Form 13551 Application to Participate in the IRS Acceptance Agent P

Form

13551

(Rev. October 2006)
Department of the Treasury
Internal Revenue Service

Application to Participate in the
IRS Acceptance Agent Program

OMB Number 1545-1896

Please check the type of acceptance agent for which you are applying:
1

For Official Use Only
Control Number:

New

Renewal

Acceptance Agent
Certifying Acceptance Agent
Please check the box that best describes the applicant’s
professional status:

Amended

Organization status:

Financial Institution

Attorney*

Partnership

Educational Institution

CPA*

Corporation

Government Agency or
Military Organization

Enrolled Agent: Enter No.

LLC

ERO

Sole Proprietorship

Casino
Other
Tax Preparer
* See instructions for proof requirements
Applicant’s legal name (If an entity, also enter location where organized or created.) 3 EFIN:

4 Applicant’s Employer Identification Number (EIN)

5

Name of Authorized Representative of the Business
(first, middle, last)

6

Date of birth
(month, day, year)

7 Social Security Number (SSN)
Individual Taxpayer Identification Number (ITIN)

8

Home address (street, city/county, state/country, and ZIP
code/foreign postal code)

9

Check the
appropriate box
U.S. Citizen

2

Other

(Specify)

10 Have you ever been assessed any preparer penalties, been
convicted of a crime, failed to file personal tax returns, or
pay tax liabilities, or been convicted of any criminal offense
under the U.S. Internal Revenue laws?
U.S. Resident Alien
(green card holder)
Yes
No (Please attach an explanation
for a “Yes” response.)

Nonresident Alien

See instructions for fingerprinting requirements.
11

Applicant’s (Doing Business As (DBA)) name (if other than the name in item 2)

12

Applicant’s Business location address*

13
14

Fax Number: (
Applicant’s Telephone: Number: (
)
)
Mailing address of the applicant if different from the location address on line 12
Number and Street
City/County
State/Country
ZIP Code/Foreign Postal Code

15

Are you open for business 12 months a year?

Street

City/County

State/Country

ZIP Code/Foreign Postal Code

*If more than one location, attach a separate sheet listing all locations.

Number and Street

Yes

City/County

No If “No,” provide an address and telephone number that is available
12 months of the year.
State/Country
ZIP Code/Foreign Postal Code
Telephone

15a How many Form W-7 applications do you plan to submit within a 12-month calendar period?
Complete the following information for the Primary Contact. (See instructions)
16
Title:
Phone Number: (
Complete the following information for the Alternate Contact.
Primary Contact Name (first, middle initial, last)

17

)

E-mail Address:
(
Fax Number:

)

Title:
E-mail Address:
(
)
Phone Number: (
)
Fax Number:
Identify the programs (activities) you will use the Acceptance Agent Certification to perform. (i.e., agricultural workers, foreign
investors, foreign students, etc.)
Alternate Contact Name (first, middle initial, last)

18

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.

The signature of the person listed authorizes the Internal Revenue Service to conduct a suitability check on the person whose name appears on line 5.
19
20

If you would like to be included on the published list of Acceptance Agents located on the IRS web site, check here.
Name and title of Applicant (type or print)
21 Signature of applicant
22 Date

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.
Cat. No. 38262Q

Form

13551

(Rev. 10-2006)

Form 13551 (Rev. 10-2006)

Page

2

Instructions for Completing Form 13551
Application to Participate in the IRS Acceptance Agent Program
General Instructions
Purpose of this Form. All persons who wish to
participate in the TIN (Taxpayer Identification
Number) Acceptance Agent Program must apply
by completing this application.
What is an Acceptance Agent/Certifying
Acceptance Agent. Acceptance agents are
individuals or entities (colleges, financial
institutions, accounting firms, etc.) that have
entered into formal agreements with the IRS that
permit them to assist alien individuals and other
foreign persons with obtaining TINs. The type of
duties that you are permitted to perform is based
upon your application to become an acceptance
agent or a certifying acceptance agent. (See
Revenue Procedure 2006-10 for additional
information).
Who must Apply. New applicants (U.S. and
Foreign) and current participants amending or
seeking renewal of their agreement.
When to Apply. Applications are accepted all
year for the IRS Acceptance Agent Program. It is
recommended that you submit your completed
application (and fingerprint card if applicable) 60
days prior to the date you intend to begin filing
TIN applications with the IRS.
When to Update Information. Acceptance
Agents must notify the IRS within 30 days of all
changes to the information they originally
submitted on Form 13551, Application to
Participate in the IRS Acceptance Agent (AA)
Program, by completing another Form 13551
and checking the “amended” box. This is
important for several reasons. If information is
not up-to-date on our database, you may not
receive important IRS information or
correspondence. Be sure to fully complete the
application changing only the information that is
different from that submitted on the original
Form 13551. The revised Form 13551 will not
change your address of record for tax purposes,
nor will it automatically update information
associated with your EIN (Employer’s
Identification Number.)
Where to Apply. Send Form 13551, along with
your completed fingerprint card or evidence of
professional status, if required, to
Internal Revenue Service
Mail Stop 983
Andover, MA 05501
Note: Be sure that your application has been
fully completed and contains the signature of the
authorized representative of the business.
Who to Contact for Assistance. If you need
additional assistance in completing this form,
you may call (404) 338-8963 where someone will
be available to assist you. For additional
information about Acceptance Agents, refer to
Revenue Procedure 2006-10. For additional
information about the Form W-7, see Publication
1915, Individual Taxpayer Identification Number ITIN.

How To Complete The Form
Check the applicable box to indicate (1) if you
are a new applicant, (2) if you are amending
information submitted on a previously submitted
Form 13551, or (3) if you are seeking renewal of
your status as an Acceptance Agent or a
Certifying Acceptance Agent. See Revenue
Procedure 2006-10 for additional information on
Acceptance Agents.
For information on submitting application, see
“When to Update Information” above.
Line 1. Check the box which best describes the
professional status of the applicant. If the

“Other” box is checked, please insert a brief
explanation that best describes the applicant’s
professional status. Also check the box that best
describes the organizational status of the
applicant. If the “Other” box is checked, please
insert a brief explanation that best describes the
applicant’s organizational status.
Line 2. Enter the legal name of the business. If
your firm is a sole proprietorship, enter the name
of the sole proprietor. If the applicant is an
entity, provide the state, including the District of
Columbia (or if outside the United States, the
country under whose laws the entity was created
or organized). If submitting an amended
application and the legal name of the business is
not changing, be sure this entry is identical to
the one on your original application.
Line 3. If you are already an authorized IRS e-file
provider, enter your EFIN (Electronic Filing
Identification Number). An authorized IRS e-file
provider is a business (sole proprietorship,
partnership, corporation, or other entity) that has
been accepted into the IRS e-filing program and
has been assigned an electronic filing
identification number.
Line 4. Enter your IRS Employer Identification
Number (EIN). Note: All applicants must obtain
an EIN before submiting your application.
Line 5. Enter the name and title of the
authorized representative who has the authority
to sign the application and agreement on behalf
of the applicant. This person will be the official
point of contact with the IRS, have the authority
to sign revised applications, and is responsible
for ensuring that all requirements of the
Acceptance Agent program are followed. If you
need more space to provide additional names of
alternate authorized representatives of the
business, please attach a continuation sheet.
The continuation sheet should include the
information entered on line 5,6,7,8,9, and 10 for
each additional person.
Line 6. Enter the date of birth of the authorized
representative of the business listed on Line 5.
This information should be entered in
mm/dd/yyyy format (i.e. April 15, 1950, should
be entered as 04/15/1950.)
Line 7. Enter the Social Security Number or ITIN
of the authorized representative of the business.
If you are a foreign national and do not have an
SSN or ITIN, please enter N/A.
Line 8. Enter the complete home address of the
authorized representative of the business (street,
city/county, state/country and zip code/foreign
postal code).
Line 9. Check the box which describes the legal
status (in the U.S.) of the person entered on
line 5.
Line 10. Each individual listed as an authorized
representative or owner of the business must
have attained the age of 21 as of the date of this
application. If the applicant is an attorney, CPA,
enrolled agent, but not a certified Electronic
Return Originator (ERO), evidence of U.S.
professional status may be submitted in lieu of
the fingerprint card. The following applicants are
exempted from the fingerprinting requirement: a
financial institution within the meaning of I.R.C.
265(b)(5) or Treasury Regulations
1.165-12(c)(1)(iv), a college or university that
qualifies as an educational organization under
Treasury Regulations 1.501(c)(3)-1(d)(3)(i), a
casino, a govenment agency or military
organization and an ERO in good standing with
the IRS. However, all applicants who are EROs
must submit proof of ERO status in order to be
exempted from the fingerprinting requirement.
Individuals CANNOT take their own fingerprints.

The fingerprint card used for the Acceptance
Agent is unique, and should be obtained by
calling the IRS Andover Campus at
1-866-255-0654. If the authorized representative
of the applicant changes, the applicant must
submit an amended application, including a new
fingerprint card, if required, for the authorized
representative. If the new authorized
representative is an attorney, CPA, or enrolled
agent, proof of professional status may be
provided in lieu of the fingerprint card. If the new
authorized representative is an ERO, proof of
ERO status must be provided in order to be
exempted from the fingerprinting requirement.
Your application will not be processed if you do
not provide a completed fingerprint card or
evidence of professional status and the original
signature of the responsible officer, official, or
owner of the business. Faxed copies of this
application will not be accepted. If you answered
“Yes” to the suitability question in box 10,
please provide an explanation including dates
and circumstances.
Line 11. If, for the purpose of becoming an
acceptance agent, a “doing business as” (DBA)
name is used other than the name provided on
Line 2, enter that information here and include a
brief explanation. Use an additional sheet if you
need more space.
Line 12. Enter the complete street address,
city/county, state/country and zip code/foreign
postal code where the business is located. Note:
A post office box (P.O. Box) will not be
accepted as part of the address.
Line 13. Enter the telephone number and fax
number of the business. If, in addition to the
business telephone, there is another number
where you would like to be contacted by IRS,
you may enter that information on this line also,
notating that it is the alternative telephone
number.
Line 14. This line should be completed only if
you are using a business mailing address that
is different from the address entered on Line 12.
Line 15. If the business is not open 12 months a
year, you must provide a year-round mailing
address and telephone number. You may include
a P.O. Box if applicable.
Line 15a. Enter the volume of Forms W-2 that
you anticipate filing during a 12 month calendar
period.
Lines 16 and 17. Enter the name of the primary
and alternate contacts who have been
authorized by the business to submit
applications for tax identification numbers
(Forms W-7 and SS-4) on its behalf, and who
has also been designated to respond to IRS
questions during the calendar year. Also provide
the person’s business title, telephone and fax
numbers and their e-mail address. If you need
more space to provide additional primary or
alternate contact names please attach a
continuation sheet. The continuation sheet
should include all information requested on lines
16 and 17.
Line 18. Enter the types of customers for whom
you will be submitting W-7 Applications.
(i.e.: foreign students, foreign investors,
agricultural workers, etc.)
Lines 20 and 21. The authorized representative
of the business must print and sign their name
to this application. By signing the application you
are authorizing the Internal Revenue Service to
conduct suitability checks as referenced in the
Revenue Procedure.
Line 22. Enter the date that this application is
signed.
Form

13551

(Rev. 10-2006)