Federal Free Printable Form 13803 (Rev. 9-2016) for 2017 Federal lncome Verification Express Service (IVES) Application

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lncome Verification Express Service (IVES) Application
Form 13803 (Rev. 9-2016)

Department of the Treasury - Internal Revenue Service Form Application to Participate in the Income Verification Express Service (IVES) Program 13803 (September 2016) For Official Use Only Control Number: (Please read the instructions carefully before submitting this form) OMB Number 1545-2032 1. Check the type of application you are submitting: New Renewal Amended Add New Location Cancellation Address Change Sole Proprietorship Corporation LLC 2. Check the box that describes your organization status: Government Agency Partnership Other (Specify) 3. Reason(s) for using the IVES Program: (Select all that apply) Mortgage Services Background Check Credit Check Banking Service Licensing Requirement Other (Specify) 4. Legal name of business (required) 5. Employer Identificaton Number (EIN) or Social Security Number (SSN)(required) 6. Doing Business As (DBA) name (Complete only if the business is operating under a different business name listed on line 4) 7. Business location address (required) Street address City State Business telephone number (required) Fax number (required) Business e-mail address Zip Code 8. Billing address required if different from the location address on line 7 Street address City State Zip Code 9. Complete the following information for the principal, company official, partner, or owner of business. Company official name (first, middle initial, last) Title Date of Birth (mm/dd/yyyy) (required) Social Security Number (required) E-mail address Home street address City State Telephone number Zip Code 10. Primary contact name (required if different than the principal). A contact must be available on a day to day basis to answer IRS questions during testing and through the processing year. Last name First name Telephone number (required) E-mail address (required) MI 11a. Have you been convicted of a felony in the last 10 years? (Attach an explanation for a Yes response) Yes No 11b. Are you current with your individual and business taxes, including any corporation and employment tax obligations? (Attach an explanation for a No response) Yes No 12. Estimated annual volume of IVES product requests: Catalog Number 48547A www.irs.gov Form 13803 (Rev. 9-2016) 13. Complete the following information for the responsible official. The responsible official is an individual with responsibility for the operation and IVES users at the business location listed above. A principal listed above may also be a responsible official. Responsible official name (first, middle initial, last) Title Date of Birth (mm/dd/yyyy) (required) Social Security Number (required) E-mail address Home street address City State 14. Telephone number Zip Code By marking this box, you agree to review Publication 4557, Safeguarding Taxpayer Data and abide by the guidelines of the publication. In addition, you can only use taxpayer information that you recieve via a Form 4506-T or Form 45-6 T-EZ request for the purpose(s) the taxpayer/requestor intended. Failing to complete this section will result in the application being rejected and returned. Where to fax your application: Fax your application to your closest IVES location listed below: IVES location Austin, Texas Cincinnati, Ohio Fresno, California Kansas City, Missouri Ogden, Utah Fax number 877-477-9603 877-477-0578 877-477-0576 877-477-9601 877-477-0580 The IRS conducts a suitability check on the applicant, and on all Principals listed on the application to determine the applicant's suitability to be an IVES participant. After an applicant passes the suitability check and the IRS completes processing the application, the IRS notifies the applicant of acceptance to participate in the program. A responsible company official must sign the application agreement indicating understanding of the Privacy Act restrictions relating to the use of this service. Non-Transferable: Acceptance for participation is not transferable. I understand if this business is sold or its organizational structures changes, a new application must be filed. I further understand noncompliance will result in the business and/or the individuals listed on this application, being suspended from participation in the IVES program. Privacy Act Notice: Our right to ask for information is 5 U.S.C 301 and the Internal Revenue Code Section 6109 and applicable regulations. The registration information we are requesting is used to create an account for you, authenticate your identity and for billing purposes. We may disclose the information to the Department of Justice, to enforce the tax laws, civil and criminal, to cities, states, the District of Columbia and U.S. commonwealths or possessions to carry out their tax laws. we may give it to other countries under a tax treaty, to federal and state agencies to enforce federal non-tax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. Your participation in the Income Verification Express Services (IVES) program is voluntary; however, if you do not provide all or part of the information required to create your account, you will not be eligible for access to IVES. Under the penalties of Perjury, I declare 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. In addition, I have read the Internal Revenue Service rules and procedures for participating in the Income Verification Express Service program and I agree to abide by them and to pay resulting fees timely. I understand failure to do so will result in a temporary or permanent exclusion from the program. Name and title of Principal, Partner or Owner (type or print) Catalog Number 48547A Signature of Principal, Partner or Owner www.irs.gov Date signed Form 13803 (Rev. 9-2016)
Extracted from PDF file 2016-federal-form-13803.pdf, last modified September 2016

More about the Federal Form 13803 Other TY 2016

We last updated the lncome Verification Express Service (IVES) Application in May 2017, so this is the latest version of Form 13803, fully updated for tax year 2016. You can download or print current or past-year PDFs of Form 13803 directly from TaxFormFinder. You can print other Federal tax forms here.


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Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 13803 from the Internal Revenue Service in May 2017.

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Historical Past-Year Versions of Federal Form 13803

We have a total of four past-year versions of Form 13803 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2016 Form 13803

Form 13803 (Rev. 9-2016)

lncome Verification Express Service (IVES) Application 2015 Form 13803

Form 13803 (Rev. 7-2011)

lncome Verification Express Service (IVES) Application 2012 Form 13803

Form 13803 (Rev. 7-2011)

Income Verification Express Service  Application 2011 Form 13803

Form 13803 (Rev. 11-2009)


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