c

b

i

d

e

h

j

Firm’s legal name as shown on firm’s tax return

Firms Employer Identification Number (EIN) or Social Security Number (SSN)

Primary Contact Name

(first, middle initial, last)

Business location address Country City

Doing Business As (DBA) name (if other than the name in item 1c)

Is the firm open 12 months a year? Yes No

Alternate Contact Name

(first, middle initial, last)

2 Please answer the following questions by checking the

appropriate box or boxes.

Yes No

Will you originate the submission of electronic returns

to the IRS? (Electronic Return Originator)

c

d

Will you write electronic filing software? (Software Developer)

Will you receive tax return information from EROs, or

from taxpayers who have prepared their own returns

using commercial software, or on an Internet site,

process the information, and either forward it to a

transmitter, or send the information back to the ERO?

(Intermediate Service Provider) 

6 Has the firm failed to file business tax returns, or pay

tax liabilites under U.S. Internal Revenue laws? (Please

attach an explanation for a “Yes” response.)

See Paperwork Reduction Act Notice and Privacy Act Notice on page 4. Cat. No. 64225N Form 8633 

a

e

Will you file as a Reporting Agent for Forms 940/941 as

defined in Revenue Procedure 96-17? (Reporting Agent)

If you are a Not for Profit service, check the one box 

below:

VITA TAC (Tax Assistance Center

Military Base Employee Member Benefit

TCE (Tax Counseling for the Elderly)

State ZIP Code/C

f Business telephone number Fax Number ( )

g Mailing address of the Firm if

different from the location

address only (street or P.O. box)

Title:

Phone Number: ( ) Fax Number:

E-mail address (optional):

b

Will you transmit returns prepared by you or those of another

ERO? (Transmitter) 

Are you currently listed on the IRS Reporting Agent’s File

(RAF) for this EIN?

(If you answer NO, you must furnish complete,

signed copies of your Forms 8655 for the clients for

whom you intend to file returns. You must also

furnish a list of your clients containing the Business

Name and EIN (Agents List).

Will you transmit individual or business income tax return

information prepared by a taxpayer using commercially

purchased software or software you provide through an

on-line Internet site? (On-line Provider)

f

3

Check the individual and/or business form types you 

940 941

4

990 1040 

1041 1065 1120

If you are a transmitter/software developer and chec

or 941 box, please check the software format which 

940 XML

5

941 XML EDI Non-EDI

1120 POL 

Telephone 

Note: If you answer No to 2b, skip to 2c. Check Yes in

box 2c if you transmit returns you prepared.

Check the 1120 box for 1120 and 1120S. Check the 

990, 990-EZ, and 8868. See instructions for additiona

on check boxes State Ack and ETD.

Non-EDI

Country City State ZIP Code/C

Address

( )

Title:

Phone Number: ( ) Fax Number:

E-mail address (optional):

On-line

On-line 

On-line 

If you answer “No,” please give address and telephone number

that are available 12 months of the year.

(If you answer YES, please follow the instructions on

Page 3 for Line 2d.)

Street

Street

( )

( )

( )
C.P.A.

enrolled agent

Home address Social Security Number Not app

Date of birth (month, day, year) Signature

Type or print name (first, middle, last)

Title:

U.S. citizenship?

Yes No

Legal

resident

alien

Are you a/an:

attorney

banking official

C.P.A.

enrolled agent

officer of a

publicly owned

corporation

Are you licens

in accordance 

local requirem

Yes 

Home address Social Security Number Not app

Date of birth (month, day, year) Signature

8 Responsible Official (Please complete this section and provide signature even if it is the same as Line 7.) A Not for Prof

selected in a box on Line 3, Page 1, must complete this section.

The responsible official is the individual with responsibility for and authority over the operations at designated sites. The responsible official is the first p

with the IRS, has the authority to sign revised applications, and is responsible for ensuring that all requirements of the IRS e-file program are adhered to

official may be responsible for more than one office. A principal listed in Section 7 may also be a responsible official.

Name of responsible official (first, middle initial, last)

Title:

U.S. citizenship?

Yes No

Legal

resident

alien

Are you a/an:

attorney

banking official

C.P.A.

enrolled agent

officer of a

publicly owned

corporation

Are you licens

in accordance 

local requirem

Yes 

Home address Social Security Number Not applica

Date of birth (month, day, year) Signature

Applicant Agreement

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 

the information being provided is true, correct, and complete. This firm and employees will comply with all of the provisions of the Revenue Procedure 

Filing of Individual Income Tax Returns and Business Tax Returns, and related publications, for each year of our participation.

Acceptance for participation is not transferable. I understand that if this firm is sold or its organizational structure changes, a new application must be 

further understand that noncompliance will result in the firm’s and/or the individuals listed on this application, being suspended from participation in the 

program. I am authorized to make and sign this statement on behalf of the firm.

9 Name and title of Principal, Partner, or Owner (type or print) Signature of Principal, Partner, or Owner D10 11

Add 

Add 

(Fingerprint

Card Required)

None apply 

(Fingerprint

Card Required)

E-mail (optional):

E-mail (optional):

E-mail (optional):

Have you ever been assessed any preparer penalties, been conv

crime, failed to file personal tax returns, or pay tax liabilites, or b

of any criminal offense under the U.S. Internal Revenue laws?

Yes No (Please attach an explanation for a “Yes

enrolled agent #_________

enrolled agent #_________

None apply 

(Fingerprint

Card Required)

enrolled agent #_________

Have you ever been assessed any preparer penalties, been conv

crime, failed to file personal tax returns, or pay tax liabilites, or b

of any criminal offense under the U.S. Internal Revenue laws?

Yes No (Please attach an explanation for a “Yes

Have you ever been assessed any preparer penalties, been conv

crime, failed to file personal tax returns, or pay tax liabilites, or b

of any criminal offense under the U.S. Internal Revenue laws?

Yes No (Please attach an explanation for a “Yes
Who Must File Form 8633. (1) New

applicants (including foreign filers) and

(2) Current participants revising a

previously submitted Form 8633, in

accordance with the IRS e-file program

requirements outlined in Publication

1345, Handbook For Authorized IRS

e-file Providers. In some instances, you

may revise your application by calling

1-866-255-0654.

When to File: New Applications— Year

Round Application Acceptance.

Effective August 1, 2003, paper

applications are accepted all year for

individuals and business e-file programs.

This change allows individual and

business e-file applicants the

opportunity to apply to participate in the

e-file program at any given time.

Additionally, the on-line e-file application

offers the same year round application

process. It is recommended that you

submit your completed application 45

days prior to the date you intend to

begin filing returns electronically

(business and/or individual).

Where to File. Send Form(s) 8633 to the

Andover Campus. (See Page 4 for

mailing addresses.)

Lines 1i and 1j.—Contact names must

be available on a daily basis to answer

IRS questions during testing and

throughout the processing year.

Line 6.—Misrepresentation wh

answering this question will re

rejection of your application to

participate in the IRS e-file Pr

your application is denied, you 

able to apply again for particip

years from the date of the den

Lines 7 and 8.—Each individu

must be a U.S. citizen or lega

alien (lawful permanent reside

attained the age of 21 as of th

the application, and if applying 

Electronic Return Originator, m

and local licensing and/or bon

requirements. Fingerprints mu

by a trained specialist. Individ

CANNOT take their own finge

The e-file program fingerprint 

unique and should be obtaine

calling the Andover Campus a

1-866-255-0654.

Page 2

Line 3.—Check the box that applies.

q

get answers, call toll free,

1-866-255-0654. If this is a foreign call,

call the non-toll-free number

01-512-416-7750. For additional

information about Business e-file

programs, see the following publications:

Publication 1524, Procedures for the

Form 1065 e-file Programs; Publication

1525, File Specifications for Form 1065

e-file; Publication 1855, Technical

Specifications Guide for the Electronic

Filing of Form 941; Publication 3715,

Technical Specifications Guide for the

Electronic Filing of Form 940;

Publication 1437, Procedures for

Electronic Filing of Form 1041; and

Publication 1438, File Specifications for

Form 1041.

employer identification number (EIN). If

your firm is a sole proprietorship, with

employees, provide the business

employer identification number (EIN). If

you do not have employees, provide

your social security number (SSN).

Lines 9–11—Signature Lines

principal, partner, or the owne

firm must sign new applicatio

Responsible Officials may sign 

applications.

Line 1c.—If your firm is a sole

proprietorship, enter the name of the

sole proprietor. If your firm is a

partnership or corporation, enter the

name shown on the firm’s tax return. If

submitting a revised application, and the

firm’s legal name is not changing, be

sure this entry is identical to your

original application.

Line 1d.—If, for the purpose of IRS

e-file, you or your firm use a “doing

business as” (DBA) name(s) other than

the name on line 1a, include the name(s)

on this line. Use an attachment sheet if

necessary to list all names.

Line 1e.—Address of the location of the

firm. A Post Office box (P.O. box) will not

be accepted as the location of your firm.

Line 1g.—Mailing address if different

from the business address. Include P.O.

box if applicable. You must provide a

year-round mailing address.

Note: Those transmitters and software

developers who are planning to transmit

Forms 990, 990-EZ, 1120, 1120S,

1120-POL, or 8868 through the Internet

must apply using the on-line e-file

application instead of completing

Form 8633.

Reapply—complete an application to

reapply to the program if you were

suspended and want to be reconsidered

or if you were dropped from the program

and would like to continue. Please

remember to include your previously

assigned EFIN.

Line 2d.—1040 on-line filing applicants

must also provide the following

information on a separate sheet of

paper:

State Ack (Restricted to Sof

Developers or Transmitters) 

acknowledgement files transm

the state taxing agency to the 

containing the results of the s

returns for pick-up by the orig

transmitter of the return.

1. The brand name of the software the

applicant will be using, has developed,

or will be transmitting, including the

name of the software developer; the

name of the transmitter for the software;

the retail cost of the software; any

additional costs for transmitting the

electronic portion of the taxpayer’s

return; whether the software can be

used for Federal/State returns; whether

the software is available on the Internet

and if so, the Internet address; the

professional package name of the

software submitted for testing;

2. The applicant’s point of contact

(including telephone number) for matters

relating to on-line filing, and the

applicant’s customer service number;

3. The procedures the applicant will use

to ensure that no more than five returns

are transmitted from one software

package or from one e-mail address;

and

4. The website URL of the on-line filer

Line 6 instruction also appli

7 and Line 8. Attach an expla

“Yes” response to the suitabil

question.

Unless you marked a box o

Page 1, or your only “Yes” res

section 2 is question e, you m

provide a completed fingerprin

each responsible official, corp

officer, owner, or partner listed 

7 and 8. If a corporate officer, 

partner changes, a completed 

card must be provided for eac

corporate officer, owner, or pa

corporate officer, owner, or pa

attorney, banking official who 

and has been fingerprinted in 

two years, CPA, enrolled agen

officer of a publicly owned co

evidence of current profession

may be submitted in lieu of th

fingerprint card (see Revenue

Procedures). Your application 

be processed if you do not p

completed fingerprint card o

evidence of professional sta

the signature of each respon

official, corporate officer, pa

owner.
Privacy Act Notice.—The Privacy Act of

1974 requires that when we ask for

information we tell you our legal right to

ask for the information, why we are

asking for it, and how it will be used. We

must also tell you what could happen if

we do not receive it, and whether your

response is voluntary, required to obtain

a benefit, or mandatory.

Our legal right to ask for information is

5 U.S.C. 301, 5 U.S.C. 500, 551-559,

31 U.S.C. 330, and Executive Order

9397.

We are asking for this information to

verify your standing as a person

qualified to participate in the electronic

filing program. The information you

provide may be disclosed to the FBI and

other agencies for background checks,

to credit bureaus for credit checks, and

to third parties to determine your

suitability.

The IRS also may be compelled to

disclose information to the public. In

response to requests made under 5

Your response is voluntary. However, if

you do not provide the requested

information, you could be disqualified

from participating in the IRS e-file

program.

If you provide fraudulent information,

you may be subject to criminal

prosecution.

Paperwork Reduction Act Notice. We

ask for the information on this form to

carry out the Internal Revenue laws of

the United States. You must give us the

information if you wish to participate in

the IRS e-file program. We need it to

process your application to file individual

income tax returns electronically.

You are not required to provide the

information requested on a form that is

subject to the Paperwork Reduction Act

Generally, tax returns and re

information are confidential, a

by Code section 6103. The tim

to complete this form will vary

depending on the individual

circumstances. The estimated 

minutes. If you have commen

concerning the accuracy of th

estimate or suggestions for m

form simpler, we would be ha

hear from you.

You can write to the Tax Pro

Coordinating Committee, Wes

Distribution Center, Rancho C

95743-0001. DO NOT send th

application to this office. Inste

Where to File on page 3.

U.S.C. 552, the Freedom of Information

Act, information that may be released

could include your name and business

address and whether you are licensed or

bonded in accordance with state or local

requirements.

unless the form displays a val

control number. Books or reco

relating to a form or its instruc

be retained as long as their co

may become material in the

administration of any Internal 

law.
Printed on recycled paper

Did you read all of Section 7? Did you provide us with a fingerprint card for all principals of your firm who 

exempt, evidence of professional status on those who are exempt, and all original signatures? Yes 

Acceptable evidence of current professional status consists of the following:

CPA CERTIFICATION—copy of current state license. (LPAs are not considered exempt/fingerprint cards required

ENROLLED AGENT—copy of current enrollment card issued by the IRS

ATTORNEY—copy of credentials

BANK OFFICIAL—a copy of the bonding certificate and proof of fingerprinting within the last two years

OFFICER OF A PUBLICLY OWNED CORPORATION—a copy on corporate letterhead which carries the name of 

the stock symbol, the exchange where listed, and the name under which the stock is traded for the individual lis

section 7 or 8 on Form 8633.

Have the principals and responsible officials of your firm reached age 21 as of the date on your

application? Yes No

Your application will be rejected if anyone listed is under the age of 21.

Have you been suspended from the IRS e-file program? Yes No

If you answer Yes, your suspension period must be complete. Please call the Andover Campus at: 1-866-255-0

free) to verify this information.

Did you remember to provide original signatures for 7, 8, and 10? Yes No

If you failed to provide signatures in the areas listed above, your application will be returned.

2.

3.

4.

5.

6.

Did you complete 1e and 1g? Yes No

Your application may be returned to you if 1e and 1g are incomplete. However, if your business address in 1e is 

as your mailing address, you are not required to complete 1g.