Form 8655 Reporting Agent Authorization

8655

Reporting Agent Authorization

Form
(Rev. December 2012)

Department of the Treasury
Internal Revenue Service

▶

OMB No. 1545-1058

Information about Form 8655 is at www.irs.gov/form8655.

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

Address (number, street, and room or suite no.)

5 Other identification number

.

City or town, state, and ZIP code
6

7 Daytime telephone number

Contact person

8 Fax 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

944

945

1042

941-SS
CT-1

943

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
1041

941
1042

943
1120

944
CT-1

945
990-PF

720
990-T

Disclosure of Information to Reporting Agents
17 a
b

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 lines 15, 16, and/or line 18 . . . . . . . . . . . . . . . . . . . . . . . .
Check here if the reporting agent also wants to receive copies of notices from the IRS

.

.

.

.

.

.

.

.

.

.

.

.

.

.

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Disclosure Authorization
18 a

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
.

c

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 Forms 3921 and 3922. 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.

▶

Signature of taxpayer

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

Title
Cat. No. 10241T

▶

Date
Form 8655 (Rev. 12-2012)

Page 2

Form 8655 (Rev. 12-2012)

General Instructions
What's New
Beginning in 2012, Form 944-PR and Form 944-SS have been deleted from
line 15. Taxpayers who would otherwise file Form 944-PR or Form 944-SS
will file Form 944 or Form 944(SP) unless they request to file quarterly Forms
941-PR or 941-SS.

Purpose of Form
Use Form 8655 to authorize a reporting agent to:
• Sign and file certain returns. Reporting agents must file returns
electronically except as provided under Rev. Proc. 2012-32. You can find
Rev. Proc. 2012-32 on page 267 of Internal Revenue Bulletin 2012-34 at
www.irs.gov/pub/irs-irbs/irb12-34.pdf;
• 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. A new authorization must be
submitted to the Service for any increase or decrease in the authority of a
reporting agent to act for its client. The preceding authorization remains in
effect except as modified by the new one. 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), or payment
voucher. 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.

Additional Information
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. 2012-32.

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.
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 “09/2012” 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 2012 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 “08/2012” 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 2012 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.
Trust or estate. The fiduciary.
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. Our authority to request this information is Internal
Revenue Code sections 6011, 6061, 6109, and 6302 and the regulations
thereunder. We use this information to identify you and record your reporting
agent authorization. You are not required to authorize a reporting agent to
act on your behalf. However, if you choose to authorize a reporting agent,
you are required to provide the information requested, including your
identification number. Failure to provide all the information requested may
prevent or delay processing of your authorization; providing false or
fraudulent information may subject you to penalties.
Routine uses of this information include giving it 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 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 1 hour, 7 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. Email us at [email protected] and enter "Form 8655" 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 8655 to this address. Instead, see Where To File
above.