Form 13551 Application to Participate in the

For Official Use Only

Control Number:
(Rev. October 2006)
Department of the Treasury IRS Acceptance Agent Program
Internal Revenue Service OMB Number 1545-1896
Please check the type of acceptance agent for which you are applying: New Renewal Amended
Acceptance Agent Certifying Acceptance Agent
1 Please check the box that best describes the applicant’s
professional status: Organization status:

Financial Institution Attorney* Partnership

Educational Institution CPA* Corporation
Government Agency or Enrolled Agent: Enter No. LLC
Military Organization ERO Sole Proprietorship
Casino Other Other (Specify)
Tax Preparer * See instructions for proof requirements
2 Applicant’s legal name (If an entity, also enter location where organized or created.) 3 EFIN: 4 Applicant’s Employer Identification Number (EIN)

5 Name of Authorized Representative of the Business 6 Date of birth 7 Social Security Number (SSN)
(first, middle, last) (month, day, year) Individual Taxpayer Identification Number (ITIN)

8 Home address (street, city/county, state/country, and ZIP 9 Check the 10 Have you ever been assessed any preparer penalties, been
code/foreign postal code) appropriate box convicted of a crime, failed to file personal tax returns, or
U.S. Citizen pay tax liabilities, or been convicted of any criminal offense
U.S. Resident Alien under the U.S. Internal Revenue laws?
(green card holder) Yes No (Please attach an explanation
Nonresident Alien for a “Yes” response.)
See instructions for fingerprinting requirements.
11 Applicant’s (Doing Business As (DBA)) name (if other than the name in item 2)

12 Applicant’s Business location address* Street City/County State/Country ZIP Code/Foreign Postal Code

*If more than one location, attach a separate sheet listing all locations.
13 Applicant’s Telephone: Number: ( ) Fax Number: ( )
14 Mailing address of the applicant if different from the location address on line 12
Number and Street City/County State/Country ZIP Code/Foreign Postal Code

15 Are you open for business 12 months a year? Yes No If “No,” provide an address and telephone number that is available
12 months of the year.
Number and Street City/County State/Country ZIP Code/Foreign Postal Code Telephone

15a How many Form W-7 applications do you plan to submit within a 12-month calendar period?
16 Complete the following information for the Primary Contact. (See instructions)
Title: E-mail Address:
Primary Contact Name (first, middle initial, last)
Phone Number: ( ) Fax Number: ( )
17 Complete the following information for the Alternate Contact.
Title: E-mail Address:
Alternate Contact Name (first, middle initial, last)
Phone Number: ( ) Fax Number: ( )
18 Identify the programs (activities) you will use the Acceptance Agent Certification to perform. (i.e., agricultural workers, foreign
investors, foreign students, etc.)
Under the penalties of Perjury, I declare that I have examined this application and read all accompanying information, and to the best of my knowledge and belief, the
information being provided is true, correct, and complete. I or my institution and its employees acting on behalf of the institution will comply with all of the provisions of
the Revenue Procedure for Acceptance Agents and related publications each year of our participation.
Acceptance for participation is not transferable. I understand that if this institution is sold or its organizational structure changes, a new application must be filed. I
further understand that noncompliance will result in the institution and/or the individuals listed on this application, being suspended from participation in the IRS
Acceptance Agent Program. I am authorized to make and sign this statement on behalf of the institution.
The signature of the person listed authorizes the Internal Revenue Service to conduct a suitability check on the person whose name appears on line 5.
19 If you would like to be included on the published list of Acceptance Agents located on the IRS web site, check here.
20 Name and title of Applicant (type or print) 21 Signature of applicant 22 Date

Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. Your response is voluntary. 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 code section 6103. The estimated average time to complete this form is 30 minutes.
If you have comments concerning the accuracy of this time estimate or suggestions for making this form simpler, we will be happy to hear from you. You can write to
the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, Washington, DC 20224. Do NOT send this
form to this address. Instead, enclose it with the magnetic tape and send it to the Service Center to which you submit your tapes or send it to the transmission reception
site that received your transmitted returns.
Cat. No. 38262Q Form 13551 (Rev. 10-2006)
Form 13551 (Rev. 10-2006) Page 2

Instructions for Completing Form 13551

Application to Participate in the IRS Acceptance Agent Program
General Instructions “Other” box is checked, please insert a brief The fingerprint card used for the Acceptance
explanation that best describes the applicant’s Agent is unique, and should be obtained by
Purpose of this Form. All persons who wish to professional status. Also check the box that best calling the IRS Andover Campus at
participate in the TIN (Taxpayer Identification describes the organizational status of the 1-866-255-0654. If the authorized representative
Number) Acceptance Agent Program must apply applicant. If the “Other” box is checked, please of the applicant changes, the applicant must
by completing this application. insert a brief explanation that best describes the submit an amended application, including a new
What is an Acceptance Agent/Certifying applicant’s organizational status. fingerprint card, if required, for the authorized
Acceptance Agent. Acceptance agents are Line 2. Enter the legal name of the business. If representative. If the new authorized
individuals or entities (colleges, financial your firm is a sole proprietorship, enter the name representative is an attorney, CPA, or enrolled
institutions, accounting firms, etc.) that have of the sole proprietor. If the applicant is an agent, proof of professional status may be
entered into formal agreements with the IRS that entity, provide the state, including the District of provided in lieu of the fingerprint card. If the new
permit them to assist alien individuals and other Columbia (or if outside the United States, the authorized representative is an ERO, proof of
foreign persons with obtaining TINs. The type of country under whose laws the entity was created ERO status must be provided in order to be
duties that you are permitted to perform is based or organized). If submitting an amended exempted from the fingerprinting requirement.
upon your application to become an acceptance application and the legal name of the business is Your application will not be processed if you do
agent or a certifying acceptance agent. (See not changing, be sure this entry is identical to not provide a completed fingerprint card or
Revenue Procedure 2006-10 for additional the one on your original application. evidence of professional status and the original
information). signature of the responsible officer, official, or
Line 3. If you are already an authorized IRS e-file owner of the business. Faxed copies of this
Who must Apply. New applicants (U.S. and provider, enter your EFIN (Electronic Filing
Foreign) and current participants amending or application will not be accepted. If you answered
Identification Number). An authorized IRS e-file “Yes” to the suitability question in box 10,
seeking renewal of their agreement. provider is a business (sole proprietorship, please provide an explanation including dates
When to Apply. Applications are accepted all partnership, corporation, or other entity) that has and circumstances.
year for the IRS Acceptance Agent Program. It is been accepted into the IRS e-filing program and
recommended that you submit your completed has been assigned an electronic filing Line 11. If, for the purpose of becoming an
application (and fingerprint card if applicable) 60 identification number. acceptance agent, a “doing business as” (DBA)
days prior to the date you intend to begin filing name is used other than the name provided on
Line 4. Enter your IRS Employer Identification Line 2, enter that information here and include a
TIN applications with the IRS. Number (EIN). Note: All applicants must obtain brief explanation. Use an additional sheet if you
When to Update Information. Acceptance an EIN before submiting your application. need more space.
Agents must notify the IRS within 30 days of all Line 5. Enter the name and title of the
changes to the information they originally Line 12. Enter the complete street address,
authorized representative who has the authority city/county, state/country and zip code/foreign
submitted on Form 13551, Application to to sign the application and agreement on behalf
Participate in the IRS Acceptance Agent (AA) postal code where the business is located. Note:
of the applicant. This person will be the official A post office box (P.O. Box) will not be
Program, by completing another Form 13551 point of contact with the IRS, have the authority
and checking the “amended” box. This is accepted as part of the address.
to sign revised applications, and is responsible
important for several reasons. If information is for ensuring that all requirements of the Line 13. Enter the telephone number and fax
not up-to-date on our database, you may not Acceptance Agent program are followed. If you number of the business. If, in addition to the
receive important IRS information or need more space to provide additional names of business telephone, there is another number
correspondence. Be sure to fully complete the alternate authorized representatives of the where you would like to be contacted by IRS,
application changing only the information that is business, please attach a continuation sheet. you may enter that information on this line also,
different from that submitted on the original The continuation sheet should include the notating that it is the alternative telephone
Form 13551. The revised Form 13551 will not information entered on line 5,6,7,8,9, and 10 for number.
change your address of record for tax purposes, each additional person. Line 14. This line should be completed only if
nor will it automatically update information you are using a business mailing address that
associated with your EIN (Employer’s Line 6. Enter the date of birth of the authorized
representative of the business listed on Line 5. is different from the address entered on Line 12.
Identification Number.)
This information should be entered in Line 15. If the business is not open 12 months a
Where to Apply. Send Form 13551, along with mm/dd/yyyy format (i.e. April 15, 1950, should year, you must provide a year-round mailing
your completed fingerprint card or evidence of be entered as 04/15/1950.) address and telephone number. You may include
professional status, if required, to a P.O. Box if applicable.
Internal Revenue Service Line 7. Enter the Social Security Number or ITIN
Mail Stop 983 of the authorized representative of the business. Line 15a. Enter the volume of Forms W-2 that
Andover, MA 05501 If you are a foreign national and do not have an you anticipate filing during a 12 month calendar
SSN or ITIN, please enter N/A. period.
Note: Be sure that your application has been
fully completed and contains the signature of the Line 8. Enter the complete home address of the Lines 16 and 17. Enter the name of the primary
authorized representative of the business. authorized representative of the business (street, and alternate contacts who have been
city/county, state/country and zip code/foreign authorized by the business to submit
Who to Contact for Assistance. If you need postal code). applications for tax identification numbers
additional assistance in completing this form, (Forms W-7 and SS-4) on its behalf, and who
you may call (404) 338-8963 where someone will Line 9. Check the box which describes the legal
status (in the U.S.) of the person entered on has also been designated to respond to IRS
be available to assist you. For additional questions during the calendar year. Also provide
information about Acceptance Agents, refer to line 5.
the person’s business title, telephone and fax
Revenue Procedure 2006-10. For additional Line 10. Each individual listed as an authorized numbers and their e-mail address. If you need
information about the Form W-7, see Publication representative or owner of the business must more space to provide additional primary or
1915, Individual Taxpayer Identification Number - have attained the age of 21 as of the date of this alternate contact names please attach a
ITIN. application. If the applicant is an attorney, CPA, continuation sheet. The continuation sheet
enrolled agent, but not a certified Electronic should include all information requested on lines
How To Complete The Form Return Originator (ERO), evidence of U.S. 16 and 17.
professional status may be submitted in lieu of
Check the applicable box to indicate (1) if you the fingerprint card. The following applicants are Line 18. Enter the types of customers for whom
are a new applicant, (2) if you are amending exempted from the fingerprinting requirement: a you will be submitting W-7 Applications.
information submitted on a previously submitted financial institution within the meaning of I.R.C. (i.e.: foreign students, foreign investors,
Form 13551, or (3) if you are seeking renewal of 265(b)(5) or Treasury Regulations agricultural workers, etc.)
your status as an Acceptance Agent or a 1.165-12(c)(1)(iv), a college or university that Lines 20 and 21. The authorized representative
Certifying Acceptance Agent. See Revenue qualifies as an educational organization under of the business must print and sign their name
Procedure 2006-10 for additional information on Treasury Regulations 1.501(c)(3)-1(d)(3)(i), a to this application. By signing the application you
Acceptance Agents. casino, a govenment agency or military are authorizing the Internal Revenue Service to
For information on submitting application, see organization and an ERO in good standing with conduct suitability checks as referenced in the
“When to Update Information” above. the IRS. However, all applicants who are EROs Revenue Procedure.
must submit proof of ERO status in order to be Line 22. Enter the date that this application is
Line 1. Check the box which best describes the
exempted from the fingerprinting requirement. signed.
professional status of the applicant. If the
Individuals CANNOT take their own fingerprints.

Form 13551 (Rev. 10-2006)