8821

OMB No. 1545-1165

Form

Tax Information Authorization

IF THIS AUTHORIZATION IS NOT SIGNED AND DATED, IT WILL BE RETURNED.

For IRS Use Only

Received by:

Name

 Telephone (

)

Function

(Rev. January 2000)

Department of the Treasury Internal Revenue Service

1 Taxpayer information.

Date

Taxpayer name(s) and address (please type or print)

2 Appointee.

Name and address (please type or print)

CAF No.

Telephone No.

Fax No.

Check if new: Address

Telephone No.

3 Tax matters. The appointee is authorized to inspect and/or receive confidential tax information in any office of the IRS for the tax matters listed on this line.

4 Specific use not recorded on Centralized Authorization File (CAF). If the tax information authorization is for a specific use

not recorded on CAF, check this box. (See the instructions on page 2.)

If you checked this box, skip lines 5 and 6.

5 Disclosure of tax information (you must check the box on line 5a or b unless the box on line 4 is checked):

a If you want copies of tax information, notices, and other written communications sent to the appointee on an ongoing basis,

check this box

	

b If you do not want any copies of notices or communications sent to your appointee, check this box

	

6 Retention/revocation of tax information authorizations. This tax information authorization automatically revokes all prior

authorizations for the same tax matters you listed above on line 3 unless you checked the box on line 4. If you do not want to revoke a prior tax information authorization, you MUST attach a copy of any authorizations you want to remain in effect AND

check this box

	

To revoke this tax information authorization, see the instructions on page 2.

7 Signature of taxpayer(s). If a tax matter applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner, guardian, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to execute this form with respect to the tax matters/periods covered.

Signature

Date

Signature

Date

Print Name

Title (if applicable)

Print Name

Title (if applicable)

General Instructions

Use Form 56, Notice Concerning Fiduciary Relationship, to notify the IRS of the existence of a fiduciary relationship. A fiduciary (trustee, executor, administrator, receiver, or guardian) stands in the position of a taxpayer and acts as the taxpayer. Therefore, a fiduciary does not act as an appointee and should not file Form 8821. If a fiduciary wishes to authorize an appointee to inspect and/or receive confidential tax information on behalf of the fiduciary, Form 8821 must be filed and signed by the fiduciary acting in the

Section references are to the Internal Revenue Code unless otherwise noted.

Purpose of form. Form 8821 authorizes any individual, corporation, firm, organization, or partnership you designate to inspect and/or receive your confidential information in any office of the IRS for the type of tax and the years or periods you list on this form. You may file your own tax information authorization without using Form 8821, but it must include all the information that is requested on the form.

position of the taxpayer.

Form 8821 does not authorize your appointee to advocate your

Taxpayer identification numbers (TINs). TINs are used to identify taxpayer information with corresponding tax returns. It is important that you furnish correct names, social security numbers (SSNs), individual taxpayer identification numbers (ITINs), or employer identification numbers (EINs) so that the IRS can respond to your request.

position with respect to the Federal tax laws; to execute waivers, consents, or closing agreements; or to otherwise represent you before the IRS. If you want to authorize an individual to represent you, use Form 2848, Power of Attorney and Declaration of

Representative.

For Privacy Act and Paperwork Reduction Act Notice, see page 2.

Cat. No. 11596P

Form 8821 (Rev. 1-2000)

Employer identification number

Plan number (if applicable)

//

Social security number(s)		
		
Daytime telephone number		
()		

()
()
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(a)
Type of Tax
(Income, Employment, Excise, etc.)	(b)
Tax Form Number
(1040, 941, 720, etc.)	(c)
Year(s) or Period(s)	(d)
Specific Tax Matters (see instr.)	

				

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Form 8821 (Rev. 1-2000)

Page 2

Partnership items. Sections 6221–6231 authorize a Tax Matters Partner to perform certain acts on behalf of an affected partnership. Rules governing the use of Form 8821 do not replace any provisions

(5) application for EIN, or (6) claims filed on Form 843, Claim for Refund and Request for Abatement. If you check the box on line 4, your appointee should mail or fax Form 8821 to the IRS office handling the matter. Otherwise, your appointee should bring a copy of Form 8821 to each appointment to inspect or receive information. A specific use tax information authorization does not automatically

of these sections.

When to file. Form 8821 must be received by the IRS within 60 days of the date it was signed and dated by the taxpayer. Where to file. Generally, mail or fax Form 8821 directly to the Centralized Authorization File (CAF) Unit at the service center where the related return was, or will be, filed. To find the service center address, see the related tax return instructions. To get the fax number, call 1-800-829-1040.

revoke any prior tax information authorizations.

Line 6—Retention/revocation of tax information authorizations. Check the box on this line and attach a copy of the tax information

authorization you do not want to revoke.

If Form 8821 is for a specific tax matter, mail or fax it to the office handling that matter. For more information, see the instructions for line 4.

To revoke an existing authorization, send a copy of the previously executed Form 8821 to the IRS office where it was filed. Write “REVOKE” across the top of the form and sign your name again

Specific Instructions

under the existing signature (line 7). If you do not have a copy of the prior Form 8821, send a letter to the IRS office where you filed it. The letter must indicate that the authority of the tax information authorization is revoked and must be signed by the taxpayer. Include the name and address of each appointee whose authority is

Line 1—Taxpayer information

Individuals. Enter your name, TIN, and your street address in the

revoked.

space provided. Do not enter your appointee’s address or post office box. If a joint return is used, also enter your spouse’s name

Note: Filing Form 8821 does not revoke any Form 2848 that is in

effect.

and TIN. Also enter your EIN if applicable.

Line 7—Signature of taxpayer(s)

Corporations, partnerships, or associations. Enter the name,

Individuals. You must sign and date the authorization. Either husband or wife must sign if Form 8821 applies to a joint return.
Corporations. Generally, Form 8821 can be signed by: (1) an officer having legal authority to bind the corporation, (2) any person designated by the board of directors or other governing body, (3) any officer or employee on written request by any principal officer and attested to by the secretary or other officer, and (4) any other person

EIN, and business address.

Employee plan. Enter the plan name, EIN of the plan sponsor,
three-digit plan number, and business address of the plan sponsor.

Trust. Enter the name, title, and address of the trustee, and the

name and EIN of the trust.

Estate. Enter the name, title, and address of the decedent’s executor/personal representative, and the name and identification number of the estate. The identification number for an estate includes both the EIN, if the estate has one, and the decedent’s TIN.

authorized to access information under section 6103(e).

Line 2—Appointee. Enter your appointee’s full name. Use the identical full name on all submissions and correspondence. If you wish to name more than one appointee, indicate so on this line and attach a list to the form.

Partnerships. Generally, Form 8821 can be signed by any person who was a member of the partnership during any part of the tax period covered by Form 8821. See Partnership items above.
All others. See section 6103(e) if the taxpayer has died, is insolvent, is a dissolved corporation, or if a trustee, guardian,

executor, receiver, or administrator is acting for the taxpayer.

Note: Only the first three appointees you list will be input on the CAF.

Enter the nine-digit CAF number for each appointee. If an appointee has a CAF number for any previously filed Form 8821 or power of attorney (Form 2848), use that number. If a CAF number has not been assigned, enter “NONE,” and the IRS will issue one

Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the

United States. Form 8821 is provided by the IRS for your

directly to your appointee.

convenience and its use is voluntary. If you designate an appointee to inspect and/or receive confidential tax information, you are required by section 61 03(c) to provide the information requested on the form. Under section 6109, you must disclose your social security number (SSN), employer identification number (EIN), or individual taxpayer identification number (ITIN). If you do not provide all the information requested on this form, we may not be able to honor the

The CAF number is a number that the IRS assigns to appointees. The appointee’s CAF number must be used on all future Forms 8821 or 2848. The IRS does not assign CAF numbers to requests for

employee plans and exempt organizations.

Line 3—Tax matters. Enter the type of tax, the tax form number, the years or periods, and the specific tax matter. Enter “Not

authorization.

applicable,” in any of the columns that do not apply.

Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation, and to cities, states, and the District of Columbia for use in administering their tax laws. We may also give this information to other countries pursuant to tax

In column (c), write the years using the YYYY format, for example, “2000.” Do not use general references such as “all years,” or “all

periods.” If you do, your application will be returned.

You may list any prior years or periods, but for future periods, you are limited to the 3 future periods that end no later than 3 years after the date Form 8821 is received by the IRS. For employment tax or excise tax returns, enter the applicable quarters of the tax year. For estate tax returns, enter the date of the decedent’s death instead of

treaties.

the year or period.

You are not required to provide the information requested on a form unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Disclosure of the information on this form may

In column (d), enter any specific information you want the IRS to provide. Examples of column (d) information are: transcript of an account, a balance due amount, a specific tax schedule, or a tax liability.

be made as provided in section 6103.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is: Recordkeeping, 7 min.; Learning about the law or the form, 12 min.; Preparing the form, 24 min.; Copying, assembling, and

For requests regarding a foreign certification shown on Form 6166, Certification of Filing A Tax Return, enter “Form 6166” in

sending the form to the IRS, 20 min.

column (d) and check the box on line 4.

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Tax Forms Committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. DO NOT send Form 8821 to this address. Instead, see Where to file on this page.

Line 4—Specific use not recorded on CAF. Generally, the IRS records all tax information authorizations on the CAF system.

However, authorizations relating to a specific issue are not recorded.

Check the box on line 4 if Form 8821 is filed for any of the following reasons: (1) requests to disclose information to loan companies or educational institutions, (2) requests to disclose information to Federal or state agency investigators for background checks, (3) civil penalty issues, (4) trust fund recovery penalty,