Fillable IRS Form 8655 (Rev. January 2012) - Internal Revenue Service
Reporting Agent Authorization
(Rev. November 2009)
Department of the Treasury Internal Revenue Service
OMB No. 1545-1058
1a Name of taxpayer (as distinguished from trade name) 1b Trade name, if any 3 Address (number, street, and room or suite no.) City or town, state, and ZIP code 6 Contact person 7 Daytime telephone number 8 Fax number 2 Employer identification number (EIN) 4...
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