IRS 23-EP Application for Enrollment to Practice Before the Internal Revenue Service as an Enrolled Retirement Plan Agent Form

In the case of wanting to become enrolled in the practice before the internal revenue service, the following form has to be completed and submitted.

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Form   	23-EP	
(Rev. April 2012)
Department of the Treasury 
Internal Revenue Service	
Application for Enrollment to Practice Before the Internal Revenue Service as an Enrolled Retirement Plan Agent  (ERPA)	
See Instructions on Page 3	
OMB No. 1545-0950	
Important things you need to know and do before you file this form:
• Take and pass the Enrolled Retirement Plan Agent Special Enrollment\
 Examination
• Read Circular 230
• The application fee is $30.
Visit www.pay.gov to file and pay electronically. This fee is non-refundable.	
Check here if you are a former Internal Revenue Service Employee, and en\
ter the date you separated 
from the Service                                      .	
       /       /	
For IRS use: 
  
Date Enrolled: 
  
  
Enrollment Number:	
Part 1. Tell Us About Yourself
1 Your Social Security Number	
If you do not have an SSN, please check this box.
2 Your Full Legal Name	
Last	First	MI	
3Current Address	
Number                              Street                              \
         Suite or Apt. Number	
City	State	Zip Code	Country	
Your email Address:
Your Contact Telephone Number:	
4 Enter your PTIN number issued by the IRS or Candidate Number assigned by\
 the 
American Institute of Retirement Education (AIRE).
5Do you have an Employer Identification Number (EIN)?	Yes	No
If Yes, enter all EINs, business names, and addresses below (attach add\
itional pages, if necessary):	
EIN	Business Name	Business Address	
For Privacy Act and Paperwork Reduction Act Notice, see page 3.	Cat. No. 51483V	Form 	23-EP	 (Rev. 4-2012)

Form 23-EP (Rev. 4-2012)	Page 	2 	
6Do you have a Centralized Authorization File (CAF) number?	Yes	No
If Yes, enter all CAF numbers assigned to you (attach additional pages,\
 if necessary):	
7 Have you been sanctioned by a federal or state licensing authority?	Yes	No
8  Has  any application  you filed  with a court,  government  department, 
commission, or agency for admission to practice ever been denied?	
Yes	No
9 Have you been convicted of a tax crime or any felony?	
Yes	No
10  Have you been  permanently  enjoined from preparing  tax returns,  or 
representing others before the IRS?	
Yes	No
NOTE:  If you  answered  yes to question  7, 8, 9 or  10,  please  describe  on a separate  page, the matter,  including  the date  of
when the matter occurred, and provide any additional information about t\
he matter that you would like us to consider.
11 Are you a CPA?	
Yes	NoIf Yes, enter the states where you are licensed to practice.	
12
Are you an Attorney?	Yes	NoIf Yes, enter the States where you are licensed to practice.	
13
Are you a Registered Tax Return Preparer (RTRP)?	Yes	No
14 Are you an Enrolled Agent (EA)?	
Yes	No	
Part 2. Sign here
Under penalties of perjury, I declare that I have examined this applicat\
ion, and to the best of my knowledge and belief, it is true, correct, an\
d complete.
Signature	Date	
Form 	23-EP	 (Rev. 4-2011)	
Filling out this form:
It is important to answer all questions on the form. Failure to answer a\
ny questions or sign the form could result in processing delays.
An intentionally  false statement  or omission  identified  with your  application  is a violation  of Circular  230 10.51(a)(4)  and 18 U.S.C.  1001 
and may be grounds for suspension or disbarment from practice.

DRAFT AS OF April 6, 2012	
Form 23-EP (Rev. 4-2012)	Page 	3 	
Instructions:
• You must take and pass the EPRA-SEE before you can apply. 
You may register for the examination at www.erpaexam.org. 
Former IRS Employees:
Please Note: your eligibility to practice may be limited based 
upon your work experience. 
You may request a waiver to take the ERPA-SEE through the 
submission of an application within three (3) years from the date 
of your separation with the Internal Revenue Service (IRS). 
Please check the box at the top of the form which indicates you 
are requesting a waiver from taking the ERPA-SEE. See Circular 
230 Section 10.4(d) for more information. To gain full enrollment 
status you must take and pass the ERPA-SEE before you can 
apply. You may register for the examination at 
www.erpaexam.org. 
What if I don't have a Social Security 
Number?
If you are living and working in the United States (US), you are 
required to have a Social Security Number (SSN). If you are 
working outside of the US and you do not have an SSN or an 
ITIN, check the box on line 1. 
Electronic Application and Payments:
You can pay electronically by visiting www.pay.gov. 
Where to send this form:
You can use overnight mail or regular mail to send us this form. 
If you want to use regular mail: U.S. Treasury/Enrollment                                                \
     
PO Box 301510                                                           \
         
Los Angeles, CA 90030-1510 
If you want to use overnight mail:  Internal Revenue Service                                                \
     
Attn: Box 301510                                                        \
           
19220 Normandie Ave. Ste. B 
Torrance, CA. 90502
How long will it take to process your 
application for enrollment?
It generally takes about 60 days to process applications. Your 
enrollment status is not effective until we approve your request. 
You are not authorized to practice before the IRS as an ERPA 
until enrollment has been granted.
Who do I call if I have questions?
Please allow 60 days for processing before calling to check on 
the status of your application. To check on the status of your 
application, you may call 1-313-234-1280. Privacy Act and Paperwork Reduction Act Notice. Section 
330 of title 31 of the United States Code authorizes us to collect 
this information. We ask for this information to administer the 
program of enrollment to practice before the IRS. Applying for 
renewal of enrollment is voluntary; however, if you apply you 
must provide the information requested on this form. Failure to 
provide this information may delay or prevent processing your 
application; providing false or fraudulent information may 
subject you to penalties. Generally, this information is 
confidential pursuant to the Privacy Act. However, certain 
disclosures are authorized under the Act, including disclosure 
to: the Department of Justice, and courts and other adjudicative 
bodies, with respect to civil or criminal proceedings; public 
authorities and professional organizations for their use in 
connection with employment, licensing, disciplinary, regulatory, 
and enforcement responsibilities; contractors as needed to 
perform the contract; third parties as needed in an investigation; 
the general public to assist them in identifying enrolled 
individuals; state tax agencies for tax administration purposes; 
appropriate persons when the security of information may have 
been compromised for their use to prevent, mitigate, or remedy 
harm. 
You are not required to provide the information requested on 
a form that is subject to the requirements of the Paperwork 
Reduction Act unless the form displays a valid OMB control 
number. Books and records relating to a form or its instructions 
should be retained as long as their contents may become 
material in the administration of the law. The time needed to 
complete and file this form will vary depending on individual 
circumstances. The estimated average time is 30 minutes, 
including recordkeeping, learning about the law or the form, 
preparing the form, and copying and sending the form to the 
IRS. 
If you have comments concerning the accuracy of this time 
estimate or suggestions for making this form simpler, we would 
be happy to hear from you. You can write to Office of Enrolled 
Agent Policy & Management; P.O. Box 33968; Detroit, MI, 
48232. Do not send this form to this address; instead see the 
Where to send this form section of the instructions.