Form 13748 (10-2005)
Catalog Number 47482W Department of the Treasury - Internal Revenue Service
Internal Revenue Service
Please complete a separate form for each participant.
Workshop/Seminar(s) Planning to Attend
Would you like a certificate for CPE credits? Yes No
*Important Note: Your e-mail address may be used to send important information regarding the seminars or workshops,
such as confirmation of registration, directions, change in location, payment information, special accommodations, or
other pertinent information.
For further information or questions, please contact the Registration Point of Contact. Thank you.
Professional Education Credits (If available)
Date(s) Time(s) City State
City State Zip Code
Telephone Number Fax Number *Email Address (required)