Catalog Number 69796Z www.irs.gov
Form
15101 (Rev. 10-2017)
Complete this form, and fax or mail it to us at:
Standard:
Internal Revenue Service
Stop 6182
Austin, TX 73301-0066
Overnight:
Internal Revenue Service
3651 S. Interregional Hwy 35
Stop 6182
Austin, TX 78741
Fax number: (855) 250-1731
If you have any questions contact us at (737) 800-5511 (not toll free)
Contact Information
If you changed your address, write your new address below.
Name Taxpayer Identification Number
Name Taxpayer Identification Number
Address City State ZIP code
Primary telephone number Best time to call
a.m.
p.m.
Secondary telephone number Best time to call
a.m.
p.m.
I received social security number
Name of adoptee
I was assigned the following ATIN
Original signatures of adoptive parents
Name (print/type) Signature Date
Name (print/type) Signature Date
Form 15101
(October 2017)
Department of the Treasury - Internal Revenue Service
Provide a Social Security Number (SSN)
for Adoptive Child
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signature
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Catalog Number 69796Z www.irs.gov
Form
15101 (Rev. 10-2017)
Instructions for Form 15101, Provide a Social Security Number (SSN) for Adoptive Child
General Instructions
Future Developments
For the latest information about developments related to Form 15101 and its instructions, such as legislation enacted after they were
published, go to www.irs.gov/w7a.
Purpose of Form
Use Form 15101, Provide a Social Security Number (SSN) for Adoptive Child, ONLY to inform the Internal Revenue Service (IRS) of
the social security number (SSN) for your adoptive child if the IRS provided an ATIN for your adoptive child.
Caution: Don't file Form 15100 with the IRS to obtain a social security number (SSN) for your child or adoptive child. Only the Social
Security Administration (SSA) can assign a SSN.
After the adoption is final
Apply for an SSN for the child, fill in Form SS-5, Application for a Social Security Card, and return it, with the appropriate evidence
documents, to the Social Security Administration (SSA). You can get Form SS-5 online at www.socialsecurity.gov, from your local SSA
office, or by calling the SSA at 1-800-772-1213. It usually takes about 2 weeks to get an SSN once the SSA has all the evidence and
information it needs.
Application for SSN denied. If the SSA denies your application for an SSN, contact the IRS to request an extension or reactivation of
the ATIN. When you request the extension or reactivation of the ATIN, include the SSA’s denial letter or an explanation with your
correspondence.
How Long Can You Use an ATIN
After the adoption is final, don't continue using the ATIN. Instead use the Form 15101, Provide a Social Security Number (SSN) for
Adoptive Child, to provide the SSN received for the adoptive child.
Where To File
Department of the Treasury
Internal Revenue Service
Austin, TX 73301-0066