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Click ‘Get Form’ to open it in the editor.
Begin by entering your Taxpayer Identification Number (SSN/EIN) in the designated field. Ensure accuracy as this information is crucial for processing your authorization.
Next, fill in your Mailing Address, ensuring that all details are correct and complete to avoid any delays.
Provide your Daytime Telephone number and E-mail Address. This information will help facilitate communication regarding your account.
Once you have completed these fields, wait until you are in the presence of a certifying officer to sign the form. Remember, identification may be required at this stage.
The certifying officer must complete their section, including their signature and official stamp or seal. Ensure that they are an authorized employee of an insured depository institution or corporate central credit union.
Finally, review all entered information for accuracy before mailing the completed form to the specified address: Department of the Treasury, Bureau of the Public Debt, P.O. Box 7015, Parkersburg, WV 26106-7015.

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