Form 23 Application for Enrollment to Practice Before the Intern

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13
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 23, 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

23

Date

Revised proofs
requested

Application for Enrollment to Practice Before
the Internal Revenue Service

(Rev. October 2007)
Department of the Treasury
Internal Revenue Service

Signature

O.K. to print

PRINTS: HEAD TO HEAD
INK: BLACK

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

Form

Action

OMB No. 1545-0950

See instructions on page 2.

Important things you need to do before you file this form:
● Take and pass the Special Enrollment Examination.
● Read Circular 230.

For IRS use:

● Enclose a check or money order for $125 made payable to the Internal Revenue Service.
Note: This fee is non-refundable.

Date Enrolled:

Enrollment Number:

Check here if you are a current or former Internal Revenue Service employee.
Part 1. Tell us about yourself
1

Social Security Number

2

Print full legal name

—

Last

3

—

First

Intial

Current address

Number

Street

City

Suite or room number

State

4

Enter the candidate number assigned to you by Prometric

5

Do you own a business

No

ZIP code

Country

Yes Enter the Employer Identification Numbers (EINs) and names of your businesses below.
EIN

Business Name

5a
5b
5c
6

Have you ever appeared before or been sanctioned by a professional body, federal or
state agency for alleged misconduct

No

Yes

7

Has any application you filed with a court, government department, commission, or
agency for admission to practice ever been denied or rejected

No

Yes

8

Has any Internal Revenue Service office ever held you ineligible for limited practice
without enrollment

No

Yes

9

Have you been convicted, or fined $500 or more, for violating any law, excluding traffic
tickets

No

Yes

Note: If you answered “Yes” to question 6, 7, 8, or 9, describe the nature of the offense, tell us when it occurred,
and provide details on a separate page.
Part 2: Sign here
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief,
it is true, correct, and complete.

✗

Sign your
name here
Email address

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

/

Date

Best daytime phone

(

Cat. No. 16233B

)

/

–
Form

23

(Rev. 10-2007)

13
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 23, 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

Form 23 (Rev. 10-2007)

Page

Instructions

How long will it take to process this request?

You must take and pass the Special Enrollment Examination
(SEE) before you can apply for Enrolled Agent (EA) status. If
you did not pass the required SEE, go to
www.Prometric.com and register to take the test.

It will generally take about 90 days for us to process your
request. Your status is not effective until we approve your
request.

Special instructions for current or former IRS
employees
If you are a current IRS employee within 45 days of
retirement, or you are a former IRS employee who held a
position that qualifies you for EA status, you are not required
to take the SEE. Check the box at the top of the form to tell
us you are a current or former IRS employee who meets the
exception criteria.

Filling out the form
It is important that you answer all questions in Part 1, as
required, and that you sign your name in Part 2 so that we
can process your request. Failure to complete the form, as
requested, could result in processing delays.

Enclose the fee
Enclose a check or money order for $125 made payable to
the Internal Revenue Service.
Effective October 1, 2007, all personal check remittances
will be debited from your account electronically, within 24
hours of receipt. Please visit www.irs.gov for more detailed
information.

What we will do when we receive your form
As part of the application process, we will check your filing
history to verify that you have timely filed and paid all federal
taxes. If you own or have any interest in a business, we will
also check the history of your business tax return filings.
An intentionally false statement or omission identified with
your application is a violation of 18 U.S.C. 1001 and may
also be grounds for denial of your application.

Where to send this form
You can use overnight mail or regular mail to send us this
form.
If you want to use overnight mail, send it to:
Internal Revenue Service
Attn: Box 4191
5860 Uplander Way
Culver City, CA. 90230
If you want to use regular mail to, send it to:
U.S. Treasury/Enrollment
P.O. Box 894191
Los Angeles, CA 90189-4191

2

Upon receipt of your Form 23, we will send you an
acknowledgement letter. Until we approve the request, you
are not authorized to practice before the IRS on anyone’s
behalf.

Who do I call if I have questions?
To check on the status of your request, call 1-313-234-1280.
Please allow 90 days for processing before calling to check
on the status of your application.
Privacy Act and Paperwork Reduction Act Notice. Section
330 of title 31, United States Code, authorizes the IRS to
collect this information. The primary use of the information is
to administer the enrolled agent program. Information may be
disclosed to: public authorities for use in law enforcement
and in connection with employment, contracting, licensing,
and other benefits; courts and other adjudicative bodies and
the Department of Justice for litigation purposes; contractors
to perform the contract; third parties during the course of an
investigation; the general public to identify individuals
currently or formerly eligible to represent taxpayers, including
their location; and professional organizations or associations
to assist them in meeting their responsibilities in connection
with the administration and maintenance of standards of
conduct and discipline. Applying for enrollment is voluntary,
however, providing the information requested on this form is
a requirement to obtain the benefit of enrollment. Failure to
provide the requested information could delay or prevent
processing of your application. Providing false information
could subject you to penalties.
Notwithstanding any other provision of law, no person is
required to respond to, nor shall any person be subject to a
penalty for failure to comply with, a collection of information
subject to the requirements of the Paperwork Reduction Act,
unless that collection of information displays a currently valid
OMB Control Number. Public reporting burden for this
collection of information is estimated to average 15 minutes
per response, including the time for reviewing the
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing
the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden,
to: IRS/Office of Professional Responsibility; SE:OPR; 1111
Constitution Avenue, NW; Washington, DC 20224.