Form 8821 Tax Information Authorization

Form

8821

OMB No. 1545-1165

Tax Information Authorization

For IRS Use Only
Received by:

▶ Information

(Rev. October 2012)
Department of the Treasury
Internal Revenue Service

about Form 8821 and its instructions is at www.irs.gov/form8821.
▶ Do not sign this form unless all applicable lines have been completed.
▶ To request a copy or transcript of your tax return, use Form 4506, 4506-T, or 4506T-EZ.

Name
Telephone
Function
Date

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

Taxpayer name 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 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, Payroll, Excise, Estate,
Gift, Civil Penalty, etc.) (see instructions)

(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. 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.
7 Signature of taxpayer. 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 and tax
periods shown 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

Date

Print Name

Title (if applicable)
PIN number for electronic signature

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

Cat. No. 11596P

Form 8821 (Rev. 10-2012)

THIS PAGE INTENTIONALLY LEFT BLANK

Page 3

Form 8821 (Rev. 10-2012)

General Instructions
Section references are to the Internal Revenue Code
unless otherwise noted.
Future developments. For the latest information about
developments related to Form 8821 and its instructions,
such as legislation enacted after they were published, go
to www.irs.gov/form8821.

Purpose of Form
Form 8821 authorizes any individual, corporation, firm,
organization, or partnership you designate to inspect
and/or receive your confidential information 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 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 4506T-EZ, Short Form Request for Individual
Tax Return Transcript, to request a tax return transcript
for the current and three prior tax years that includes
most lines of the original return. The transcript will not
show payments, penalty assessments, or adjustments
made to the originally filed return.
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
Generally, mail or fax Form 8821 directly to the IRS. See
the Where To File Chart, below. Exceptions are listed
next.
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.

Where To File Chart
IF you live in . . .
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
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
All APO and FPO addresses, American Samoa,
nonpermanent residents of Guam or the U.S. 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.

THEN use this address . . .

Fax Number*

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

855-214-7519

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

855-214-7522

Internal Revenue Service
International CAF
2970 Market St. MS 3-E08.123
Philadelphia, PA 19104

855-772-3156

*These numbers may change without notice. For updates to these fax numbers, go to www.irs.gov/form8821.
**Permanent residents of Guam should use Department of Taxation, Government of Guam, P.O. Box 23607, GMF, GU
96921; permanent residents of the U.S. Virgin Islands should use: V.I. Bureau of Internal Revenue, 6115 Estate Smith
Bay, Suite 225, St. Thomas, V.I. 00802.

Page 4

Form 8821 (Rev. 10-2012)

Your appointee may be able to file Form 8821
electronically with the IRS from the IRS website. For more
information, go to IRS.gov. Under the for Tax Pros tab, go
to Other Tools & Information and click on Use e-Services
for Tax Pros. 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.

Taxpayer Identification Number (TIN)
A TIN is used to confirm the identity of a taxpayer and
identify the taxpayer's return and return information. It is
important that you furnish your correct name, social
security number (SSN), individual taxpayer identification
number (ITIN), and/or employer identification number
(EIN).

Partnership Items
A Tax Matter Partner is authorized to perform certain acts
on behalf of an affected partnership. Rules governing the
use of Form 8821 do not replace any provisions of law
concerning the tax treatment of partnership items.

Appointee Address Change
If your appointee's address changes, a new Form 8821 is
not required. The appointee can provide the IRS with the
new information by sending written notification of the new
address to the location where the Form 8821 was filed.
Your appointee must sign and date the written notice.

Specific Instructions
Line 1. Taxpayer Information
Individual. 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 return is a
joint return, the appointee(s) identified will only be
authorized for you. Your spouse, or former spouse, must
submit a separate Form 8821 to designate an appointee.
Corporation, partnership, or association. Enter the
name, EIN, and business address.
Employee plan or exempt organization. Enter the
name, address, and EIN or SSN of the plan sponsor/plan
name, exempt organization or bond issuer. Enter the
three-digit plan number when applicable. If you are the
plan's trustee and you are authorizing the IRS to disclose
the tax information of the plan's trust, see the instructions
relating to trust.
Trust. Enter the name, title, and address of the trustee,
and the name and EIN of the trust.
Estate. Enter the name and address of the estate. If the
estate does not have an identification number, enter the
decedent’s SSN or ITIN.

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. If more than two appointees are listed and you
request copies of notices and communications be sent to
your new appointees (see line 5), copies of notices and
communications will be sent only to the first two
appointees.
Note. Because the IRS will send copies of notices and
communications to no more than two persons, if you
previously filed a Form 2848, Power of Attorney and
Declaration of Representative, for the same tax matters
and periods and you requested copies of notices and
communications be sent to your representative(s) at that
time, requesting your new appointee(s) receive copies of
notices and communications may stop notices and
communications from being sent to your authorized
representative(s).
Check the appropriate box to indicate if either the
address, telephone number, or fax number is new.

Line 3. Matters
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 “2010” and “Excise, 720” for “2010” (this covers all
quarters in 2010). Multiple years or a series of inclusive
periods, including quarterly periods, you may list 2008
through (thru or a hyphen) 2010. For example, “2008 thru
2010” or “2nd 2009-3rd 2010.” 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). Only
tax forms directly related to the taxpayer may be listed on
line 3. If the matter relates to estate tax, enter the date of
the decedent's death instead of the year or period.
If you appoint someone only with respect to a penalty
and interest due on that penalty, enter “civil penalty” in
the description of matters column. If applicable, enter the
tax year(s) for the penalty. Enter “NA” (not applicable) in
the tax form number column. You do not have to enter
the specific penalty.
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. Enter “not applicable” in
column (d) if you are not limiting your appointee's
authority to inspect and/or receive confidential tax
information described in columns (a), (b), and (c).

Page 5

Form 8821 (Rev. 10-2012)

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.
Note. If Form W-2 is listed on line 3, then the appointee
may receive information regarding any civil penalties
charged that relate to that Form W-2.
A Form 8821 that lists a particular tax return will also
entitle the appointee to receive the taxpayer notices
regarding any return-related civil penalties and a specific
reference to penalties is not required. However, any civil
penalty that is not return-related is not covered by the
Form 8821 unless it references “civil penalties” or a
specific penalty is stated.

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 any tax
information authorization you do not want to revoke. The
filing of Form 8821 will not revoke any Form 2848 that is
in effect.
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,
earlier. The copy of the tax information authorization must
have a current signature of the taxpayer and date 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. In the statement:
(a) indicate that the authority of the appointee is
revoked,

(b) list the name and address of each recognized
appointee whose authority is revoked,
(c) list the tax matters and tax periods, and
(d) 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.
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.

Line 7. Signature of Taxpayer
Individual. You must sign and date the authorization. If
a joint return has been filed, your spouse must execute
his or her own authorization on a separate Form 8821 to
designate an appointee.
Corporation. Generally, Form 8821 can be signed by:
(a) an officer having authority under applicable state law
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)(1)(D), except for a person
described in section 6103(a)(1)(D)(ii) (bona fide
shareholders of record owning 1% or more of the
outstanding stock of the corporation).
Partnership. 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, earlier. If the Form 8821 covers more
than one tax year or tax period, the person must have
been a member of the partnership for all or part of each
tax year or period covered by Form 8821.
Employee plan. If the plan is listed as the taxpayer on
line 1, a duly authorized individual having authority to bind
the taxpayer must sign and that individual's exact title
must be entered.
If the trust is the taxpayer, listed on line 1, a trustee
having the authority to bind the trust must sign with the
title of trustee entered. If the trust has not previously
submitted a completed Form 56, Notice Concerning
Fiduciary Relationship, identifying the current trustee, the
trust must submit a Form 56 to identify the current
trustee.
Estate. If there is more than one executor, only one
executor having the authority to bind the estate is
required to sign. See regulations section 601.503(d).
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.

Form 8821 (Rev. 10-2012)

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

Page 6

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, Individual and
Specialty Forms and Publications Branch,
SE:W:CAR:MP:T:I, 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.