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8821
(Rev. October 2011)
Department of the Treasury
Internal Revenue Service
OMB No. 1545-1165
Tax Information Authorization
For IRS Use Only
Received by:
▶ Do
not sign this form unless all applicable lines have been completed.
▶ Do not use this form to request a copy or transcript of your tax return.
Instead, use Form 4506 or Form 4506-T.
Name
Telephone
Function
Date
1 Taxpayer information. Taxpayer(s) must sign and date this form on line 7.
Taxpayer identification number
Taxpayer name(s) and address (type or print)
Daytime telephone number
Plan number (if applicable)
2 Appointee. If you wish to name more than one appointee, attach a list to this form.
CAF No.
Name and address
PTIN
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
Print Name
PIN number for electronic signature
For Privacy Act and Paperwork Reduction Act Notice, see page 4.
Date
Title (if applicable)
PIN number for electronic signature
Cat. No. 11596P
Form 8821 (Rev. 10-2011)
Page 2
Form 8821 (Rev. 10-2011)
General Instructions
Section references are to the Internal Revenue Code unless
otherwise noted.
What's New
Appointees will no longer receive inserts, such as forms,
publications, and other related materials, with notices.
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 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 120 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
2970 Market St. MS 3-E08.123
Philadelphia, PA 19104
267-941-1017
*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.
Page 3
Form 8821 (Rev. 10-2011)
Where To File
Specific Instructions
Generally, mail or fax Form 8821 directly to the IRS. See the
Where To File Chart, above. Exceptions are listed below.
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.
Your appointee 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.
Line 1. Taxpayer Information
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,
above. 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.
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.
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
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.
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.
Taxpayer Identification Numbers (TINs)
Line 3. Matters
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.
Enter the type of tax, the tax form number, the years or
periods, and the specific 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.
If you do not have a copy of the tax information
authorization you want to revoke, send a statement to the
IRS. In the statement, indicate that the authority of the
appointee is revoked, list the name and address of each
recognized appointee whose authority is revoked, list the
tax matters and periods, and sign and date the statement. If
you are completely revoking the authority of the appointee,
state “remove all years/periods” instead of listing the
specific tax matters, years, or periods on the form.
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.
Appointee Address Change
If the appointee's address has changed, a new Form 8821
is not required. The appointee can send a written
notification that includes the new information and their
signature to the location where the Form 8821 was filed.
Form 8821 (Rev. 10-2011)
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.
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) (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).
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.
Page 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.
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
authorizes the IRS to disclose your confidential tax
information to the person you appoint. This form is provided
for your convenience and its use is voluntary. The
information is used by the IRS to determine what confidential
tax information your appointee can inspect and/or receive.
Section 6103(c) and its regulations require you to provide
this information if you want to designate an appointee to
inspect and/or receive your confidential tax information.
Under section 6109, you must disclose your identification
number. If you do not provide all the information requested
on this form, we may not be able to honor the authorization.
Providing false or fraudulent information may subject you to
penalties.
We may disclose this information to the Department of
Justice for civil or criminal litigation, and to cities, states, the
District of Columbia, and U.S. commonwealths and
possessions for use in administering 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:M:S, 1111 Constitution Ave.
NW, IR-6526, Washington, DC 20224. Do not send Form
8821 to this address. Instead, see the Where To File Chart
earlier.
File Type | application/pdf |
File Title | Form 8821 (Rev. October 2011) |
Subject | Fillable |
Author | SE:W:CAR:MP |
File Modified | 2011-10-31 |
File Created | 2008-09-03 |