Form 2678 Employer/Payer Appointment of Agent

Version A, Cycle 1

Form

2678

Employer/Payer Appointment of Agent

OMB No. 1545-0748

Department of the Treasury — Internal Revenue Service

(Rev. April 2011)

Use this form if you want to request approval to have an agent file returns and make
deposits or payments 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, complete Parts 1
and 2 and sign Part 2. Then give it to the agent. Have the agent complete Part 3 and
sign it.
Note. This appointment is not effective until we approve your request. See the
instructions for filing Form 2678 on page 3.
• If you are an employer, payer, or agent who wants to revoke an existing appointment,
complete all three parts. In this case, only one signature is required.
Part 1: Why you are filing this form...
(Check one)
You want to appoint an agent for tax reporting, depositing, and paying.
You want to revoke an existing appointment.
Part 2: Employer or Payer Information: Complete this part if you want to appoint an agent or revoke an appointment.
1 Employer identification number (EIN)

—

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

DRAFT AS OF
November 19, 2010

4 Address

Number

Street

Suite or room number

City

ZIP code

State

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

For ALL
employees/
payees

For SOME
employees/
payees

Form 941, 941-PR, 941-SS (Employer’s QUARTERLY Federal Tax Return)
Form 943, 943-PR (Employer’s Annual Federal Tax Return for Agricultural Employees)
Form 944, 944-PR, 944-SS, 944(SP) (Employer’s ANNUAL Federal Tax Return)
Form 945 (Annual Return of Withheld Federal Income Tax)
Form CT-1 (Employer’s Annual Railroad Retirement Tax Return)
Form CT-2 (Employee Representative's Quarterly Railroad Tax Return)
Form 940 (Employer's Annual Federal Unemployment (FUTA) Tax Return)
"Insert space"
Note. Generally, you cannot appoint an agent to report, deposit, and pay taxes reported on Form 940, Employer's Annual
Federal Unemployment (FUTA) Tax Return, unless you are a home care service recipient.
Check here if you are a home care service recipient, and you want to appoint the agent to report, deposit, and pay FUTA
taxes for you. See the instructions.
"Lefta-align checkbox."
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 deposits and 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 deposits and 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 complete. ■▶
Cat. No. 18770D

Form 2678 (Rev. 4-2011)

Version A, Cycle 1
Page 2

Form 2678 (Rev. 4-2011)

Part 3: Agent Information: If you will be an agent for an employer or payer, or want to revoke an appointment, complete this part.
6

Agent’s employer identification number (EIN)

7

Agent’s name (not trade name)

8

Trade name (if any)

9

Address

—

Number

Street

City

Suite or room number

State

ZIP code

Check here if the employer is a home care service recipient receiving home care services through a program administer by a
federal, state, or local government agency.
ed /
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

/

/

Best daytime phone

DRAFT AS OF
November 19, 2010

Form 2678 (Rev. 4-2011)

Version A, Cycle 1
Form 2678 (Rev. 4-2011)

Page

Instructions for Form 2678
Section references are to the Internal Revenue Code.
Use this form if you want to request approval to have an agent
file returns and make deposits or payments of employment or
other withholding taxes or if you want to revoke an existing
appointment. You cannot use a prior version of this form. All
prior versions are obsolete and will not be accepted.
• If you want to appoint an agent, check the box in Part 1 that
says, “You want to appoint an agent for tax reporting,
depositing, and paying,” and complete Part 2.
• If you are an agent and you want to accept an appointment,
complete Part 3. If you are a corporate officer, partner, or tax
matters partner, you must have the authority to execute this
appointment of agent.
Note. If the employer/payer will be making payments not
covered by the appointment, the employer/payer must file all
related returns and deposit and pay taxes for those payments.
When completing line 5, check the box(es) “For SOME
employees/payees.”
• If you are an employer, payer, or agent and you want to
revoke an existing appointment of an agent, check the box in
Part 1 that says, “You want to revoke an existing
appointment,” and complete Parts 2 and 3. However, only one
signature is required. If an existing appointment is revoked, the
IRS cannot disclose confidential tax information to anyone other
than the employer/payer for periods after the appointment is
revoked.

3

liable for filing all returns and making all tax deposits and
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 tax deposits or
payments and the third party fails to do so, the agent, employer,
and payer remain liable.
Privacy Act and Paperwork Reduction Act Notice. We ask
for this information to carry out the Internal Revenue laws of the
United States. The principal purpose of this information is to
permit you to appoint an agent to act on your behalf. You do not
have to appoint an agent; however, if you choose to appoint an
agent, you must provide the information requested on Form
2678. Our authority to collect this information is section 3504.
Section 6109 requires you and the agent to provide your
taxpayer identification numbers. Failure to provide this
information could delay or prevent processing your appointment
of agent. Intentionally providing false information could subject
you and the agent to penalties.
Generally, tax returns and return information are confidential,
as required by section 6103. However, section 6103 allows or
requires the IRS to disclose or give the information shown on
this form to others as described in the Code. For example, we
may disclose your tax information 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 and intelligence
agencies to combat terrorism.

DRAFT AS OF
November 19, 2010

Filing Form 2678

Send Form 2678 to the address in the Where To File Chart
below for your location. We will send a letter to the agent after
we have approved the request. Until we approve the request,
the agent is not liable for filing any tax returns or making any
deposits or payments.

What are the reporting, deposit, and payment
requirements after the IRS approves the
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/employer agents” and “household
employer agents.” All agents, employers, and payers remain

You do not have 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.
The time needed to complete and file Form 2678 will vary
depending on individual circumstances. The estimated average
time is 30 minutes. If you have comments concerning the 2 hrs.,
accuracy of this time estimate or suggestions for making Form
2678 simpler, we would be happy to hear from you. You can
send comments by email to *[email protected] or you can write
to: 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 2678
to this address. Instead, see the Where To File Chart below.

Where To File Chart

Then use this
address ...

If you are in ...
Connecticut
Delaware
District of
Columbia

Illinois
Indiana
Kentucky
Maine

Maryland
Massachusetts
Michigan
New Hampshire

New Jersey
New York
North Carolina
Ohio

Pennsylvania
Rhode Island
South Carolina
Vermont

Virginia
West Virginia
Wisconsin

Department of the Treasury,
Internal Revenue Service,
Cincinnati, OH
45999

Alabama
Alaska
Arizona
Arkansas
California

Colorado
Florida
Georgia
Hawaii
Idaho

Iowa
Kansas
Louisiana
Minnesota
Mississippi

Missouri
Montana
Nebraska
Nevada
New Mexico

North Dakota
Oklahoma
Oregon
South Dakota
Tennessee

Texas
Utah
Washington
Wyoming

Department of the Treasury,
Internal Revenue Service,
Ogden, UT
84201

No legal residence or place of
business in any state

Department of the Treasury,
Internal Revenue Service,
Ogden, UT
84201

Exempt organization or government
entity

Department of the Treasury,
Internal Revenue Service,
Ogden, UT 84201-0046

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