2 - Irs 57

Form 56
(Rev. December 2019)

Notice Concerning Fiduciary Relationship
(Internal Revenue Code Sections 6036 and 6903)
OMB No. 1545-0013
Department of the Treasury
Internal Revenue Service
▶ Go to www.irs.gov/Form56 for instructions and the latest information.
Part I Identification
Name of person for whom you are acting (as shown on the tax return) Identifying number Decedent’s social security no.
JOHN HENRY DOE COMPANY ACCT #/FED RESERVE #/ BC SEE PRIOR 123-45-6789
Address of person for whom you are acting (number, street, and room or suite no.)
YOUR LEGAL ADDRESS

City or town, state, and ZIP code (If a foreign address, see instructions.)
Fiduciary’s name
First Last
Address of fiduciary (number, street, and room or suite no.)
c/o Home Address

City or town, state, and ZIP code Telephone number (optional)
City, State Republic [zip] ( 123 ) 456-7890
Section A. Authority
1 Authority for fiduciary relationship. Check applicable box:
a Court appointment of testate estate (valid will exists)
b Court appointment of intestate estate (no valid will exists)
c Court appointment as guardian or conservator
d Fiduciary of intestate estate
e ✔ Valid trust instrument and amendments
f ✔ Bankruptcy or assignment for the benefit or creditors
g ✔ Other. Describe ▶ Trustee under Declaration of Trust (custodial/living trust); State Non-UCC-1 File No.
2a If box 1a, 1b, or 1d is checked, enter the date of death ▶
b If box 1c, 1e, 1f, or 1g is checked, enter the date of appointment, taking office, or assignment or transfer of assets ▶ DATE
the day the acct or case inicitiated, or the date the bc was reg
Section B. Nature of Liability and Tax Notices

3 Type of taxes (check all that apply): ✔ Income ✔ Gift ✔ Estate ✔ Generation-skipping transfer ✔ Employment
✔ Excise ✔ Other (describe) ▶ Exempt per 1 Esdras 8:22
4 Federal tax form number (check all that apply): a ✔ 706 series b ✔ 709 c ✔ 940 d ✔ 941, 943, 944
e ✔ 1040 or 1040-SR f ✔ 1041 g ✔ 1120 h ✔ Other (list) ▶ 1099's and schedules
5 If your authority as a fiduciary does not cover all years or tax periods, check here . . . . . . . . . . . . . ▶
and list the specific years or periods ▶
For Paperwork Reduction Act and Privacy Act Notice, see separate instructions. Cat. No. 16375I Form 56 (Rev. 12-2019)
Form 56 (Rev. 12-2019) Page 2
Part II Revocation or Termination of Notice

Section A—Total Revocation or Termination
6 Check this box if you are revoking or terminating all prior notices concerning fiduciary relationships on file with the Internal
Revenue Service for the same tax matters and years or periods covered by this notice concerning fiduciary relationship ▶ ✔
Reason for termination of fiduciary relationship. Check applicable box:

a Court order revoking fiduciary authority
b Certificate of dissolution or termination of a business entity
c ✔ Other. Describe ▶ See attached of Power of Attorney, Certification of Trust, express trust cert of trust Non-UCC-1 file no.
Section B—Partial Revocation

7a Check this box if you are revoking earlier notices concerning fiduciary relationships on file with the Internal Revenue Service
for the same tax matters and years or periods covered by this notice concerning fiduciary relationship . . . . . . ▶
b Specify to whom granted, date, and address, including ZIP code.
▶
Section C—Substitute Fiduciary

8 Check this box if a new fiduciary or fiduciaries have been or will be substituted for the revoking or terminating fiduciary and
specify the name(s) and address(es), including ZIP code(s), of the new fiduciary(ies) . . . . . . . . . . . . ▶ ✔
▶ Director of Internal revenue Service 111 Constitution Drive, Washington, DC
Part III Court and Administrative Proceedings

Name of court (if other than a court proceeding, identify the type of proceeding and name of agency) Date proceeding initiated
SMALL BUSINESS ADMINISTRATION date

Address of court Docket number of proceeding
2 North 20th Street acct/case number

City or town, state, and ZIP code Date Time a.m. Place of other proceedings
Birmingham, AL 35203 date p.m.
Part IV Signature
Under penalties of perjury, I declare that I have examined this document, including any accompanying statements, and to the best of my
Please knowledge and belief, it is true, correct, and complete.
Sign
Here Trustee Entered
▲
Fiduciary’s signature Title, if applicable Date
Form 56 (Rev. 12-2019)

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Form 56

(Rev. December 2019)

YOUR LEGAL ADDRESS

c/o Home Address

City, State Republic [zip] ( 123 ) 456-7890

Section B. Nature of Liability and Tax Notices

Part II Revocation or Termination of Notice

Reason for termination of fiduciary relationship. Check applicable box:

Section B—Partial Revocation

Section C—Substitute Fiduciary

▶ Director of Internal revenue Service 111 Constitution Drive, Washington, DC

Part III Court and Administrative Proceedings

SMALL BUSINESS ADMINISTRATION date

2 North 20th Street acct/case number

Birmingham, AL 35203 date p.m.

Fiduciary’s signature Title, if applicable Date

Form 56 (Rev. 12-2019)

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