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Get IRS 1128 2014-2021

E or print name and title Date Check if self-employed Firm s name Firm s EIN Firm s address Phone no. For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 21115C PTIN Form 1128 (Rev. 10-2014) Form 1128 (Rev. 10-2014) Part II Page 2 Automatic Approval Request (see instructions) Identify the revenue procedure under which this automatic approval request is filed Section A Corporations (Other Than S Corporations or P.

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