Form 8821 OMB No. 1545-1165

Tax Information Authorization

(Rev. December 1995)

Department of the Treasury

Internal Revenue Service

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

Taxpayer name(s) and address (Please type or print.) Social security number(s) Employer identification number

Daytime telephone number Plan number (if applicable)

( )

2 Appointee

CAF No. Name and address (Please type or print.)

Telephone No.

Fax No.

Check if new: Address Telephone No.

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

3 Tax Matters

Type of Tax (Income, Employment, Excise, etc.) Tax Form Number (1040, 941, 720, etc.) Year(s) or Period(s)

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 Line 4—Specific use not recorded on CAF on page 2.) ©

4

Do not use lines 5 and 6 if the line 4 box is checked.

5 Disclosure of Tax Information (you must check one of the following unless box 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. This will cause copies of all computer-generated notices to be sent to the appointee ©

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

Retention/Revocation of Tax Information Authorization.—This tax information authorization automatically revokes all earlier

tax information authorizations on file with the Internal Revenue Service for the same tax matters and years or periods covered

by this document. If you do not want to revoke a prior tax information authorization, check this box ©

6

You MUST attach a copy of any tax information authorization you want to remain in effect.

7 Signature of Taxpayer(s).—If a tax matter concerns 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.

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

Signature Date Title (if applicable)

Print Name

Signature Date Title (if applicable)

Print Name

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 choose to designate an

appointee to inspect and/or receive

confidential information, under section 6109

you must disclose your social security

number (SSN) or your employer identification

number (EIN). The principal purpose of this

disclosure is to secure proper identification of

the taxpayer. We also need this information

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, 11 min.; Preparing the

Cat. No. 11596P Form 8821 (Rev. 12-95)

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 Filing the tax

information authorization on page 2.

For IRS Use Only

Telephone

Function

Date / /

Name

( )

( )

( )

to gain access to your tax information in our

files and properly respond to your request.

If you do not disclose this information, the

IRS may suspend processing the tax

information authorization and may not be able

to fill your request until you provide the

number.

form, 22 min.; Copying, assembling, and

sending the form to the IRS, 20 min.

Received by:
Form 8821 (Rev. 12-95) Page 2

Line 4—Specific use not recorded on

CAF.—Generally, the IRS records all tax

information authorizations on the CAF

system. However, a tax information

authorization will not be recorded on the CAF

if it relates to a specific issue. Examples of

specific issues include but are not limited to:

(1) requests to disclose information to loan

companies or educational institutions, 

(2) requests to disclose information to Federal

Specific Instructions

Line 1—Taxpayer information

Individuals.—Enter your name, SSN

(and/or EIN, if applicable), and street address

in the space provided. If a joint return is used,

also enter your spouse’s name and social

security number.

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.

General Instructions

Line 6—Retention/revocation of prior tax

information authorizations.—If there are any

existing tax information authorizations you do

not want to revoke, check the box on this line

and attach a copy of the tax information

authorization.

Section references are to the Internal

Revenue Code unless otherwise noted.

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 SSN.

Purpose of the form.—Form 8821 authorizes

any individual, corporation, firm, organization,

or partnership you designate to inspect

and/or receive 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 a tax information authorization

without using Form 8821, but it must reflect

all information that is required on Form 8821.

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 each IRS office where the tax

information authorization was filed. The copy

of the tax information authorization must have

a current signature of the taxpayer under the

signature already on line 7. Write “REVOKE”

across the top of the form. If you do not have

a copy of the tax information authorization

you want to revoke, send a statement to each

IRS office where you filed the tax information

authorizations. The statement of revocation

must indicate that the authority of the tax

information authorization is revoked and must

be signed by the taxpayer. Also, the name

and address of each recognized appointee

whose authority is revoked must be listed.

If you want an individual to have the

authority to represent you and/or perform

other acts on your behalf, such as the

execution of waivers, consents, or closing

agreements, use Form 2848, Power of

Attorney and Declaration of Representative,

instead of Form 8821.

Fiduciaries.—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 a tax

information authorization. Form 56, Notice

Concerning Fiduciary Relationship, should be

filed to notify the IRS of the existence of a

fiduciary relationship. If a fiduciary wishes to

authorize an appointee to inspect and/or

receive confidential tax information on behalf

of the entity, a tax information authorization

must be filed and signed by the fiduciary

acting in the position of the taxpayer.

The CAF number is a unique nine-digit

identification number (not the SSN or EIN)

that the IRS assigns to appointees. The CAF

number is not an indication of authority to

practice. The appointee should use the

assigned CAF number on all future tax

information authorizations. CAF numbers will

not be assigned for employee plans and

exempt organization application requests.

The filing of a Form 8821 will not revoke

any Form 2848 that is in effect.

Line 7—Signature of taxpayer(s)

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 upon written request signed by any

principal officer and attested by the secretary

or other officer, and (4) any other person

authorized to access information under

section 6103(e). (For shareholders in S

corporations not excepted and provided for

under sections 6241-6245, see Partnership/

Subchapter S items above.)

Partnership/Subchapter S items.—Sections

6221-6231 and 6241-6245 authorize a Tax

Matters Partner or Tax Matters Person to

perform certain acts on behalf of an affected

partnership or S corporation. Rules governing

the use of Form 8821 do not replace any

provisions of the above referenced sections.

Line 3—Tax matter(s).—Enter the type of

tax, the tax form number, and the years or

periods. For example, you may list “Income

tax Form 1040” for calendar year “1995” and

“Excise tax Form 720” for the “1st, 2nd, 3rd,

and 4th quarters of 1995.” A general

reference to “All years,” “All periods,” or “All

taxes” is not acceptable. Any tax information

authorization with a general reference will be

returned. You may list any tax years or

periods already ended as of the date you sign

the tax information authorization. However,

the number of future periods that can be

recorded on the CAF is limited. You may

include on line 3 future tax periods that end

no later than three years after the date Form

8821 is received by the IRS. If the matter

relates to estate tax, enter the date of the

taxpayer’s death instead of the year or

period. If either the type of tax, tax form

number, or years or periods do not apply to

the matter, specifically describe on this line

the matter to which the tax information

authorization pertains and enter “Not

Applicable” in the appropriate column(s).

Filing the tax information authorization.—

File the original, photocopy, or facsimile

transmission (fax) of the tax information

authorization with each IRS office in which

you want your appointee to inspect and/or

receive confidential tax information on your

behalf. If the tax information authorization is

filed for a matter currently pending before an

office of the IRS, such as an examination, file

the authorization with that office. Otherwise,

file the authorization with the service center

where the related return was, or will be, filed.

See the instructions for the related tax return

for the service center addresses. Form 8821

must be received by the IRS within 60 days

of the date it was signed and dated by the

taxpayer.

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. (For partners in

partnerships provided for and defined by

sections 6221-6231, see Partnership/

Subchapter S items above.)

Other.—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, see

section 6103(e).

Corporations, partnerships, or

associations.—Enter the name, EIN, and

business address.

Line 2—Appointee.—Enter the name of your

appointee. Use the identical name on all

submissions. If you wish to name more than

one appointee, indicate so on this line and

attach a list to the form. Enter the nine-digit

CAF number for each appointee. If an

appointee has been issued a CAF number for

any previously filed tax information

authorization (Form 8821) or power of

attorney (Form 2848), that number should be

used. If a CAF number has not been

assigned, enter “NONE,” and the IRS will

issue one directly to your appointee.

Individuals.—You must sign and date the

authorization. If a joint return is used, either

husband or wife must sign.

or state agency investigators for background

checks, (3) civil penalty issues, (4) trust fund

recovery penalty, (5) application for employer

identification number, and (6) claims filed on

Form 843, Claim for Refund and Request for

Abatement. Check the specific use box on

line 4 if the tax information authorization is for

a use that will not be recorded on the CAF. If

the box on line 4 is checked, the appointee

should bring a copy of the tax information

authorization to each meeting with the IRS. A

specific use tax information authorization will

not automatically revoke any prior tax

information authorizations.

You may enter on this line any specific

information you want the IRS to provide. For

example, you may request a transcript of an

account, a balance due amount, or whether a

return was filed.