Form 8655 Reporting Agent Authorization

Form

8655

Reporting Agent Authorization

OMB No. 1545-1058

(Rev. November 2009)
Department of the Treasury
Internal Revenue Service

Taxpayer
1a Name of taxpayer (as distinguished from trade name)

2 Employer identification number (EIN)

1b Trade name, if any

4 If you are a seasonal employer,
check here

3

5 Other identification number

Address (number, street, and room or suite no.)
City or town, state, and ZIP code

6

Contact person

8 Fax number

7 Daytime telephone number

(

)

(

)

Reporting Agent
9

10 Employer identification number (EIN)

Name (enter company name or name of business)

11

Address (number, street, and room or suite no.)
City or town, state, and ZIP code

12

13 Daytime telephone number

Contact person

(

14 Fax number

)

(

)

Authorization of Reporting Agent To Sign and File Returns
15

Use the entry lines below to indicate the tax return(s) to be filed by the reporting agent. Enter the beginning year of annual tax returns or
beginning quarter of quarterly tax returns. See the instructions for how to enter the quarter and year. Once this authority is granted, it is
effective until revoked by the taxpayer or reporting agent.

940

941

940-PR

941-PR

943-PR
CT-1

944

944-PR

944-SS

941-SS
945

943
1042

Authorization of Reporting Agent To Make Deposits and Payments
Use the entry lines below to enter the starting date (the first month and year) of any tax return(s) for which the reporting agent is authorized
to make deposits or payments. See the instructions for how to enter the month and year. Once this authority is granted, it is effective until
revoked by the taxpayer or reporting agent.

16

940

941

943

944

945

720

1041

1042

1120

CT-1

990-PF

990-T

Disclosure of Information to Reporting Agents
17a

Check here to authorize the reporting agent to receive or request copies of tax information and other communications from the IRS related
to the authorization granted on line 15 and/or line 16
b Check here if the reporting agent also wants to receive copies of notices from the IRS

Form W-2 Series or Form 1099 Series Disclosure Authorization
18a

The reporting agent is authorized to receive otherwise confidential taxpayer information from the IRS to assist in responding to certain IRS
notices relating to the Form W-2 series information returns. This authority is effective for calendar year forms beginning
.

b The reporting agent is authorized to receive otherwise confidential taxpayer information from the IRS to assist in responding to certain IRS
notices relating to the Form 1099 series information returns. This authority is effective for calendar year forms beginning
.

State or Local Authorization
19

Check here to authorize the reporting agent to sign and file state or local returns related to the authorization granted on line 15 and/or line 16

Authorization Agreement
I understand that this agreement does not relieve me, as the taxpayer, of the responsibility to ensure that all tax returns are filed and that all deposits and payments are made. If line
15 is completed, the reporting agent named above is authorized to sign and file the return indicated, beginning with the quarter or year indicated. If any starting dates on line 16 are completed,
the reporting agent named above is authorized to make deposits and payments beginning with the period indicated. Any authorization granted remains in effect until it is revoked by the taxpayer
or reporting agent. I am authorizing the IRS to disclose otherwise confidential tax information to the reporting agent relating to the authority granted on line 15 and/or line 16, including disclosures
required to process Form 8655. Disclosure authority is effective upon signature of taxpayer and IRS receipt of Form 8655. The authority granted on Form 8655 will not revoke any Power of Attorney
(Form 2848) or Tax Information Authorization (Form 8821) in effect.

Sign
Here

I certify I have the authority to execute this form and authorize disclosure of otherwise confidential information on behalf of the taxpayer.

䊳

Signature of taxpayer

䊳

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

Title
Cat. No. 10241T

䊳

Date
Form

8655 (Rev. 11-2009)

Page

Form 8655 (Rev. 11-2009)

General Instructions
Purpose of Form
Form 8655 is used to authorize a reporting agent to:
● Sign and file certain returns;
● Make deposits and payments for certain returns;
● Receive duplicate copies of tax information, notices, and other
written and/or electronic communication regarding any authority
granted; and
● Provide IRS with information to aid in penalty relief determinations
related to the authority granted on Form 8655.

Authority Granted
Once Form 8655 is signed, any authority granted is effective
beginning with the period indicated on lines 15 or 16 and continues
indefinitely unless revoked by the taxpayer or reporting agent. No
authorization or authority is granted for periods prior to the period(s)
indicated on Form 8655.
Where authority is granted for any form, it is also effective for
related forms such as the corresponding non-English language form,
amended return, (Form 941-X, 941-X(PR), 943-X, 944-X(PR), 945-X,
or CT-1X) payment voucher, or deposit coupon. In addition to the
returns shown on lines 15 and 16, Form 8655 can be used to
provide authorization for Form 944-SP using the entry spaces for
Form 944. The form also can be used to authorize a reporting agent
to make deposits and payments for other returns in the Form 1120
series, such as Form 1120-C, using the entry space for Form 1120
on line 16.
Disclosure authority granted on line 17a is effective on the date
Form 8655 is signed by the taxpayer. Any authority granted on Form
8655 does not revoke and has no effect on any authority granted on
Forms 2848 or 8821, or any third-party designee checkbox authority.

Where To File
Send Form 8655 to:
Internal Revenue Service
Accounts Management Service Center
MS 6748 RAF Team
1973 North Rulon White Blvd.
Ogden, UT 84404
You can fax Form 8655 to the IRS. The number is 801-620-4142.

2

Withdrawing from reporting authority. A reporting agent can
withdraw from authority by filing a statement with the IRS, either on
paper or using a delete process. The statement must be signed by
the reporting agent (if filed on paper) and identify the name and
address of the taxpayer and authorization(s) from which the reporting
agent is withdrawing. For information on the delete process, see
Pub. 1474.

Specific Instructions
Line 15
Use the “YYYY” format for annual tax returns. Use the “MM/YYYY”
format for quarterly tax returns, where “MM” is the ending month of
the quarter the named reporting agent is authorized to sign and file
tax returns for the taxpayer. For example, enter “09/2008” on the line
for “941” to indicate you are authorizing the named reporting agent
to sign and file Form 941 for the July–September quarter of 2008
and subsequent quarters.

Line 16
Use the “MM/YYYY” format to enter the starting date, where “MM”
is the first month the named reporting agent is authorized to make
deposits or payments for the taxpayer. For example, enter “08/2009”
on the line for “720” to indicate you are authorizing the named
reporting agent to make deposits or payments for Form 720 starting
in August 2009 and all subsequent months.

Who Must Sign
Sole proprietorship. The individual owning the business.
Corporation (including a limited liability company (LLC) treated as a
corporation). Generally, Form 8655 can be signed by: (a) an officer
having legal authority to bind the corporation, (b) any person
designated by the board of directors or other governing body, (c) any
officer or employee on written request by any principal officer, and
(d) any other person authorized to access information under section
6103(e).
Partnership (including an LLC treated as a partnership) or an
unincorporated organization. Generally, Form 8655 can be signed by
any person who was a member of the partnership during any part of
the tax period covered by Form 8655.
Single member LLC treated as a disregarded entity. The owner of
the LLC.

Additional Information

Trust or estate. The fiduciary.

Additional information concerning reporting agent authorizations may
be found in:
● Pub. 1474, Technical Specifications Guide for Reporting Agent
Authorizations and Federal Tax Depositors.
● Rev. Proc. 2007-38. You can find Rev. Proc. 2007-38 on
page 1442 of Internal Revenue Bulletin 2007-25 at
www.irs.gov/pub/irs-irbs/irb07-25.pdf.

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. Form 8655 is provided by the IRS for your convenience
and its use is voluntary. If you choose to authorize a reporting agent to
act on your behalf, under section 6109, you must disclose your EIN. The
principal purpose of this disclosure is to secure proper identification of
the taxpayer. We need this information to gain access to your tax
information in our files and properly respond to your request. If you do
not disclose this information, the IRS may suspend processing your
reporting agent authorization and may not be able to honor your
reporting agent authorization until you provide your EIN.
Routine uses of this information include giving it to the Department of
Justice for civil and criminal litigation, and to cities, states, and the
District of Columbia for use in administering their tax laws. We may also
disclose this information to other countries under a tax treaty, to federal
and state agencies to enforce federal nontax criminal laws, or to federal
law enforcement agencies and intelligence agencies to combat terrorism.
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
instructions must be retained as long as their contents may become
material in the administration of any Internal Revenue law.
The time needed to complete and file Form 8655 will vary depending
on individual circumstances. The estimated average time is 6 minutes.
If you have comments concerning the accuracy of this time estimate or
suggestions for making Form 8655 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, IR-6526, Washington, DC 20224. Do not send Form 8655 to this
address. Instead, see Where To File above.

Substitute Form 8655
If you want to prepare and use a substitute Form 8655, see
Pub. 1167, General Rules and Specifications for Substitute Forms
and Schedules. If your substitute Form 8655 is approved, the form
approval number must be printed in the lower left margin of each
substitute Form 8655 you file with the IRS.

Revoking an Authorization
If you have a valid Form 8655 on file with the IRS, the filing of a new
Form 8655 revokes the authority of the prior reporting agent
beginning with the period indicated on the new Form 8655. However,
the prior reporting agent is still an authorized reporting agent and
retains any previously granted disclosure authority for the periods
prior to the beginning period of the new reporting agent’s
authorization unless specifically revoked.
If the taxpayer wants to revoke an existing authorization, send a
copy of the previously executed Form 8655 to the IRS at the
address under Where To File, above. Re-sign the copy of the Form
8655 under the original signature. Write “REVOKE” across the top of
the form. If you do not have a copy of the authorization you want to
revoke, send a statement to the IRS. The statement of revocation
must indicate that the authority of the reporting agent is revoked and
must be signed by the taxpayer. Also, list the name and address of
each reporting agent whose authority is revoked.