Form 2678 Employer/Payer Appointment of Agent

Form

2678

Employer/Payer Appointment of Agent

OMB No. 1545-0748

Department of the Treasury — Internal Revenue Service

(Rev. June 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)
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 940, 940-PR (Employer's Annual Federal Unemployment (FUTA) Tax Return)*
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)
*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.
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. ■▶

For Paperwork Reduction Act Notice, see the instructions.

Cat. No. 18770D

Form 2678 (Rev. 6-2011)

Page 2

Form 2678 (Rev. 6-2011)

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 administered by a
federal, state, or local government agency.
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
Form 2678 (Rev. 6-2011)

Form 2678 (Rev. 6-2011)

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.
Note. Generally you cannot appoint an agent to file an
aggregate Form 940. Beginning with the 2010 tax year, if you
are a home care service recipient you may request approval for
an agent to report, file, and pay taxes on a Form 940, by
checking the box in the footnote on line 5.
At the time this form went to print, proposed regulations
REG-137036-08 were issued to modify Regulations section
31.3504-1 to allow home care service recipients to appoint an
agent to report, file, and pay taxes on Form 940.
• 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.

Filing Form 2678
Send Form 2678 to the address for your location in the Where
To File Chart later. 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.

Filing Schedule R (Form 940) and Schedule R (Form 941)
An agent for a home care service recipient that files an
aggregate Form 940 must complete Schedule R (Form 940),
Allocation Schedule for Aggregate Form 940 Filers, and file it
with the aggregate Form 940.
An agent that files an aggregate Form 941 must complete
Schedule R (Form 941), Allocation Schedule for Aggregate Form
941 Filers, and file it with the aggregate Form 941.

Page

3

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 subagent for a state
agent under Notice 2003-70) and Revenue Procedure 84-33 for
backup withholding. Agents for employers who are home care
service recipients receiving home care services through a
program administered by a federal, state, or local government
agency may also use this form. These agents are often referred
to as “fiscal/employer agents” and “household employer
agents.” All agents, employers, and payers remain 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 the information on Form 2678 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 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.
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 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, the District of
Columbia, and U.S. commonwealths and possessions 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.
The time needed to complete and file Form 2678 will vary
depending on individual circumstances. The estimated average
time is 2 hrs., 12 minutes. If you have comments concerning the
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]. Enter “Form
2678” on the subject line. Or 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 later.

Form 2678 (Rev. 6-2011)

Page

Where To File Chart
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

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

Then use this
address ...
Department of the Treasury,
Internal Revenue Service,
Cincinnati, OH
45999
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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