Form W-12 - Irs Paid Preparer Tax Identification Number (Ptin) Application And Renewal
Download a blank fillable Form W-12 - Irs Paid Preparer Tax Identification Number (Ptin) Application And Renewal in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form W-12 - Irs Paid Preparer Tax Identification Number (Ptin) Application And Renewal with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3W-12
IRS Paid Preparer Tax Identification Number (PTIN)
Form
Application and Renewal
OMB No. 1545-2190
(Rev. October 2014)
Department of the Treasury
Information about Form W-12 and its separate instructions is available at
▶
Internal Revenue Service
1 Name and PTIN
First name
Middle name
Last name
(Print in ink or
Type)
Initial application
Renewal application
(Enter PTIN: P
)
If you checked the Initial application box and are applying for a PTIN between Oct. 1 and Dec. 31, indicate
2 Year of
below whether you want your PTIN to be valid for the current calendar year or the next calendar year.
Application/
Renewal
Current calendar year
Next calendar year
If you checked the Renewal application box and also need to renew for a previous calendar year, indicate the
year below and see the line 2 instructions for additional guidance.
Prior year(s):
,
,
(YYYY)
3 SSN and Date
SSN
Date of birth (month, day, year)
of Birth
-
-
/
/
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/province, and, if outside U.S., country. Include ZIP or postal code where appropriate. Do
not abbreviate name of country.
Phone Number (
)
-
Business address (if different than line 4 information above)
5a Business
Mailing
Address and
Phone Number
Business city or town, state/province, and, if outside U.S., country. Include ZIP or postal code where
appropriate. Do not abbreviate name of country.
Domestic business phone number
International business phone number
(
)
-
EXT.
+
5b Business Name
Enter the business name and website address (optional).
and Website
Address
6 Email Address Enter the email address that should be used to contact you.
7 Past Felony
Yes
No
Have you been convicted of a felony in the past 10 years?
Convictions
If “Yes,” list the date and the type of felony conviction(s).
W-12
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form
(Rev. 10-2014)
Cat. No. 55469F
ADVERTISEMENT
0 votes
Related Articles
Related forms
Instructions For Form W-12 - Irs Paid Preparer Tax Identification Number (ptin) Application And Renewal - 2014
Legal
Instructions For Form W-12 - Irs Paid Preparer Tax Identification Number (ptin) Application And Renewal - 2013
Financial
Instructions For Form W-12 - Irs Paid Preparer Tax Identification Number (ptin) Application And Renewal
Financial
Related Categories
Parent category: Financial