2678 Employer/Payer Appointment of Agent

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Version A, Cycle 4

Form

2678

Employer/Payer Appointment of Agent
OMB No. 1545-0748

(Rev. December 2023) Department of the Treasury — Internal Revenue Service

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’re 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.

TREASURY/IRS
AND OMB USE
ONLY DRAFT
July 27, 2023
DO NOT FILE

Note: This appointment isn’t effective until we approve your request. See the instructions
for more information.
• If you’re 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’re 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

State

Foreign country name

Foreign province/county

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/payments

ZIP code

Foreign postal code

For SOME
employees/
payees/payments

Form 940, Employer’s Annual Federal Unemployment (FUTA) Tax Return* (all 940 series)
Form 941, Employer’s QUARTERLY Federal Tax Return (all 941 series)
Form 943, Employer’s Annual Federal Tax Return for Agricultural Employees (all 943 series)
Form 944, Employer’s ANNUAL Federal Tax Return (all 944 series)
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 can’t appoint an agent to report, deposit, and pay tax reported on Form 940, unless you’re a home care
service recipient.
Check here if you’re a home care service recipient, and you want to appoint the agent to report, deposit, and pay FUTA tax
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

Print your title here
Date

/

/

Best daytime phone
Now give this form to the agent to complete.

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

www.irs.gov/Form2678

Cat. No. 18770D

Form 2678 (Rev. 12-2023)

Page 2

Form 2678 (Rev. 12-2023)

Part 3:

Agent Information: If you’ll 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)

TREASURY/IRS
AND OMB USE
ONLY DRAFT
July 27, 2023
DO NOT FILE

8 Trade name (if any)
9 Address

Number

Street

City

Suite or room number

State

Foreign country name

Foreign province/county

ZIP code

Foreign postal 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, they
are true, correct, and complete.
Print your name here

Sign your
name here

Print your title here

Date

/

/

Best daytime phone

Form 2678 (Rev. 12-2023)