What is Form 8655 used for?

Form 8655 authorizes a reporting agent to file returns, make deposits, or receive tax information on behalf of a payer. It clarifies which actions the agent may perform and links the agent to specific IRS accounts.

Who must sign the form?

An authorized officer of the payer or a person with delegated authority must sign. Verify internal corporate authority and retain documentation showing the signer’s capacity to avoid IRS rejection or internal disputes.

Can Form 8655 be signed electronically?

Yes; electronic signatures meeting ESIGN and UETA standards are generally valid. Use a platform that captures intent, attribution, authentication, and retention to support legal enforceability and IRS acceptance.

Is notarization required?

Form 8655 itself does not generally require notarization. Check state rules and internal policies; some payers or agents may request notarized signatures for additional assurance.

How do I revoke an authorization?

To revoke, provide written notice to the reporting agent and the IRS as required by IRS procedures. Keep copies of revocation notices and confirmations for your records to document termination of authority.

Where should signed copies be kept?

Retain the signed form and audit trail in your records according to tax and industry retention policies—commonly at least three years for tax purposes and longer if industry rules or state law require it.

Insurance Form 8655

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Insurance Form 8655

Applicant / Insured Information

Full legal name Address

Date of birth

Primary phone

Email address

Policy Details

Policy number

Policy type: Property Liability Auto Life Health Other

If Other, specify

Coverage amount

Deductible

Annual premium

Policy period start

Policy period end

Coverage Selection

Select coverages to be included in the policy (initial all that apply). Selections made below form part of the policy declaration and are subject to policy terms, conditions, limits and exclusions.

Comprehensive coverage
Collision coverage
Theft coverage
Fire / Smoke coverage
Water / Flood (note: separate endorsement may be required)
Liability coverage
Medical payments coverage
Umbrella / Excess liability

Coverage sublimits or special endorsements (describe)

Exclusions

The following exclusions are standard to the proposed coverage. The insured acknowledges awareness of these exclusions and agrees that additional exclusions may be applied in the issued policy.

Pre-existing condition exclusion
Flood exclusion (unless separate flood endorsement purchased)
Earthquake exclusion
Nuclear and war risks exclusion

Other exclusions or clarifications

Beneficiary Designation

Designate primary beneficiaries to receive proceeds as provided by policy terms. Percentages must total 100% for primary beneficiaries.

Primary beneficiary 1 — Name

Relationship

Percentage

Primary beneficiary 2 — Name

Relationship

Percentage

Primary beneficiary 3 — Name

Relationship

Percentage

Agent / Broker Information

Agent or broker name

License number

Agent phone / email

Authorizations and Declarations

By signing below the undersigned certifies, under penalty of law, that the information provided in this form and any supporting documentation is true, complete and accurate to the best of the undersigned's knowledge. The undersigned acknowledges that any material misrepresentation, omission, or fraudulent statement may result in denial of coverage, rescission of the policy, or other remedies permitted under the policy and applicable law.

The undersigned authorizes the insurer and its authorized agents to obtain and exchange information necessary to underwrite and administer this policy, including claims investigation. The undersigned further authorizes the insurer to provide notices and correspondence electronically when permitted by law and to charge premiums to the payment method authorized below.

I authorize electronic delivery of policy documents and notices.
I authorize premium payment by the payment method on file or by invoice as arranged with my agent.

Additional declarations or instructions

The insurer may require further documentation, inspection, or endorsements prior to binding coverage. This form is an application for insurance and does not guarantee issuance of coverage until a policy is issued and the required premium is paid in accordance with the insurer's terms.

Applicant Name:

Signature:

Date:

What Insurance Form 8655 Is and when it applies

Insurance Form 8655 is the IRS Reporting Agent Authorization form used to allow a third party to perform federal tax-related electronic filings or to receive tax information on behalf of an employer or payer. Organizations in the insurance industry commonly use this authorization when they engage payroll providers, third-party administrators, or tax preparers to file W-2s, 1099s, and employment tax returns electronically. The form documents the payer, the agent, permitted responsibilities, and the effective period of the authorization so the IRS recognizes the agent’s authority to act on the payer’s behalf.

Why completing Form 8655 matters for insurers

Form 8655 formally establishes who may file or receive tax returns and related information for your insurance business, reducing misrouting, enabling compliant electronic filing, and documenting delegated duties for audit readiness and internal controls.

Who typically completes or signs Insurance Form 8655

Typical users span internal payroll, external agents, and compliance teams; the form clarifies roles and filing authority.

Insurance employers and plan administrators who retain reporting agents to file payroll or information returns
Third-party administrators and payroll providers acting as reporting agents for multiple payer clients
Corporate finance, tax, or compliance officers who approve delegation and maintain authorization records

Ensure signers have explicit authority to delegate tax filing to avoid later disputes or IRS processing issues.

Step-by-step: completing Insurance Form 8655

Follow a linear completion process to avoid delays: gather identity and tax account details, enter authorized actions, verify signatory authority, and deliver the form to the IRS and your chosen agent.

01

Gather Documents: Collect employer identification and account numbers.
02

Fill Form: Enter payer and agent details clearly.
03

Authorize Signer: Ensure an authorized officer signs and dates.
04

Deliver Copies: Send signed form to IRS and agent.

Configuring a digital workflow for Form 8655

Set up fields, authentication, and routing before sending the form to ensure secure, auditable eSubmission.

Field	Configuration
Authentication	Email link plus optional SMS code
Template	Lock required fields and prefill known values
Routing	Signer order: authorized officer then agent
Storage	Archive signed PDF and certificate of completion

Typical eSubmission flow for the authorization

An electronic workflow reduces turnaround: prepare the form, assign signers, verify identity, collect signatures, and retain an audit trail for compliance.

Prepare Document: Upload prefilled PDF with locked fields
Assign Signers: Add responsible officer and agent
Authenticate Signer: Use email link or additional verification
Complete & Archive: Capture signed PDF and audit record

Platform and integration considerations for eSigning

Choose a signing platform that supports secure authentication, PDF locking, and certified audit trails for tax authorizations.

CRM and ERP: Salesforce, NetSuite integration available
Cloud Storage: Supports Google Workspace, Box, Egnyte
Document Formats: Accepts PDF, DOCX, and XLSX

Core elements to include on a professional Form 8655

A compliant Form 8655 includes identification, precise authorization language, signature and date, and records retention details to support filing and audit needs.

Payer Identification

Full legal name, address, and EIN to link authorization to the correct tax accounts and filings.

Agent Identification

Reporting agent legal name, address, and IRS authorizing identifiers for proper processing and correspondence.

Scope of Authorization

Clear listing of permitted actions such as electronic filing, payment handling, and receipt of tax information.

Effective Period

Start date and any termination terms so responsibilities are bounded and auditable.

Signature and Authority

Authorized officer’s printed name, title, signature, and date certifying delegation to the agent.

Recordkeeping Note

Retention instructions and where signed copies will be stored for IRS or internal review.

Security and compliance checklist for eSigned Form 8655

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Audit Trail: Signed PDF with timestamp and action log

Identity Verification: Email link, SMS code, or stronger authentication

Regulatory Compliance: ESIGN and UETA compliant for eSign validity

HIPAA: BAA available where protected health data exists

Certifications: SOC 2, ISO 27001, PCI DSS attestations

Common preparation mistakes to avoid

Submitting the form without the correct EIN or mismatched payer name which can invalidate the agent’s authority and delay filings.
Using vague authorization language that does not specify which returns or actions the agent may perform, causing ambiguity in IRS processing.
Failing to confirm signatory authority or to obtain an officer’s signature, exposing the payer to rejection or dispute.
Losing or failing to retain the signed record and audit trail, which complicates IRS inquiries or internal compliance reviews.

Penalties and risks tied to incorrect authorization and filings

Backup Withholding: 24% rate triggered by incorrect TIN

Late Filing Penalty: $60 to $330 per information return

Intentional Disregard: Higher penalties with no maximum cap

I-9 Paperwork: Civil fines ranging widely per violation

Rejection Delays: Incorrect authorizations can stop electronic filing

Reputational Risk: Client and regulator trust erosion if filings fail

Timing to consider when authorizing a reporting agent

Provide authorization well before the agent’s first scheduled filing and align internal deadlines with IRS reporting timelines to prevent missed submissions.

Before First Filing:

Deliver Form 8655 to agent prior to their first IRS submission

W-2 Due Date:

Employee copy and federal filing generally due by January 31

1099-NEC Due Date:

Recipient and IRS filing deadline is January 31

Individual Tax Return:

Calendar year returns typically due April 15

Change Notifications:

Update authorization on role or agent changes immediately

Key processing milestones after submitting Form 8655

Track milestones from submission through confirmation to ensure the agent is officially recognized and filings proceed without interruption.

01

Submission

Sign and send form to reporting agent and retain a copy

02

Agent Acceptance

Agent confirms receipt and readiness to file

03

First Electronic Filing

Agent submits the first authorized return to IRS

04

Record Retention

Store signed authorization and audit trail securely

Real customer examples of digitizing tax authorizations

Organizations across industries use eSignature platforms to collect and retain signed tax authorizations, improving turnaround and record availability.

Optica Ventures LLC

The interface is simple and easy-to-use for our team; more importantly, it is just as easy for our customers.

They reduced manual routing and follow-ups.
As a result, the finance team maintains consistent signed records and shortened filing preparation time while improving client transparency.

Fertility Centers of Illinois

The airSlate SignNow team has been exceptional, responsive, the API has been great, and we're extremely happy that we chose airSlate SignNow as a company.

They integrated signed authorizations into clinical workflows.
This integration helped the administrative team centralize signed documents and reduce physical storage needs while preserving audit trails.

Practical tips for accurate, auditable Form 8655 completion

Adopt consistent controls and templates so each authorization is complete, accurate, and easy to audit.

Confirm signer authority and identity

Before sending, verify the signer is legally authorized to delegate tax filing (corporate officer or elected representative). Maintain documentation of board or officer delegations and match printed name and title to corporate records to prevent IRS rejection or internal disputes.

Lock required fields in templates

Use a single prefilled template with locked EIN, payer name, and authorized actions to avoid accidental edits. Locking critical fields reduces data-entry errors and ensures all agents receive uniform authorizations tied to the correct tax accounts.

Retain signed PDF and audit trail

Store the signed PDF plus the certificate of completion (timestamps, IP, authentication method) in a secure archive compliant with your retention policy. This supports IRS inquiries and preserves evidence of intent and attribution for the electronic signature.

Review and update authorizations regularly

Reassess active authorizations after vendor changes or organizational restructuring and promptly revoke or replace Form 8655 entries to keep agent access current and minimize unauthorized filing risk.

eSignature vendor comparison for processing Form 8655

Compare vendors on price, HIPAA support, bulk send, and envelope limits when selecting a provider for tax authorization workflows.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Frequently asked questions about Insurance Form 8655

Answers to common questions about authority, signing, eSubmission, revocation, and recordkeeping for Form 8655.

Need help? Contact support

What is Form 8655 used for?
Form 8655 authorizes a reporting agent to file returns, make deposits, or receive tax information on behalf of a payer. It clarifies which actions the agent may perform and links the agent to specific IRS accounts.
Who must sign the form?
An authorized officer of the payer or a person with delegated authority must sign. Verify internal corporate authority and retain documentation showing the signer’s capacity to avoid IRS rejection or internal disputes.
Can Form 8655 be signed electronically?
Yes; electronic signatures meeting ESIGN and UETA standards are generally valid. Use a platform that captures intent, attribution, authentication, and retention to support legal enforceability and IRS acceptance.
Is notarization required?
Form 8655 itself does not generally require notarization. Check state rules and internal policies; some payers or agents may request notarized signatures for additional assurance.
How do I revoke an authorization?
To revoke, provide written notice to the reporting agent and the IRS as required by IRS procedures. Keep copies of revocation notices and confirmations for your records to document termination of authority.
Where should signed copies be kept?
Retain the signed form and audit trail in your records according to tax and industry retention policies—commonly at least three years for tax purposes and longer if industry rules or state law require it.

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