Legal Name Change Request
COMPANY INFORMATION
Company DBA Name Company Number for Payroll (found at top of your payroll reports) Federal Employer Identification Number (FEIN) currently used Please provide State Employer Identification Numbers (EIN) for every state in which you have employees. Attach a separate sheet of paper if necessary. State ______ State ______ State ______ Acct. # Withholding ____________________ Acct. # Withholding ____________________ Acct. # Withholding ____________________ Acct. # Unemployment ____________________________ Acct. # Unemployment ____________________________ Acct. # Unemployment ____________________________
FORMER BUSINESS NAME & INFORMATION
[ M U S T B E T H E S A M E A S I N F O R M AT I O N O N F I L E W I T H T H E I R S ]
Former Legal Name of Business Former Legal Phone Number Former Fax Number
NEW BUSINESS NAME & INFORMATION
[MUST BE THE SAME AS INFORMATION ON FILE WITH THE IRS]
New Legal Name of Business New New Legal Business Phone Number New Fax Number
AUTHORIZATION TO CHANGE BUSINESS NAME
Please note the following regarding your Legal Name Change Request:
If making a change to the legal name of an incorporated business, include a copy of the Certificate of Amendment to the Articles of Incorporation, Reporting Agent Authorization for Magnetic Tape/Electronic Filers and a State Reporting Agent Authorization for each state that you have employee’s. When your request is received, a representative from our Entity Control group will contact you to gather the additional information our service will need to complete the legal name change with federal and state agencies on your behalf. If you are not a payroll tax client, you must make these changes with tax agencies. Please notify us of the changes, however, so that we may maintain accurate records in our payroll system. This form must be signed by a principal or duly authorized officer of the company (i.e., Chief Executive Officer, President, Partner, Owner or Corporate Official).
Authorized Signature
Title
Date
03/28/2008
Mail or fax completed form with any required documentation to: 877-471-2801
ATTN:
Intuit Inc. Attn: Entity Department P.O. Box 30005 Reno, Nevada 89520
TAX-201 (Rev. 03/26/2008)
Form
(Rev. May 2005)
8655
Reporting Agent Authorization
OMB No. 1545-1058
Department of the Treasury Internal Revenue Service
T axpayer
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 If you are a seasonal employer, check here 5 Other identification number
(
)
(
)
Reporting Agent
9 11 Name (enter company name or name of business) Address (number, street, and room or suite no.) City or town, state, and ZIP code 10 Employer identification number (EIN)
Computing Resources, Inc. PO Box 30005 Reno, Nevada 89520-3005
12 Contact person 13 Daytime telephone number
88 0146711
14 Fax number
RAF Agent ( 775 ) 424-8000 Authorization of Reporting Agent To Sign and File Returns
15
( 866 ) 293-2047
Use the entry lines below to indicate the tax return(s) to be filed by the reporting agent. Enter the beginning year of annual tax returns or beginning quarter of quarterly tax returns. See the instructions for how to enter the quarter and year. Once this authority is granted, it is effective until revoked by the taxpayer or reporting agent. 941 940-PR 944-PR
940 943-PR
N/A
N/A
944
N/A
941-PR 945
N/A
941-SS 1042
N/A N/A
943 CT-1
N/A
N/A
Authorization of Reporting Agent T Make Deposits and Payments o
16 Use the entry lines below to enter the starting date (the first month and year) of any tax return(s) for which the reporting agent is authorized to make deposits or payments. See the instructions for how to enter the month and year. Once this authority is granted, it is effective until revoked by the taxpayer or reporting agent. 941 943
940 1042
N/A
N/A
944 990-C
N/A
1120
N/A
CT-1
N/A
945 990-PF
720
N/A
990-T
N/A N/A
1041
N/A
Disclosure of Information to Reporting Agents
17a b 18a b Check here to authorize the reporting agent to receive or request copies of tax information and other communications from the IRS related ˙ to the authorization granted on line 15 and/or line 16 ˙ Check here if the reporting agent also wants to receive copies of notices from the IRS The reporting agent is authorized to receive otherwise confidential taxpayer information from the IRS to assist in responding to certain IRS 2005 notices relating to the Form W-2 series information returns. This authority is effective for calendar year forms beginning . The reporting agent is authorized to receive otherwise confidential taxpayer information from the IRS to assist in responding to certain IRS notices relating to the Form 1099 series information returns. This authority is effective for calendar year forms beginning . 2005 Check here to authorize the reporting agent to sign and file state or local returns related to the authorization granted on lin e 15 and/or line 16
Form W-2 series or Form 1099 series Disclosure Authorization
State or Local Authorization
19
˙
Authorization Agreement
I understand that this agreement does not relieve me, as the taxpayer, of the responsibility to ensure that all tax returns are filed and that all deposits and payments are made. If line 15 is completed, the reporting agent named above is authorized to sign and file the return indicated, beginning with the quarter or year indicated. If any starting dates on line 16 are completed, the reporting agent named above is authorized to make deposits and payments beginning with the period indicated. Any authorization granted remains in effect until it is revoked by the taxpayer or reporting agent. I am authorizing the IRS to disclose otherwise confidential tax information to the reporting agent relating to the authority granted on line 15 and/or line 16, including disclosures required to process Form 8655. Disclosure authority is effective upon signature of taxpayer and IRS receipt of Form 8655. The authority granted on Form 8655 will not revoke any Power of Attorney (Form 2848) or Tax Information Authorization (Form 8821) in effect.
Sign Here
I certify I have the authority to execute this form and authorize disclosure of otherwise confidential information on behalf of the taxpayer.
03/28/2008
Signature of taxpayer Title Form Date
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
BAA
8655 (Rev. 5-2005)
Form 8655 (Rev. 5-2005)
Page
2
General Instructions
What’s New
● Magnetic tape is no longer a filing method for the returns on line 15. ● The “Other” box in line 16 has been deleted. Authority to make deposits and payments can only be granted for the forms listed in line 16. ● New Forms 944 and 944-PR have been added to line 15. New Form 944 has been added to line 16. Form 944 should be available for calendar year 2006. ● Lines 18a and 18b have been added to allow taxpayers to grant reporting agents disclosure authority for the Form W-2 series and Form 1099 series information returns.
Withdrawing from reporting authority. A reporting agent can withdraw from authority by filing a statement with the IRS, either on paper or using a delete process. The statement must be signed by the reporting agent (if filed on paper) and identify the name and address of the taxpayer and authorization(s) from which the reporting agent is withdrawing. For information on the delete process, see Pub. 1474.
Specific Instructions
Line 15
Use the “YYYY” format for annual tax returns. Use the “MM/YYYY” format for quarterly tax returns, where “MM” is the ending month of the quarter the named reporting agent is authorized to sign and file tax returns for the taxpayer. For example, enter “03/2005” on the line for “941” to indicate you are authorizing the named reporting agent to sign and file Form 941 for the January–March quarter of 2005 and subsequent quarters.
Purpose of Form
Form 8655 is used to authorize a reporting agent to: ● Sign and file certain returns; ● Make deposits and payments for certain returns; ● Receive duplicate copies of tax information, notices, and other written communication regarding any authority granted; and ● Provide IRS with information to aid in penalty relief determinations related to the authority granted on Form 8655.
Line 16
Use the “MM/YYYY” format to enter the starting date, where “MM” is the first month the named reporting agent is authorized to make deposits or payments for the taxpayer. For example, enter “08/2005” on the line for “720” to indicate you are authorizing the named reporting agent to make deposits or payments for Form 720 starting in August 2005 and all subsequent months.
Authority Granted
Once Form 8655 is signed, any authority granted is effective beginning with the period indicated on lines 15 or 16 and continues indefinitely unless revoked by the taxpayer or reporting agent. No authorization or authority is granted for periods prior to the period(s) indicated on Form 8655. Disclosure authority by checking the box in line 17a is effective with the dated signature of the taxpayer on Form 8655. Any authority granted on Form 8655 does not revoke and has no effect on any authority granted on Forms 2848 or 8821, or any third-party designee checkbox authority.
Who Must Sign
Sole proprietorship–The individual owning the business. Corporation (including an LLC treated as a corporation)–Generally, Form 8655 can be signed by: (a) an officer having legal authority to bind the corporation, (b) any person designated by the board of directors or other governing body, (c) any officer or employee on written request by any principal officer, and (d) any other person authorized to access information under section 6103(e). Partnership (including an LLC treated as a partnership) or an unincorporated organization–Generally, Form 8655 can be signed by any person who was a member of the partnership during any part of the tax period covered by Form 8655. Single member limited liability company (LLC) treated as a disregarded entity–The owner of the LLC. Trust or estate–The fiduciary. Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. Form 8655 is provided by the IRS for your convenience and its use is voluntary. If you choose to authorize a reporting agent to act on your behalf, under section 6109, you must disclose your EIN. The principal purpose of this disclosure is to secure proper identification of the taxpayer. We need this information to gain access to your tax information in our files and properly respond to your request. If you do not disclose this information, the IRS may suspend processing your reporting agent authorization and may not be able to honor your reporting agent authorization until you provide your EIN. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation, and to cities, states, and the District of Columbia for use in administering their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement agencies and intelligence agencies to combat terrorism. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. The time needed to complete and file Form 8655 will vary depending on individual circumstances. The estimated average time is 6 minutes. If you have comments concerning the accuracy of this time estimate or suggestions for making Form 8655 simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6406, Washington, DC 20224. Do not send Form 8655 to this address. Instead, see Where To File above.
Where To File
Send Form 8655 to: Internal Revenue Service Accounts Management Service Center MS 6748 RAF Team 1973 North Rulon White Blvd. Ogden, UT 84404 You can fax Form 8655 to the IRS. The number is 801-620-4142.
Additional Information
Additional information concerning reporting agent authorizations may be found in: ● Pub. 1474, Technical Specifications Guide for Reporting Agent Authorizations and Federal Tax Depositors, and ● Rev. Proc. 2003-69. You can find Rev. Proc. 2003-69 on page 403 of Internal Revenue Bulletin 2003-34 at www.irs.gov/pub/irs-irbs/irb03-34.pdf.
Substitute Form 8655
If you want to prepare and use a substitute Form 8655, see Pub. 1167, General Rules and Specifications for Substitute Forms and Schedules. If your substitute Form 8655 is approved, the form approval number must be printed in the lower left margin of each substitute Form 8655 you file with the IRS.
Revoking an Authorization
If you have a valid Form 8655 on file with the IRS, the filing of a new Form 8655 revokes the authority of the prior reporting agent beginning with the period indicated on the new Form 8655. However, the prior reporting agent is still an authorized reporting agent and retains any previously granted disclosure authority for the periods prior to the beginning period of the new reporting agent’s authorization unless specifically revoked. If the taxpayer wants to revoke an existing authorization, send a copy of the previously executed Form 8655 to the IRS at the address under Where To File, above. Re-sign the copy of the Form 8655 under the original signature. Write REVOKE across the top of the form. If you do not have a copy of the authorization you want to revoke, send a statement to the IRS. The statement of revocation must indicate that the authority of the reporting agent is revoked and must be signed by the taxpayer. Also, list the name and address of each reporting agent whose authority is revoked.
TAXPAYER FEDERAL I.D. NUMBER
1.
Limited Power of Attorney And Tax Information Authorization
(In accordance with Internal Revenue Service Revenue Procedures – substitute for Form 8655)
2. 3. 4. 5.
New Federal I.D. Number Seasonal or Intermittent Filer Additional State Authorization Only
FOR REPORTING AGENT USE ONLY Company Number
6. TAXPAYER LEGAL NAME (Include spaces, ampersands, and hyphens. Do not enter any other punctuation.): 7. DBA NAME (Include spaces, ampersands, and hyphens. Do not enter any other punctuation.): 8. LEGAL ADDRESS (As on file with the Internal Revenue Service. Please ensure you show street address, city, state and zip code):
STREET ADDRESS
CITY, STATE AND ZIP CODE
REPORTING AGENT:
Computing Resources, Inc. PO Box 30005 Reno, Nevada 89520-3005
Phone: Federal EIN:
(800) 422-8800 88-0146711
Fax:
(866) 293-1994
Computing Resources, Inc., an Intuit company, is authorized as a designee of the taxpayer to receive copies of notices, correspondence, transcripts, deposit frequency data, or other information with respect to employment tax returns filed and deposits made by the designee. Note: Do Not Change Taxpayer Address of Record If the taxpayer is required to file a return electronically or to submit tax deposit data electronically, Computing Resources, Inc. is required to file the return and submit the deposit data electronically for the taxpayer. If the taxpayer is not required to file or deposit electronically, Computing Resources, Inc. may file or make deposits on their behalf in one of the methods indicated below:
9. For Reporting Agent Use Only Filing Method M M E E Filing Period
(mm/yyyy) m (yyyy)
10. STATE FORMS/DEPOSITS FEDERAL TAX DEPOSITS Deposit Payment Form Period Method 941 940 E E E E STATE NAME STATE ID NUMBER TAX TYPE FILING PERIOD
(mm/yyyy) m
Form 941 940 943 945
(mm/ yyyy)
(yyyy)
N/A
(yyyy)
943 945
N/A
The Limited Power of Attorney and Tax Information Authorization revokes all earlier tax filing powers of attorney and tax information authorizations on file with respective tax authorities with respect to the same tax matters and tax periods covered hereby, but has no effect on any other Power of Attorney or authorization. 11. Signature of Taxpayer or Authorized Representative
I understand that this authorization does not absolve me as the taxpayer of the responsibility to ensure that all returns are filed and all taxes are paid on time. Computing Resources, Inc. is hereby appointed Reporting Agent with the authority to sign and file employment tax returns and make deposits electronically, on magnetic media, or on paper, for the above stated taxpayer to Federal, State, and Local jurisdictions. This authorization shall include the appropriate State and Local forms and related deposits, Federal employment tax forms with related deposits as designated above, beginning with the tax period indicated and remaining in effect through subsequent periods until the taxpayer or designee notifies IRS or the appropriate State and Local jurisdictions, that this authorization is terminated or revoked. I authorize the taxing authorities to disclose otherwise confidential information to Computing Resources, Inc. as necessary to discuss or provide filing or account information relating to employment tax returns filed or to be filed and/or deposits made or to be made by Computing Resources, Inc. (including information relating to any penalty resulting from such deposits) as well as deposit requirements. I certify that I have the authority to authorize the disclosure of otherwise confidential tax data on behalf of the taxpayer.
CRI / Intuit Payroll Services LPOA v030907
Printed Name (Required)
Title (Required)
Telephone Number
Signature (Required)
03/28/2008
Date (Required)
Richard K. Valentine, Director of Tax Operations Computing Resources Inc., an Intuit Company
REQUIRED
TAXPAYER FEDERAL I.D. NUMBER
1.
Limited Power of Attorney And Tax Information Authorization
(In accordance with Internal Revenue Service Revenue Procedures – substitute for Form 8655) CONTINUED – PAGE 2
2. 3. 4. 5.
New Federal I.D. Number Seasonal or Intermittent Filer Additional State Authorization Only
FOR REPORTING AGENT USE ONLY Company Number
12. This Power of Attorney must be acknowledged before a notary public if you are doing business, or plan to do business, in one or more of the following states: Alabama, Delaware, Indiana, Oklahoma, South Carolina, and/or West Virginia If the power of attorney is granted to a person other than an attorney licensed to practice in said state, or certified public accountant, the taxpayer(s) signature must be notarized below. I,
NAME OF WITNESS
, affirm that
NAME OF PERSON(S) SIGNING AS OR FOR THE TAXPAYER(S) ON PAGE 1
appeared to be of sound mind and free from duress at the time this power of attorney was signed, and that he or she affirmed that he or she was aware of the nature of this document and signed it freely and voluntarily.
SIGNATURE OF WITNESS
DATE
The person(s) signing as or for the taxpayer(s) below and on page 1 of this Limited Power of Attorney and Tax Information Authorization appeared this day before a notary public and acknowledge this power of attorney as a voluntary act and deed.
Printed Name, Signature, and Title (Owner, Partner, Officer, etc.)
SUBSCRIBED AND SWORN to before me on this _________ day of ______________,
(month) (year)
(Signature of Notary Public)
Notary Public, State of: My Commission expires: NOTARIAL SEAL (If required by State Law)
CRI / Intuit Payroll Services LPOA v022005
Instructions for Completing the Limited Power of Attorney and Tax Information Authorization
(In accordance with Internal Revenue Service Revenue Procedures – substitute for Form 8655)
The instructions for completing this form are for those items that are not self-explanatory.
Item 1 – Employer Identification Number (EIN) – Nine-digit Employer Identification Number (EIN) issued by the IRS to each employer. If you do not have an EIN, apply for one on Form SS-4, Application for Employer Identification Number. Item 2 – New Federal ID Number – Check this box if you have recently applied for an EIN and have not yet received notice CP575 (Verification of your EIN) from the IRS. Item 3 – Seasonal or Intermittent Filer – Check this box if your business is seasonal or intermittent and there is any quarter during the calendar year for which you will not pay wages. Item 4 – Additional State Authorization Only – check this box ONLY if you are a current customer who is adding a state to which you do business. Item 5 – Company Number – For Reporting Agent’s use. Item 6 – Taxpayer Legal Name – Enter the Sole Proprietor, Owner’s, Business or Company name. This must match the name on IRS records. Only the first 35 characters of the first name line are used. Do not abbreviate or omit spaces – include only the first 35 characters. Valid characters are A-Z, 0-9, ampersand ( & ), hyphen ( - ), and one blank between each word. The comma ( , ), period ( . ), number sign (# ),apostrophe ( ‘ ) and multiple blanks are invalid characters. Do not use the word “The” as the first word unless it is followed by only one other word. Include legal/formal suffixes with individual names (MD, PhD, CPA, Jr., Sr., III, etc.); but, DO NOT include general/informal titles such as owner, accountant, attorney, or prefixes such as Dr., Mr., Mrs., etc. Item 7 – DBA Name – Enter the trade name of the business if different from the legal name. The trade name is the “doing business as” name. Follow the same instructions as shown for Item 6 above; however, DO NOT enter “DBA” or “TA” on this line; show the name only. NOTE: Partnerships should enter the “doing business as” name in Item 6. Enter the general partner’s name or the first partner’s name in Item 7. If a Corporation is a general partner, do not include the name in Item 7. Item 8 – Street Address, City, State, ZIP Code – Enter address of taxpayer. Valid characters are A-Z, 0-9, ampersand ( & ), hyphen ( - ), slash ( / ), percent ( % ), and one blank between each word. Invalid characters are the number sign ( # ), period ( . ), apostrophe ( ‘ ) and multiple blanks. Item 9 – For Reporting Agent’s use – Indicate filing method (Electronic, Magnetic, or both) for all tax returns to be filed and/or FTDs to be made by this Reporting Agent for this taxpayer. For Tax Form 940 enter the Tax Year (1999, 2000, etc.) this agent will start the annual filing. For Tax Form 941, enter the ending month of the quarter and year (03/2000, 06/2000, 09/2000, 12/2000), the Reporting Agent will file this return for the first time. For FTDs, enter the first month and year (021998, 062000, etc.) this Reporting Agent will make any deposit, regardless of the tax type(s). Item 10 – State Forms/Deposits – List each state in which you are doing business or plan to do business. Indicate the appropriate State ID number. If you do not have a State ID #, apply for one by contacting the applicable State Agency. Mark the State ID # field as “Applied For” in those State(s) where you have applied and are awaiting the ID. Indicate the appropriate Tax Type (WH for Withholding and/or UI for Unemployment insurance). For Filing Period, enter the quarter and year (011999, 022000). Item 11 – Signature of Taxpayer or Authorized Representative – Taxpayer name, title and signature to be reflected in this section. Acceptable signatures are as follows: Sole Proprietor LLC/LLP Corporation (any) Owner An individual or partner who is authorized to sign this form on behalf of the LLC/LLP An individual or officer who is authorized to sign this form on behalf of the corporation
Item 12 – Notarization – If you are doing business in one of the states referenced on Page 2 of this form, this Limited Power of Attorney and Tax Information Authorization Form must be witnessed and acknowledged before a notary public. When notarized, both pages must be returned to Computing Resources, Inc.
CRI / Intuit Payroll Services LPOA v022003