0926 Form 13803 (PDF)

Official source: IRS Forms, Instructions & Publications (https://www.irs.gov/pub/irs-pdf/f13803.pdf), retrieved 2026-10-03. U.S. Government work (17 U.S.C. § 105).

---

OMB Number 1545-2032

For Official Use Only Control number

(September 2026)

Department of the Treasury - Internal Revenue Service

(Read the instructions carefully before submitting this form)

1a. Check the type of application you are submitting New Renewal Amended Add new location Cancellation Address change

1b. Existing IVES participant ID number (if applicable)

2. Check the box that describes your organization status Partnership Sole proprietorship Corporation LLC

Other (specify)

3. Reason(s) for using the IVES program (select all that apply) Mortgage Services Banking Service Other (specify)

4. Legal name of business (required)

5. Employer Identification Number (EIN) or Social Security Number (SSN) (required)

6. Doing Business As (DBA) name (complete only if the business is operating under a different business name than listed on line 4)

7. Business location address (required)

Street address City State Zip Code

Business telephone number Fax number (optional) Business e-mail address (optional)

8. Billing address (required if different from the location address on line 7)

Street address City State Zip Code

9. Complete the following information for the IVES account principal (principal, company official, partner, or owner of business) (required)

IVES account principal (first, middle initial, last) Title Telephone number

Date of Birth (mm/dd/yyyy) Social Security Number E-mail address

Home street address City State Zip Code

10. Business point of contact (required if different than the principal) . A contact must be available on a day-to-day basis to answer IRS questions during testing and through the processing year

Last name First name MI

Telephone number E-mail address

11a. Have any individuals listed on Line 9 and/or Line 10 been convicted of a felony in the last 10 years? (Attach and explanation for a Yes response)

11b. Are all those listed on this application current with their individual and business tax filing and payments, including any corporation and employment tax obligations? (Attach an explanation for a No response)

Yes No

Yes No

If using a different EIN than listed in Line 5 to meet business filing requirements, list that here

12. Estimated annual volume of IVES product requests

EIN

Catalog Number 48547A www.irs.gov Form 13803 (Rev. 9-2026)

13. Complete the following information for the responsible official. The responsible official is an individual with responsibility for the operation and IVES users at the business location listed above. A principal listed above may also be a responsible official. If assigning a responsible official, all fields are required

Responsible official name (first, middle initial, last) Title Telephone number

Date of Birth (mm/dd/yyyy) Social Security Number E-mail address

Home street address City State Zip Code

14. By marking this box, you agree to review Publication 4557, Safeguarding Taxpayer Data and abide by the guidelines of the publication. In addition, you can only use taxpayer information that you receive via a Form 4506-C request for the purpose(s)

the taxpayer/requester intended. Failing to complete this section will result in the application being rejected and returned

Under the penalties of Perjury, I declare I have examined this application and read all accompanying information, and to the best of my knowledge and belief, the information being provided is true, correct, and complete. In addition, I have read the Internal Revenue Service rules and procedures for participating in the Income Verification Express Service program and I agree to abide by them and to pay resulting fees timely. I understand failure to do so will result in a suspension or permanent expulsion from the program.

Name and title of IVES account principal (type or print) Signature of IVES account principal Date signed

Fax your application to the IVES application line: 833-312-5410

The IRS conducts a suitability check on the applicant, and on all listed individuals on the application to determine the applicant's suitability to be an IVES participant. After an applicant passes the suitability check and the IRS completes processing the application, the IRS notifies the applicant of acceptance to participate in the program.

The IVES account principal listed on Line 9 must sign the application agreement indicating understanding of the Privacy Act restrictions relating to the use of this service.

Note: Electronic signatures are not permitted on the application agreement.

Note: You must notify the IVES program at ts.ives.participant.assistance@irs.gov within 30 days of any changes to the designated officials and the information on lines 4-13 to ensure timely receipt of important information or other communications from the IRS IVES program. Failure to do so can result in removal from the IVES program for non-compliance.

Non-Transferable: Acceptance for participation is not transferable. If this business is sold or its organizational structure changes, a new application must be filed. Noncompliance will result in the business and/or the individuals listed on this application, being suspended from participation in the IVES program.

Privacy Act Notice: Our right to ask for information is 5 U.S.C 301 and the Internal Revenue Code Section 6109 and applicable regulations. The registration information we are requesting is used to create an account for you, authenticate your identity and for billing purposes. We may disclose the information to the Department of Justice, to enforce the tax laws, civil and criminal, to cities, states, the District of Columbia and U.S. commonwealths or possessions to carry out their tax laws. We may give it to other countries under a tax treaty, to federal and state agencies to enforce federal non-tax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. Your participation in the Income Verification Express Services (IVES) program is voluntary; however, if you do not provide all or part of the information required to create your account, you will not be eligible for access to IVES.

Catalog Number 48547A www.irs.gov Form 13803 (Rev. 9-2026)