Form 56-F Notice Concerning Fiduciary Relationship OMB No.

1545-2159
(Rev. December 2009)
Department of the Treasury
of Financial Institution For IRS Use Only
Internal Revenue Service (Internal Revenue Code sections 6036, 6402, and 6903)

Part I Identification
1 Name of person for whom you are acting (as shown on the tax return) 2 Employer identification number

3 Address of financial institution (number, street, and room or suite no.)

4 City, state, and ZIP code 5 Telephone no.

( )

6 Check the applicable box for the type of financial institution: ✔ Bank Thrift
7 Check here ! if the financial institution is insolvent.
8 Enter the ending date of the financial institution’s tax year (mo., day, yr.) !

9 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 Check this box ! 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
through 21 are to be completed only if the financial institution is or was a member of a group filing a consolidated return.
16 Name of person for whom you are acting (as shown on the tax return) 17 Employer identification number

18 Address of the common parent (number, street, and room or suite no.)

19 City, state, and ZIP code

20 Check here ! if a copy of this form has been sent to the common parent of the group.
21 Enter the tax year(s) that the financial institution is or was a member of the consolidated group !

Part II Authority

22 Evidence of fiduciary authority. Check applicable box(es), and attach copy of applicable orders:
a Appointment of conservator b Replacement of conservator
c Appointment of receiver d Order of insolvency
e ✔ Other evidence of creation of fiduciary relationship (describe) !

Part III Tax Notices

23 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 Revocation or Termination of Notice

Section A—Total Revocation or Termination
24 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 Date

For Paperwork Reduction Act Notice, see back of form. Cat. No. 12784J Form 56-F (Rev. 12-2009)
Form 56-F (Rev. 12-2009) Page 2

General Instructions still is a fiduciary for the same financial Part II—Authority
institution, should file Form 56-F with the IRS
Section references are to the Internal Revenue as soon as possible. Check the appropriate box and attach a copy
Code unless otherwise noted. of the appropriate order.
A fiduciary (defined above), who may have
previously filed Form 56 for a financial
Purpose of Form institution, and is still acting as a fiduciary for
Part III—Tax Notices
Use Form 56-F to notify the IRS of a fiduciary the same institution, should file a new Form All notices and other written communications
relationship only if that relationship is with 56-F as soon as possible. with regard to income, employment, and
respect to a financial institution (such as a excise taxes of the financial institution will be
bank or a thrift). Until you notify the IRS of Where To File addressed to the fiduciary, with the exception
the fiduciary relationship, notices of tax of notices sent to the common parent under
For purposes of section 6402(k) and section the provisions of Regulations section
liability sent to the last known address of the 6903, send Form 56-F to the Internal Revenue
taxpayer, or transferee, subject to liability are 1.1502-77. Other notices and written
Service Center where the financial institution communications will be addressed to the
considered sufficient compliance by the IRS for whom the fiduciary is acting files its income
with the requirements of the Internal Revenue fiduciary only as specified. For example, use
tax return. this line to identify a transferee tax liability
Code. However, if the financial institution is a
For purposes of section 6036, send Form under section 6901.
member of a consolidated group, the
56-F to the Advisory Group Manager,
provisions of Regulations section 1.1502-77
apply to the extent not modified by section
Advisory, Insolvency and Quality (AIQ) Office, Part IV—Revocation or
of the area office of the IRS having
6402(k) and Regulations section 301.6402-7.
jurisdiction over the person for whom you are Termination of Notice
In addition, the filing of Form 56-F is a acting. Complete this part if you are revoking or
requirement to secure a refund pursuant to terminating all prior notices concerning
section 6402(k) and Regulations section
301.6402-7.
Specific Instructions fiduciary relationships on file with the IRS for
the same tax matters and years or periods
Section 6036 and Regulations section Part I—Identification covered by this notice concerning fiduciary
301.6036-1 state that a notice is required of a relationship.
receiver in proceedings other than Lines 1–5. Provide all the requested
bankruptcy, and other like fiduciaries. Section information concerning the financial institution
in this part.
Signature
6402(k) and Regulations section 301.6402-7
state that a fiduciary of an insolvent financial Sign Form 56-F and enter the title describing
Line 2. Section 6109 requires that the your role as a fiduciary (receiver or
institution must file Form 56-F to secure its taxpayer’s identification number must be
position with respect to any refund which conservator).
disclosed. The principal purpose is to identify
may be available to a consolidated group. the financial institution for whom you are
Section 6903 and Regulations section acting. Paperwork Reduction Act Notice. We ask for
301.6903-1 state that every person acting in a Line 7. Check this box if the financial the information on the form to carry out the
fiduciary capacity must file a written notice institution is insolvent within the meaning of Internal Revenue laws of the United States.
with the IRS. 12 U.S.C. 191, 12 U.S.C. 1821(c)(5)(A), 12 You are required to give us the information.
U.S.C. 1464(d)(2)(A), 12 U.S.C. 1464(d)(2)(C)(i) We need it to ensure that you are complying
Who Should File or any applicable state law (or any successor with these laws and to allow us to figure and
statute which adopts a substantially similar collect the right amount of tax.
Form 56-F should be filed instead of Form
56, Notice Concerning Fiduciary Relationship, statute). You are not required to provide the
by the federal agency acting as a fiduciary Lines 9–13. Provide all the requested information requested on a form that is
(defined below) in order to notify the IRS of information regarding the fiduciary in this part. subject to the Paperwork Reduction Act
the creation, termination, or change in status For example, on line 9 enter the full name of unless the form displays a valid OMB control
of a fiduciary relationship with a financial the fiduciary (such as the Federal Deposit number. Books or records relating to a form or
institution. Insurance Corporation or similar federal its instructions must be retained as long as
agency). their contents may become material in the
Definition Line 10. The contact person should be the
administration of any Internal Revenue law.
Generally, tax returns and return information
Fiduciary. A fiduciary means the Federal individual within the federal agency who has are confidential, as required by section 6103.
Deposit Insurance Corporation, or other the authority to handle all tax matters on The time needed to complete and file Form
federal agency authorized by law to act as a behalf of the financial institution. 56-F will vary depending on individual
receiver or conservator of a financial
Lines 16–21. Provide all the requested circumstances. The estimated average time is:
institution. The term also includes any federal
instrumentality, subsidiary, or agency that is a information in this part concerning the Recordkeeping 7 hrs., 39 min.
predecessor or successor of this agency that common parent of a consolidated group
which includes (or included) the financial Learning about the
is so authorized.
institution (if applicable). law or the form 47 min.
When To File If the form is submitted in compliance with Preparing the form 57 min.
the regulations under section 6402(k), the Copying, assembling,
Form 56-F must be filed with the IRS within
identification number of the common parent and sending the form
10 days from the date the fiduciary is
should be disclosed. to the IRS 0 min.
appointed to act as a receiver or conservator.
In addition, it should be filed in every If the financial institution was a member of If you have comments concerning the
subsequent tax year that the fiduciary more than one consolidated group during any accuracy of these time estimates or
continues to act as the receiver or year(s) to which the fiduciary may claim a suggestions for making Form 56-F simpler, we
conservator for that financial institution for refund under section 6402(k), then the would be happy to hear from you. You can
purposes of section 6402(k). fiduciary must file a separate Form 56-F write to the Internal Revenue Service, Tax
If a Form 56-F has been filed for a solvent providing the information on each parent. Products Coordinating Committee,
financial institution by the fiduciary and Line 20. Check the box if a copy of the form SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
subsequently that financial institution was sent to the appropriate common parent NW, IR-6526, Washington, DC 20224. Do not
becomes insolvent, the fiduciary should file a in compliance with the Regulations section send the form to this address. Instead, see
new Form 56-F and check the box on line 7. 301.6402-7. Where To File on this page.
Note. A fiduciary (defined above), who was
appointed a fiduciary of a financial institution
prior to the issuance of Form 56-F and who