f56 - 2011 J Lew Fiduciary
f56 - 2011 J Lew Fiduciary
f56 - 2011 J Lew Fiduciary
Form
(Rev. December 2011)
Department of the Treasury
Internal Revenue Service
Identification
Part I
Name of person for whom you are acting (as shown on the tax return)
Identifying number
98-0624588
Address of person for whom you are acting (number, street, and room or suite no.)
Section A. Authority
1
If your authority as a fiduciary does not cover all years or tax periods, check here .
and list the specific years or periods
If the fiduciary listed wants a copy of notices or other written communications (see the instructions) check this box . . . .
and enter the year(s) or period(s) for the corresponding line 4 item checked. If more than 1 form entered on line 4h, enter the
form number.
Income
Gift
Estate
Generation-skipping transfer
706 series b
709 c
1120 h
Other (list)
940
Employment
If this item
is checked:
4b
4d
4f
4h:
4h:
For Paperwork Reduction Act and Privacy Act Notice, see the separate instructions.
Page
Part II
Name of court (if other than a court proceeding, identify the type of proceeding and name of agency)
Address of court
Date
Time
a.m.
p.m.
Signature
Part III
I certify that I have the authority to execute this notice concerning fiduciary relationship on behalf of the taxpayer.
Please
Sign
Here
Fiduciarys signature
Title, if applicable
Date
Form 56 (Rev. 12-2011)