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Federal Free Printable Form W-12 (Rev. October 2023) for 2024 Federal IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal

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IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal
Form W-12 (Rev. October 2023)

W-12 IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal Form (Rev. October 2023) Department of the Treasury Internal Revenue Service Go to www.irs.gov/FormW12 for instructions and the latest information. 1 Name and PTIN First name (Print in ink or Type) Middle name Initial application 2 Year of Application/ Renewal 3 SSN and Date of Birth You must provide your SSN or check the N/A box OMB No. 1545-2190 Renewal application Last name (Enter PTIN: P ) If you checked the “Initial application” box and are submitting this form between October 1 and December 31, indicate below whether you want your PTIN to be valid for the current calendar year or the next calendar year. Current calendar year Next calendar year Prior year(s) (YYYY): If you are applying for a prior year(s), write each year(s) below. Use the following format. (YYYY) See line 2 instructions for additional guidance. Prior year(s) SSN Date of birth (MM/DD/YYYY) Provide your Social Security Number (SSN). If you have an SSN, you are required to provide it. / / Failure to provide your SSN or check the N/A box will result in your PTIN application being rejected. If you do not have an SSN, then check the N/A box. N/A Street address. Use a P.O. box number only if the post office does not deliver mail to your street address. 4 Personal Mailing Address and Phone Number City or town, state or province, country, and ZIP or foreign postal code. Do not abbreviate name of country. Phone Number ( ) - 5a Business Business address Check here if your business address is the same as your personal mailing address. If different, enter it below. Mailing Address and Phone Number City or town, state or province, country, and ZIP or foreign postal code. Do not abbreviate name of country. Domestic business phone number ( b Business Identification ) - International business phone number EXT. + Are you self-employed or an owner, partner, or officer of a tax return preparation business? If “Yes,” then complete this line. If “No,” go to line 6. Enter the business name. Your CAF Number EIN Yes No EFIN - Website address (optional) For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form W-12 (Rev. 10-2023) Cat. No. 55469F For Internal Use Only PID: CS: Date & Int: LTR: Page 2 Form W-12 (Rev. 10-2023) 6 Email Address Enter the email address that should be used to contact you. 7 Past Felony Convictions Have you been convicted of a felony in the past 10 years? You must check a box Yes No If “Yes,” you If “Yes,” list the date and the type of felony conviction(s). must provide an explanation. If this line is left blank, your form will not be processed 8 Address of Your Last U.S. Individual Income Tax Return Filed 9 Filing Status and Tax Year on Last U.S. Individual Income Tax Return Filed Enter the address used on your last U.S. individual income tax return you filed. Check here if you have never filed a U.S. income tax return or do not have a U.S. income tax filing requirement. If this is an initial application, See line 8 instructions for documents that must be submitted with this form. Single Head of Household Married filing jointly Qualifying widow(er) with dependent child Married filing separately Tax Year (YYYY) Note: If your last return was filed more than 4 years ago, see instructions. 10 Federal Tax Compliance Are you current on both your individual and business federal taxes, including any corporate and employment tax obligations? Note: If you have never filed a U.S. individual income tax return because you are not required to do so, check the “Yes” box. You must check a box Yes No If this line is left blank, your If “No,” provide an explanation. form will not be processed 11 Data Security I am aware that paid tax return preparers must have a data security plan to provide data and system security Responsibilities protections for all taxpayer information. Form W-12 (Rev. 10-2023) Page 3 Form W-12 (Rev. 10-2023) 12 Professional Credentials Check all that apply. Note: DO NOT check any professional credentials that are currently expired or retired. Enter state abbreviation and appropriate number(s). If the expiration date is left blank or incomplete, that professional credential will NOT be added when the application is processed. Attorney—Licensed in which jurisdiction(s): Number(s): Expiration Date(s): Certified Public Accountant (CPA)— Licensed in which jurisdiction(s): Number(s): Expiration Date(s): Enrolled Agent (EA) Number(s): Expiration Date(s): Enrolled Actuary Number(s): Expiration Date(s): Enrolled Retirement Plan Agent (ERPA) Number(s): Expiration Date(s): State Regulated Tax Return Preparer —Licensed in which jurisdiction(s): Number(s): Expiration Date(s): Certifying Acceptance Agent (CAA) Number: None 13 Fees The fee is an application processing fee and is nonrefundable. The fee to obtain or renew a PTIN is $19.75 for 2024. Full payment must be included with your application, or it will be rejected. You must submit a separate check or money order for each calendar year. Indicate the calendar year you intend the payment for on each check or money order. If your payment(s) is returned your PTIN will be placed in Suspended status. You are responsible for submitting the proper payment(s) to make your PTIN Active. Make your check or money order payable to IRS Tax Pro PTIN Fee for the correct fee amount required based on the calendar year(s) you are registering or renewing your PTIN. Do not paper clip, staple, or otherwise attach the payment to Form W-12. See the PTIN payment fee schedule below. 2024 PTIN fee: $19.75 2023 - 2021 PTIN fee: $19.75 No fee is due for years 2020 or prior. 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. I understand any false or misleading information may result in criminal penalties and/or the denial or termination of a PTIN. CAUTION: If you're a foreign preparer that resides outside of the U.S. and you obtain a PTIN without a Social Security number, you are not authorized to prepare returns in the U.S. for compensation. Your signature (Please use blue or black ink) How To File Date (MM/DD/YYYY) / / Online. Go to the webpage www.irs.gov/ptin for information. Follow the instructions to submit Form W-12. If you submit your application online, your PTIN generally will be provided to you immediately after you complete the application. By mail. Complete Form W-12. Send the form to: IRS Tax Professional PTIN Processing Center PO Box 380638 San Antonio, TX 78268 Note: Allow 6 weeks for processing of PTIN applications. For additional information, refer to the separate Instructions for Form W-12. If your application is incomplete and you do not supply the required information upon request, the IRS will be unable to process your application. For Internal Use Only Form W-12 (Rev. 10-2023)
Extracted from PDF file 2023-federal-form-w-12.pdf, last modified October 2023

More about the Federal Form W-12 Other TY 2023

We last updated the IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal in January 2024, so this is the latest version of Form W-12, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form W-12 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 W-12 from the Internal Revenue Service in January 2024.

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Historical Past-Year Versions of Federal Form W-12

We have a total of thirteen past-year versions of Form W-12 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form W-12

Form W-12 (Rev. October 2023)

2022 Form W-12

Form W-12 (Rev. October 2022)

2021 Form W-12

Form W-12 (Rev. May 2021)

2020 Form W-12

Form W-12 (Rev. October 2020)

2019 Form W-12

Form W-12 (Rev. October 2019)

2018 Form W-12

Form W-12 (Rev. October 2017)

2017 Form W-12

Form W-12 (Rev. October 2017)

2016 Form W-12

Form W-12 (Revised October 2015)

IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal 2015 Form W-12

Form W-12 (Revised October 2015)

IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal 2014 Form W-12

Form W-12 (Revised October 2014)

IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal 2013 Form W-12

Form W-12 (Revised January 2013)

IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal 2012 Form W-12

Form W-12 (Revised September 2012)

IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal 2011 Form W-12

Form W-12 (Revised November 2011)


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