Form 56-F Notice Concerning Fiduciary Relationship Of Financial Institution {56-F}

Form (Rev. December 2009) Department of the Treasury Internal Revenue Service 56-F Notice Concerning Fiduciary Relationship of Financial Institution (Internal Revenue Code sections 6036, 6402, and 6903) OMB No. 1545-2159 For IRS Use Only Part I 1 Identification 2 Employer identification number Name of person for whom you are acting (as shown on the tax return) 3 Address of financial institution (number, street, and room or suite no.) 5 4 City, state, and ZIP code Telephone no. ( ) 6 7 8 9 Check the applicable box for the type of financial institution: Bank Thrift if the financial institution is insolvent. Check here Enter the ending date of the financial institution's tax year (mo., day, yr.) Fiduciary's name 10 Contact person 11 Address of fiduciary (number, street, and room or suite no.) 12 City or town, state, and ZIP code 13 Telephone no. ( ) 14 Check the applicable box if the fiduciary is a: Receiver Conservator 15 16 18 if the financial institution is or was a member of a group filing a consolidated return and complete lines 16 to 21 below: Lines 16 Check this box through 21 are to be completed only if the financial institution is or was a member of a group filing a consolidated return. Name of person for whom you are acting (as shown on the tax return) Address of the common parent (number, street, and room or suite no.) 17 Employer identification number 19 City, state, and ZIP code 20 21 if a copy of this form has been sent to the common parent of the group. Check here Enter the tax year(s) that the financial institution is or was a member of the consolidated group Part II 22 a c e Authority Evidence of fiduciary authority. Check applicable box(es), and attach copy of applicable orders: b Replacement of conservator Appointment of conservator Appointment of receiver d Order of insolvency Other evidence of creation of fiduciary relationship (describe) Part III 23 Tax Notices All notices and other written communications with regard to income, employment, and excise taxes of the financial institution (listed on line 1) will be addressed to the fiduciary. Indicate below if other notices and written communications should be addressed to the fiduciary. Include the type of tax, tax periods or years involved. Part IV 24 Revocation or Termination of Notice Section A--Total Revocation or Termination Evidence of termination or revocation of fiduciary authority (Check applicable box(es)): a Certified copy of court order revoking fiduciary authority attached. b Copy of certificate of dissolution or termination of a business entity attached. c Other evidence of termination of fiduciary relationship (describe) I certify that I have the authority to execute this notice concerning fiduciary relationship on behalf of the taxpayer. Please Sign Here Fiduciary's signature Title, if applicable Cat. No. 12784J Date Form For Paperwork Reduction Act Notice, see back of form. 56-F (Rev. 12-2009) American LegalNet, Inc. www.FormsWorkFlow.com Form 56-F (Rev. 12-2009) Page 2 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. still is a fiduciary for the same financial institution, should file Form 56-F with the IRS as soon as possible. A fiduciary (defined above), who may have previously filed Form 56 for a financial institution, and is still acting as a fiduciary for the same institution, should file a new Form 56-F as soon as possible. Part II--Authority Check the appropriate box and attach a copy of the appropriate order. Purpose of Form Use Form 56-F to notify the IRS of a fiduciary relationship only if that relationship is with respect to a financial institution (such as a bank or a thrift). Until you notify the IRS of the fiduciary relationship, notices of tax liability sent to the last known address of the taxpayer, or transferee, subject to liability are considered sufficient compliance by the IRS with the requirements of the Internal Revenue Code. However, if the financial institution is a member of a consolidated group, the provisions of Regulations section 1.1502-77 apply to the extent not modified by section 6402(k) and Regulations section 301.6402-7. In addition, the filing of Form 56-F is a requirement to secure a refund pursuant to section 6402(k) and Regulations section 301.6402-7. Section 6036 and Regulations section 301.6036-1 state that a notice is required of a receiver in proceedings other than bankruptcy, and other like fiduciaries. Section 6402(k) and Regulations section 301.6402-7 state that a fiduciary of an insolvent financial institution must file Form 56-F to secure its position with respect to any refund which may be available to a consolidated group. Section 6903 and Regulations section 301.6903-1 state that every person acting in a fiduciary capacity must file a written notice with the IRS. Part III--Tax Notices All notices and other written communications with regard to income, employment, and excise taxes of the financial institution will be addressed to the fiduciary, with the exception of notices sent to the common parent under the provisions of Regulations section 1.1502-77. Other notices and written communications will be addressed to the fiduciary only as specified. For example, use this line to identify a transferee tax liability under section 6901. Where To File For purposes of section 6402(k) and section 6903, send Form 56-F to the Internal Revenue Service Center where the financial institution for whom the fiduciary is acting files its income tax return. For purposes of section 6036, send Form 56-F to the Advisory Group Manager, Advisory, Insolvency and Quality (AIQ) Office, of the area office of the IRS having jurisdiction over the person for whom you are acting. Part IV--Revocation or Termination of Notice Complete this part if you are revoking or terminating all prior notices concerning fiduciary relationships on file with the IRS for the same tax matters and years or periods covered by this notice concerning fiduciary relationship. Specific Instructions Part I--Identification Lines 1­5. Provide all the requested information concerning the financial institution in this part. Line 2. Section 6109 requires that the taxpayer's identification number must be disclosed. The principal purpose is to identify the financial institution for whom you are acting. Line 7. Check this box if the financial institution is insolvent within the meaning of 12 U.S.C. 191, 12 U.S.C. 1821(c)(5)(A), 12 U.S.C. 1464(d)(2)(A), 12 U.S.C.