Free Form 23 (Rev. October 2008) - Federal

File Size: 217.3 kB
Pages: 2
Date: October 21, 2008
File Format: PDF
State: Federal
Category: Tax Forms
Author: SE:W:CAR:MP
Word Count: 1,157 Words, 7,051 Characters
Page Size: 611.976 x 791.968 pts (letter)

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(Rev. October 2008)
Department of the Treasury Internal Revenue Service

Application for Enrollment to Practice Before the Internal Revenue Service
See instructions on page 2.

OMB No. 1545-0950

Important things you need to do before you file this form: Take and pass the Special Enrollment Examination. Read Circular 230. Enclose a check or money order for $125 made payable to the Internal Revenue Service. This fee is non-refundable. Check here if you are a former Internal Revenue Service employee and enter the date you separated from the Service / / Part 1. Tell us about yourself
-- --

For IRS use:
Enrollment Number: Date Enrolled:


Social Security Number


Print full legal name
Last First Intial


Current address
Number Street Suite or room number



ZIP code


4 5

Enter the candidate number assigned to you by Prometric Do you have an EIN No Yes If Yes, enter the Employer Identification Numbers (EINs) below. Enter the Employer Identification Numbers (EINs) below. EIN Name

5a 5b 5c 6 7 8 9 Have you ever appeared before or been sanctioned by a licensing board, regulatory body, federal or state agency for alleged misconduct Has any application you filed with a court, government department, commission, or agency for admission to practice ever been denied or rejected Has any Internal Revenue Service office ever held you ineligible for limited practice without enrollment Have you been convicted, or fined $500 or more, for violating any law, excluding traffic tickets No No Yes Yes

No Yes No Yes Note: If you answered "Yes" to question 6, 7, 8, or 9, describe the nature of the offense, tell us when it occurred, and provide details on a separate page. No Yes If Yes, enter the States where you are licensed to practice.

10a Are you a CPA

10b Are you an Attorney



If Yes, enter the States where you are licensed to practice.

Part 2: Sign here
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief,it is true, correct, and complete.


Sign your name here
Email address Best daytime phone (

Date )



For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Cat. No. 16233B



(Rev. 10-2008)

Form 23 (Rev. 10-2008)



You must take and pass the Special Enrollment Examination (SEE) before you can apply for Enrolled Agent (EA) status. If you did not pass the required SEE, go to and register to take the test. Note. You have one year from the date you passed the SEE to apply for enrollment.

If you want to use regular mail, send it to: U.S. Treasury/Enrollment P.O. Box 894191 Los Angeles, CA 90189-4191

How long will it take to process this request?
It will generally take about 60 days for us to process your request. Your status is not effective until we approve your request. You are not authorized to practice before the IRS on anyone's behalf, until your request has been approved.

Special instructions for former IRS employees
If you are a former IRS employee who held a position that qualifies you for EA status, you are not required to take the SEE. Check the box at the top of the form to tell us you are a former IRS employee who meets the exception criteria. If you checked the box, you must enter your date of separation (mm-dd-yyyy). Note. You must apply for enrollment within 3 years from the date you separated from the Service.

Who do I call if I have questions?
To check on the status of your request, call 1-313-234-1280. Please allow 60 days for processing before calling to check on the status of your application. Privacy Act and Paperwork Reduction Act Notice. Section 330 of title 31, United States Code, authorizes the IRS to collect this information. The primary use of the information is to administer the enrolled agent program. Information may be disclosed to: public authorities for use in law enforcement and in connection with employment, contracting, licensing, and other benefits; courts and other adjudicative bodies and the Department of Justice for litigation purposes; contractors to perform the contract; third parties during the course of an investigation; the general public to identify individuals currently or formerly eligible to represent taxpayers, including their location; and professional organizations or associations to assist them in meeting their responsibilities in connection with the administration and maintenance of standards of conduct and discipline. Applying for enrollment is voluntary, however, providing the information requested on this form is a requirement to obtain the benefit of enrollment. Failure to provide the requested information could delay or prevent processing of your application. Providing false information could subject you to penalties. Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: IRS/Office of Professional Responsibility; SE:OPR; 1111 Constitution Avenue, NW; Washington, DC 20224.

Filling out the form
It is important that you answer all questions in Part 1, as required, and that you sign your name in Part 2 so that we can process your request. Failure to complete the form, as requested, could result in processing delays.

Enclose the fee
Enclose a check or money order for $125 made payable to the Internal Revenue Service. Effective October 1, 2007, all personal check remittances will be debited from your account electronically, within 24 hours of receipt. Please visit for more detailed information.

What we will do when we receive your form
As part of the application process, we will check your filing history to verify that you have timely filed and paid all federal taxes. If you own or have any interest in a business, we will also check the history of your business tax return filings. Note. It is important that you file any delinquent tax returns and that you pay any taxes owed before you file this form. An intentionally false statement or omission identified with your application is a violation of 18 U.S.C. 1001 and may also be grounds for denial of your application.

Where to send this form
You can use overnight mail or regular mail to send us this form. If you want to use overnight mail, send it to: Internal Revenue Service Attn: Box 4191 5860 Uplander Way Culver City, CA. 90230