Fillable Printable Form 8655

What is a Form 8655 ?

Form 8655, Reporting Agent Authorization of IRS, as it meant, is used for four main functions, first, sign and file certain returns; second, make deposits and payments for certain returns; what's more, receive copies of tax info, notices, and other written and/or e-communication concerning any authority granted; last but not least, provide IRS with messages to aid in penalty relief determinations around the authority granted on this form. Get your fillable/editable, printable form 8655 at HandyPDF.

Fillable Printable Form 8655

What is a Form 8655 ?

Form 8655

Note: Form 8655 begins on the next page.

The fax number to file Form 8655 has changed.

The fax number, listed in the instructions for Form 8655 (Rev. August 2014) under the

Where To File section as 801-620-4142, has changed to 855-214-7523 beginning

March 1, 2017.

Form 8655

(Rev. August 2014)

Department of the Treasury

Internal Revenue Service

Reporting Agent Authorization

▶

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

OMB No. 1545-1058

Taxpayer

1 a Name of taxpayer (as distinguished from trade name)

1 b

Trade name, if any

Employer identification number (EIN)

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

City or town, state, and ZIP code

4 If you are a seasonal employer,

check here . . . . . . .

5 Other identification number

Contact person 7 Daytime telephone number 8 Fax number

Reporting Agent

9 Name (enter company name or name of business) 10

Employer identification number (EIN)

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

City or town, state, and ZIP code

Contact person 13 Daytime telephone number 14 Fax number

Authorization of Reporting Agent To Sign and File Returns (Caution: See Authorization Agreement)

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 941-SS 943

943-PR 944 945 1042

CT-1

Authorization of Reporting Agent To Make Deposits and Payments (Caution: See Authorization Agreement)

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.

940 941 943 944 945 720

1041 1042 1120 CT-1 990-PF 990-T

Disclosure of Information to Reporting Agents

17 a

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 . . . . . . . . . . . . . . . . . . . . . . . .

b Check here if the reporting agent also wants to receive copies of notices from the IRS . . . . . . . . . . . . . . .

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 .

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 .

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 (Caution: See Authorization Agreement)

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 and that I may enroll in the Electronic Federal Tax Payment System (EFTPS) to view deposits and payments made on my behalf. 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

▶

Title

▶

Date

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

Cat. No. 10241T

Form 8655 (Rev. 8-2014)

Page 2

General Instructions

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.

Note. An authorization does not relieve the taxpayer of the responsibility (or

from liability for failing) to ensure that all tax returns are filed timely and that

all federal tax deposits (FTDs) and federal tax payments (FTPs) are made

timely. See section 5.05 of Rev. Proc. 2012-32. Employers who enroll in the

Electronic Federal Tax Payment System (EFTPS) can view EFTPS deposits

and payments made on their behalf under their employer identification

number (EIN).

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

Authorization 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 “09/2014” 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 2014 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 “08/2014” 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 2014 and all

subsequent months.

Who Must Sign

Electronic signature. For guidance on optional electronic signature

methods, see Pub. 1474, section 01.03.

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. You can send us comments from www.irs.gov/formspubs. Click on

More Information and then click on Give us feedback. Or you can send your

comments to Internal Revenue Service, Tax Forms and Publications Division,

1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send

Form 8655 to this address. Instead, see Where To File, earlier.