columbia
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IRS
Cincinnati, OH
45999-0046

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IRS
Ogden, UT
84201-0046

Paperwork Reduction Act Notice: We ask for this information
to carry out the Internal Revenue laws of the United States. We
need it to ensure taxpayers are complying with these laws and
to allow us to figure and collect the right amount of tax. You are
required to give us this information. The time needed to
complete and file this form will vary depending on the individual
circumstances. The estimated average time is 30 minutes. If you
have comments concerning the accuracy of this time estimate or
suggestions for making this form simpler, we would 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, send it to the Internal
Revenue Service at the address indicated in the table above.
Form

2678

(Rev. 4-2007)