56 Notice Concerning Fiduciary Relationship

56

Form
(Rev. November 2017)
Department of the Treasury
Internal Revenue Service

Part I

Notice Concerning Fiduciary Relationship
▶

OMB No. 1545-0013

Go to www.irs.gov/Form56 for instructions and the latest information.
(Internal Revenue Code sections 6036 and 6903)

Identification

Name of person for whom you are acting (as shown on the tax return)

Decedent’s social security no.

Identifying number

Address of person for whom you are acting (number, street, and room or suite no.)
City or town, state, and ZIP code (If a foreign address, see instructions.)
Fiduciary’s name
Address of fiduciary (number, street, and room or suite no.)
City or town, state, and ZIP code

Telephone number (optional)

(

)

Section A. Authority
1

Authority for fiduciary relationship. Check applicable box:
a
Court appointment of testate estate (valid will exists)
b
Court appointment of intestate estate (no valid will exists)
Court appointment as guardian or conservator
c
d
Valid trust instrument and amendments
e
Bankruptcy or assignment for the benefit or creditors
Other. Describe ▶
f
2a If box 1a or 1b is checked, enter the date of death ▶
b If box 1c—1f is checked, enter the date of appointment, taking office, or assignment or transfer of assets ▶

Section B. Nature of Liability and Tax Notices
3

Type of taxes (check all that apply):
Excise
Other (describe) ▶

4

Federal tax form number (check all that apply): a
e
1040, 1040-A, or 1040-EZ f
1041
g

5

If your authority as a fiduciary does not cover all years or tax periods, check here .
and list the specific years or periods ▶

Income

Gift

706 series
1120 h

Estate

Generation-skipping transfer

b
709
c
Other (list) ▶

For Paperwork Reduction Act and Privacy Act Notice, see separate instructions.

d

940

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Cat. No. 16375I

Employment

941, 943, 944

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▶

Form 56 (Rev. 11-2017)

Form 56 (Rev. 11-2017)

Page

2

Revocation or Termination of Notice

Part II

Section A—Total Revocation or Termination
Check this box if you are revoking or terminating all prior notices concerning fiduciary relationships on file with the Internal
Revenue Service for the same tax matters and years or periods covered by this notice concerning fiduciary relationship ▶
Reason for termination of fiduciary relationship. Check applicable box:
a
Court order revoking fiduciary authority
Certificate of dissolution or termination of a business entity
b
c
Other. Describe ▶

6

Section B—Partial Revocation
Check this box if you are revoking earlier notices concerning fiduciary relationships on file with the Internal Revenue Service
for the same tax matters and years or periods covered by this notice concerning fiduciary relationship . . . . . . ▶
b Specify to whom granted, date, and address, including ZIP code.

7a

▶

Section C—Substitute Fiduciary
8

Check this box if a new fiduciary or fiduciaries have been or will be substituted for the revoking or terminating fiduciary and
specify the name(s) and address(es), including ZIP code(s), of the new fiduciary(ies) . . . . . . . . . . . . ▶
▶

Part III

Court and Administrative Proceedings

Name of court (if other than a court proceeding, identify the type of proceeding and name of agency)

Date proceeding initiated

Address of court

Docket number of proceeding

City or town, state, and ZIP code

Date

Time

a.m.

Place of other proceedings

p.m.

Part IV

I certify that I have the authority to execute this notice concerning fiduciary relationship on behalf of the taxpayer.

▲

Please
Sign
Here

Signature

Fiduciary’s signature

Title, if applicable

Date
Form 56 (Rev. 11-2017)