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2018 14653 Form: What You Should Know
Foreign Offshore Procedures). This form must include the following information: (1) Taxpayer name. (2) Personal identification number (PIN). (3) Date of birth. (4) U.S. mailing address. (5) U.S. mailing phone number. (6) U.S. telephone number (including extension). (7) U.S. fax number. (8) U.S. email address. (9) Signature of taxpayer. (10) Signature of employer. (11) Signature of U.S. financial institution. (12) Signature of third party or attorney-in-fact. (13) Written certification of the foreign entity. (14) Signing by taxpayer or owner of U.S. financial institution. (15) Signature of third party or attorney-in-fact. (16) Signature of any responsible governmental entity or government official. (17) Signature of taxpayer if the foreign entity provides the same information as required for the certification for U.S. persons filing a Form 1040X. (18) Signature of taxpayers' designee. (19) Consent or acknowledgment by taxpayer that the information on the Form 14653 is correct without undue haste. (20) Signature by U.S. person. (21) Signature of employer or third party or attorney-in-fact if the information is provided by the foreign entity. (22) A statement whether the U.S. financial institution or any other party knows of any tax or penalty owed. (23) A statement whether the foreign entity provides the same information as required for Form 1040X, the U.S. person filing Form 1040X, and the individual(s). (24) A statement whether the U.S. person provided reasonable assurance of a timely determination and notifies the foreign entity by letter or telephone of any delay in making a determination within 21 days of receipt of the information. (25) A statement whether any foreign person has been notified by the U.S. person of an actual or potential violation of the United States tax laws or other penalties or losses caused by an understatement or an underpayment of any tax payable under U.S. income tax laws, or the collection of any tax.
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