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Form 8655 Reporting Agent Authorization

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form 8655(Rev. October 2018)Department of the Treasury internal revenue Service Reporting Agent Authorization Information about form 8655 and its instructions is at No. 1545-1058Taxpayer1aName of taxpayer (as distinguished from trade name)1bTrade name, if any 2 Employer identification number (EIN)3Address (number, street, and room or suite no.)City or town, state, and ZIP code 4 If you are a seasonal employer, check here ....... 5 Other identification number (optional)6Contact person 7 Daytime telephone number 8 Fax numberReporting Agent9Name (enter company name or name of business)10 Employer identification number (EIN)11Address (number, street, and room or suite no.)

Form 8655 (Rev. October 2018) Department of the Treasury Internal Revenue Service . Reporting Agent Authorization Information about Form 8655 and its instructions is at

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