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Get Fs Form 5444 (revised June 2020) 2020

RESET For official use only Customer No Case or SR FS Form 5444 Revised April 2019 OMB No. 1530-0138 TreasuryDirect Account Authorization IMPORTANT Follow instructions in filling out this form. Making any false fictitious or fraudulent claim or statement to the United States is a crime and may be prosecuted. Print in ink or type all information. INSTRUCTIONS Sign in ink in the presence of a certifying officer. Certification by a notary isn t acceptable. Mail the completed authorization form to Treasury Retail Securities Services PO Box 7015 Minneapolis MN 55480-7015. AUTHORIZATION I submit this account authorization pursuant to the provisions of 31 CFR Part 363. I understand that my TreasuryDirect account will be activated upon receipt and approval of this authorization. Under penalty of perjury I certify the information provided is true correct and complete. Person s must sign in your presence. I CERTIFY that whose identity ies Names of Persons Who Appeared is/are known or proven to me personally appeared before me this day of Month Year City State Signature and Title of Certifying Officer Name of Financial Institution Address City State ZIP code Telephone FS Form 5444 Department of the Treasury Bureau of the Fiscal Service Acceptable seals and stamps The financial institution s official seal or stamp including Signature Guaranteed seal or stamp Endorsement Guaranteed seal or stamp Corporate seal or stamp a corporate resolution isn t required or Issuing or paying agent seal or stamp including name location and four-digit identification number or nine-digit routing number. AUTHORIZATION I submit this account authorization pursuant to the provisions of 31 CFR Part 363. I understand that my TreasuryDirect account will be activated upon receipt and approval of this authorization. Under penalty of perjury I certify the information provided is true correct and complete. Signature Print Name Social Security Number Home Address Number and Street or Rural Route Daytime Telephone Number City State ZIP Code E-mail Address Check to remove Hardlock Instructions to Certifying Officer 1. Identification may be required* Authorized certifying officers are available at financial institutions including credit unions in the United States. Certification by a notary isn t acceptable. Mail the completed authorization form to Treasury Retail Securities Services PO Box 7015 Minneapolis MN 55480-7015. Signature Print Name Social Security Number Home Address Number and Street or Rural Route Daytime Telephone Number City State ZIP Code E-mail Address Check to remove Hardlock Instructions to Certifying Officer 1. Name s of the person s who appeared and date of appearance MUST be completed* 2. If a Medallion stamp is used an original signature is required* 3. The seal or stamp of Treasury-recognized Signature Guarantee Programs or other Treasury-approved Medallion Programs. Sample certification for a financial institution Acceptable certification for a brokerage SIGNATURE GUARANTEED ABC National Bank MEDALLION GUARANTEED Hillview Branch Generic Brokerage Authorized Signature XXXXXXXX SECURITIES TRANSFER AGENTS MEDALLION PROGRAM Bar Code NOTICE UNDER THE PRIVACY AND PAPERWORK REDUCTION ACTS The collection of the information you are requested to provide on this form is authorized by 31 U*S*C.

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Reporting your income and submitting all the vital taxation reports, including TreasuryDirect FS 5444, is a US citizen?s exclusive responsibility. US Legal Forms tends to make your taxes management more accessible and precise. You can find any legal samples you want and complete them digitally.

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