Department of the Treasury - Internal Revenue Service                         OMB Number 1545-2032
                                                                                                                For Official Use Only 
Form 13803                    Application to Participate in the Income                                          Control number
   (August 2022)           Verification Express Service (IVES) Program 
                              (Please 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
   Government agency                    Partnership            Sole proprietorship                 Corporation              LLC
   Other (specify)
3. Reason(s) for using the IVES program (select all that apply)
   Mortgage Services          Background Check                 Credit Check        Banking Service                      Licensing Requirement
   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                              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                     Yes       No
   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,       Yes       No
   including any corporation and employment tax obligations? (Attach an explanation for a No response)  
   If using a different EIN than listed in Line 5 to meet business filing requirements, list that here          EIN
12. Estimated annual volume of IVES product requests

Catalog Number 48547A                                          www.irs.gov                                           Form 13803 (Rev. 8-2022)

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: 844-251-8254
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.
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. 8-2022)