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Outpatient Complete and Fax to: (877) 779-5234 Prior Authorization/REFERRAL Fax Form Request for additional units. Existing Authorization Units Urgent Request I certify this request is urgent and
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877 779 5234 is a form for reporting foreign bank accounts to the Internal Revenue Service (IRS).
US persons who have a financial interest in or signature authority over foreign financial accounts with an aggregate value exceeding $10,000 at any time during the calendar year.
Form 877 779 5234 must be filled out electronically and submitted through the Financial Crimes Enforcement Network (FinCEN) website.
The purpose of 877 779 5234 is to report foreign bank accounts and financial assets to the IRS to help combat tax evasion.
Information such as the account number, financial institution's name and address, type of account, maximum account value, and information of the account owner.
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