Fillable Form 15100 Adoption Taxpayer Identification Number Extension Request

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Form 15100 Adoption Taxpayer Identification Number Extension Request

On average this form takes 9 minutes to complete

The Form 15100 Adoption Taxpayer Identification Number Extension Request form is 1 page long and contains:

  • 2 signatures
  • 9 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

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The Internal Revenue Service (IRS) is a government agency responsible for collecting taxes and administering the federal statutory tax laws of the United States. The IRS provide tax assistance to taxpayers and pursue and resolve fraudulent tax filings.

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Catalog Number 69794D www.irs.gov
Form
15100 (Rev. 10-2017)
Form 15100
(October 2017)
Department of the Treasury - Internal Revenue Service
Adoption Taxpayer Identification Number (ATIN)
Extension Request
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.
Indicate which of the following circumstances apply to you
I received a social security number for
(Name of adoptee)
Write the social security number assigned
I need a 1 year extension for
(Name of adoptee)
ATIN
(ATIN assigned)
Reason
I couldn’t get a social security number for
(Name of adoptee)
ATIN
(ATIN assigned)
Reason
Status of your adoption
My adoption is final My adoption is pending
I am enclosing documents the placement agency or agent signed
Original signatures of adoptive parents
Name (print/type) Signature Date
Name (print/type) Signature Date
click to sign
signature
click to edit
click to sign
signature
click to edit
dd mmm yyyy
dd mmm yyyy
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Form 15100 Adoption Taxpayer Identification Number Extension Request

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Completed 23 February 2020

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