Form 8821 Tax Information Authorization

Form 8821, Tax Information Authorization (Rev. 10-2009)
Purpose: This is the first circulated draft of Form 8821 (Rev. 10-2009) for your
review and comments. See below for a discussion of the major changes.
TPCC Meeting: None, but one may be arranged if requested.
Prior Version: Form 8821 (Rev. 10-2009) is available at:
http://www.irs.gov/pub/irs-pdf/f8821.pdf
Other Products: Circulations of draft tax forms, instructions, notices, and
publications are posted at: http://taxforms.web.irs.gov/Circulations/index.htm.
Comments: Please email, fax, call, or mail any comments to me by September
18, 2009. Comments submitted by telephone must be followed up in writing to be
considered. Send a copy of any email comments to the form’s reviewer, T.L.
Reviewer, at [email protected].
Lisa C. Hysek
Tax Forms and Publications
SE:W:CAR:MP:T:B:P
Email: [email protected]
Phone: 202-283-7359
Fax: 202-283-4545
Major Changes
•

Added What’s New and a Note under Line 5. Disclosure of tax
information per Taxpayer Communications Task Group (TACT).
Appointees will no longer receive notice inserts including forms,
publications, and related materials.

1
TLS, have you
transmitted all R
text files for this
cycle update?

Date

I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 8821, PAGE 1 of 4
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20.
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: NONE

8821

Date

Revised proofs
requested

OMB No. 1545-1165

Tax Information Authorization

For IRS Use Only
Received by:

(Rev. October 2009)

©

Do not sign this form unless all applicable lines have been completed.

Department of the Treasury
Internal Revenue Service

©

Do not use this form to request a copy or transcript of your tax return.
Instead, use Form 4506 or Form 4506-T.

1

Signature

O.K. to print

PRINTS: HEAD to HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form

Action

f
o
s
a
9
t
0
f
0
a
2
r
/
D /21
8
0
Name

Telephone (
Function
Date

/

)

/

Taxpayer information. Taxpayer(s) must sign and date this form on line 7.

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

Social security number(s)

Employer identification number

Daytime telephone number

Plan number (if applicable)

(

)

2 Appointee. If you wish to name more than one appointee, attach a list to this form.
Name and address
CAF No.
Telephone No.
Fax No.
Check if new: Address
Telephone No.
Fax 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. Do not use Form 8821 to request copies of tax returns.
(a)
Type of Tax
(Income, Employment, Excise, etc.)
or Civil Penalty

(b)
Tax Form Number
(1040, 941, 720, etc.)

(c)
Year(s) or Period(s)
(see the instructions for line 3)

(d)
Specific Tax Matters (see instr.)

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 4. If you check this box, skip lines 5 and 6 ©
5 Disclosure of tax information (you must check a box on line 5a or 5b 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
Note. Appointees will no longer receive forms, publications, and other related materials with the notices.
©
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 on line 3 above 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 4.

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 on line 3 above.
© IF NOT SIGNED AND DATED, THIS TAX INFORMATION AUTHORIZATION WILL BE RETURNED.
© DO NOT SIGN THIS FORM IF IT IS BLANK OR INCOMPLETE.

Signature

Print Name

Date

Title (if applicable)

Signature

Date

Print Name

PIN number for electronic signature

For Privacy Act and Paperwork Reduction Act Notice, see page 4.

Title (if applicable)

PIN number for electronic signature

Cat. No. 11596P

Form

8821

(Rev. 10-2009)

1
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8821, PAGE 2 of 4
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE, WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8821 (Rev. 10-2009)

General Instructions

Page

f
o
s
a
9
t
0
f
0
a
2
r
/
D /21
8
0

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

What’s New

Effective June 2009, appointees will no longer receive
inserts with notices. Inserts include forms, publications,
and other related materials. Taxpayers will continue to
receive the inserts with the notices.

Purpose of Form

2

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 Form 8821. You may file your own
tax information authorization without using Form 8821,
but it must include all the information that is requested
on Form 8821.
Form 8821 does not authorize your appointee to
advocate your 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.
Use Form 4506, Request for Copy of Tax Return, to
get a copy of your tax return.
Use Form 4506-T, Request for Transcript of Tax
Return, to order: (a) transcript of tax account
information and (b) Form W-2 and Form 1099 series
information.
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 position of the taxpayer.

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 Chart
IF you live in . . .

THEN use this address . . .

Fax Number*

Alabama, Arkansas, Connecticut, Delaware,
District of Columbia, Florida, Georgia,
Illinois, Indiana, Kentucky, Louisiana, Maine,
Maryland, Massachusetts, Michigan,
Mississippi, New Hampshire, New Jersey,
New York, North Carolina, Ohio,
Pennsylvania, Rhode Island,
South Carolina, Tennessee, Vermont,
Virginia, or West Virginia

Internal Revenue Service
Memphis Accounts Management Center
PO Box 268, Stop 8423
Memphis, TN 38101-0268

901-546-4115

Alaska, Arizona, California, Colorado,
Hawaii, Idaho, Iowa, Kansas, Minnesota,
Missouri, Montana, Nebraska, Nevada,
New Mexico, North Dakota, Oklahoma,
Oregon, South Dakota, Texas, Utah,
Washington, Wisconsin, or Wyoming

Internal Revenue Service
1973 N. Rulon White Blvd. MS 6737
Ogden, UT 84404

801-620-4249

All APO and FPO addresses, American
Samoa, nonpermanent residents of Guam
or the Virgin Islands**, Puerto Rico (or if
excluding income under section 933), a
foreign country, U.S. citizens and those
filing Form 2555, 2555-EZ, or 4563.

Internal Revenue Service
International CAF DP: SW-311
11601 Roosevelt Blvd.
Philadelphia, PA 19255

215-516-1017

*These numbers may change without notice.
**Permanent residents of Guam should use Department of Taxation, Government of Guam, P.O. Box 23607,
GMF, GU 96921; permanent residents of the Virgin Islands should use: V.I. Bureau of Internal Revenue,
9601 Estate Thomas Charlotte Amalie, St. Thomas, V.I. 00802.

1
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8821, PAGE 3 of 4
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE, WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8821 (Rev. 10-2009)

Where To File

Page

3

Specific Instructions

f
o
s
a
9
t
0
f
0
a
2
r
/
D /21
8
0

Generally, mail or fax Form 8821 directly to the IRS. See the
Where To File Chart on page 2. Exceptions are listed below.

Line 1. Taxpayer Information

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.

Individuals. Enter your name, TIN, and your street address
in the 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 and TIN. Also enter your EIN if applicable.

Your representative may be able to file Form 8821
electronically with the IRS from the IRS website. For more
information, go to www.irs.gov. Under the Tax Professionals
tab, click on e-services–Online Tools for Tax Professionals. If
you complete Form 8821 for electronic signature
authorization, do not file a Form 8821 with the IRS. Instead,
give it to your appointee, who will retain the document.

Revocation of an Existing Tax Information
Authorization

If you want to revoke an existing tax information
authorization and do not want to name a new appointee,
send a copy of the previously executed tax information
authorization to the IRS, using the Where To File Chart on
page 2. The copy of the tax information authorization must
have a current signature and date of the taxpayer under the
original signature on line 7. Write “REVOKE” across the top
of Form 8821. If you do not have a copy of the tax
information authorization you want to revoke, send a
statement to the IRS. The statement of revocation or
withdrawal must indicate that the authority of the appointee
is revoked, list the tax matters and periods, and must be
signed and dated by the taxpayer or representative. If the
taxpayer is revoking, list the name and address of each
recognized appointee whose authority is revoked. When the
taxpayer is completely revoking authority, the form should
state “remove all years/periods” instead of listing the specific
tax matters, years, or periods. If the appointee is
withdrawing, list the name, TIN, and address (if known) of the
taxpayer.
To revoke a specific use tax information authorization,
send the tax information authorization or statement of
revocation to the IRS office handling your case, using the
above instructions.

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.

Partnership Items
Sections 6221-6234 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 of these sections.

Representative Address Change
If the representative’s address has changed, a new Form
8821 is not required. The representative can send a written
notification that includes the new information and their
signature to the location where the Form 8821 was filed.

Corporations, partnerships, or associations. Enter the
name, EIN, and business address.
Employee plan or exempt organization. Enter the name,
address, and EIN of the plan sponsor or exempt
organization, and the plan name and three-digit plan number.
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.

Line 2. Appointee

Enter your appointee’s full name. Use the identical full name
on all submissions and correspondence. 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
directly to your appointee. The IRS does not assign CAF
numbers to requests for employee plans and exempt
organizations.
If you want to name more than one appointee, indicate so
on this line and attach a list of appointees to Form 8821.
Check the appropriate box to indicate if either the address,
telephone number, or fax number is new since a CAF number
was assigned.

Line 3. Tax Matters
Enter the type of tax, the tax form number, the years or
periods, and the specific tax matter. Enter “Not applicable,”
in any of the columns that do not apply.
For example, you may list “Income, 1040” for calendar year
“2006” and “Excise, 720” for “2006” (this covers all quarters
in 2006). For multiple years or a series of inclusive periods,
including quarterly periods, you may list 2004 through (thru
or a hyphen) 2006. For example, “2004 thru 2006” or “2nd
2005-3rd 2006.” For fiscal years, enter the ending year and
month, using the YYYYMM format. Do not use a general
reference such as “All years,” “All periods,” or “All taxes.”
Any tax information authorization with a general reference will
be returned.
You may list the current year or period and any tax years
or periods that have already ended as of the date you sign
the tax information authorization. However, you may include
on a tax information authorization only future tax periods that
end no later than 3 years after the date the tax information
authorization is received by the IRS. The 3 future periods are
determined starting after December 31 of the year the tax
information authorization is received by the IRS. You must
enter the type of tax, the tax form number, and the future
year(s) or period(s). If the matter relates to estate tax, enter
the date of the decedent’s death instead of the year or
period.

1
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8821, PAGE 4 of 4
MARGINS: TOP 13mm (1⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE, WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (81⁄ 2 ") 3 279mm (11")
PERFORATE: NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8821 (Rev. 10-2009)

Page

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

4

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.

f
o
s
a
9
t
0
f
0
a
2
r
/
D /21
8
0

For requests regarding Form 8802, Application for United
States Residency Certification, enter “Form 8802” in column
(d) and check the specific use box on line 4. Also, enter the
appointee’s information as instructed on Form 8802.

Note. If the taxpayer is subject to penalties related to an
individual retirement account (IRA) account (for example, a
penalty for excess contributions) enter, “IRA civil penalty” on
line 3, column a.

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: (a) requests to disclose information to loan
companies or educational institutions, (b) requests to
disclose information to federal or state agency investigators
for background checks, (c) application for EIN, or (d) 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 will
not 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. The
filing of Form 8821 will not revoke any Form 2848 that is in
effect.

Line 7. Signature of Taxpayer(s)
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: (a)
an officer having legal authority to bind the corporation, (b)
any person designated by the board of directors or other
governing body, (c) any officer or employee on written
request by any principal officer and attested to by the
secretary or other officer, and (d) any other person authorized
to access information under section 6103(e).

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 convenience and its use is
voluntary. If you designate an appointee to inspect and/or
receive confidential tax information, you are required by
section 6103(c) to provide the information requested on Form
8821. 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 authorization.
The IRS may provide this information to the Department of
Justice for civil and criminal litigation, and to cities, states,
the District of Columbia, and U.S. possessions to carry out
their tax laws. We may also disclose this information to other
countries under a tax treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to federal law
enforcement and intelligence agencies to combat terrorism.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
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.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is: Recordkeeping, 6 min.; Learning about the
law or the form, 12 min.; Preparing the form, 24 min.;
Copying and sending the form to the IRS, 20 min.
If you have comments concerning the accuracy of these
time estimates or suggestions for making Form 8821 simpler,
we would be happy to hear from you. You can write to
Internal Revenue Service, Tax Products Coordinating
Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
NW, IR-6526, Washington, DC 20224. Do not send Form
8821 to this address. Instead, see the Where To File Chart
on page 2.

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 on page 3.

Printed on recycled paper