Instructions For Form 8821 - Tax Information Authorization

column (a), and if applicable, enter the tax year(s) for the

e. Form 843, Claim for Refund and Request for

penalty. Enter “NA” (not applicable) in column (b). You do

Abatement,

not have to enter the specific penalty.

f. Form 966, Corporate Dissolution or Liquidation,

If the taxpayer is subject to penalties related to an

g. Form 1096, Annual Summary and Transmittal of

individual retirement account (IRA) enter “IRA civil

U.S. Information Returns,

penalty” in column (a).

h. Form 1098, Mortgage Interest Statement,

Form 1099 Series,

Note. If Form W-2 is listed on line 3, then the appointee is

entitled to receive taxpayer notices regarding any civil

Form 1128, Application to Adopt, Change or Retain

penalties and payments related to that Form W-2. A Form

a Tax Year,

8821 that lists a particular tax return will also entitle the

k. Form 2553, Election by a Small Business

appointee to receive the taxpayer notices regarding any

Corporation, or

return-related civil penalties and payments. For example,

Form 4361, Application for Exemption From

if Form 1040 is listed, the appointee is entitled to receive

Self-Employment Tax for Use by Ministers, Members of

taxpayer notices regarding the section 5000A individual

Religious Orders and Christian Science Practitioners.

shared responsibility payment. Specific reference to those

penalties and payments is not required. However, any civil

If you check the box on line 4, your appointee should

penalty or healthcare-related payment that is not

mail or fax Form 8821 to the IRS office handling the

return-related, such as the section 4980H employer

matter. Otherwise, your appointee should bring a copy of

shared responsibility payment, the annual fee for branded

Form 8821 to each appointment to inspect or receive

prescription drug sales under section 9008 of the

information. A specific-use tax information authorization

Affordable Care Act (ACA), or health insurance provider

will not revoke any prior tax information authorizations.

fee under section 9010 of the ACA, is not covered by the

Line 5. Disclosure of Tax Information

Form 8821 unless column (a) references “civil penalties”

or the name of a specific penalty or payment.

The IRS will send copies of notices and communications

to no more than two appointees. If you check the box for

Column (d). Enter any specific information you want the

line 5a and the IRS has a prior Form 2848 or 8821 from

IRS to provide. Examples of column (d) information: lien

you that authorized other appointees to receive copies of

information, balance due amount, a specific tax schedule,

notices and communications for the same tax and tax

section 4980H employer shared responsibility payment

years, the IRS will stop sending notices and

information, or a tax liability.

communications to the appointees designated on the prior

Enter “not applicable” in column (d) if you are not

Form 2848 or 8821.

limiting your appointee's authority to inspect and/or

receive all confidential tax information described in

Line 6. Retention/Revocation of Prior Tax

columns (a), (b), and (c).

Information Authorizations

For requests regarding Form 8802, Application for

If the line 4 box is checked, skip line 6. If line 4 is not

United States Residency Certification, enter “Form 8802”

checked, the IRS will automatically revoke all prior tax

in column (d) and check the specific box on line 4. Also,

information authorizations on file unless you instruct

enter the appointee's information as instructed on Form

otherwise. If you do not want a prior tax information

8802.

authorization submission to be revoked, you must attach a

copy of the tax information authorization that you want to

Line 4. Specific Use Not Recorded on CAF

retain and check the line 6 box.

Generally, the IRS records all tax information

Revocation request. If you want to revoke a prior tax

authorizations on the CAF system. However,

information authorization without submitting a new

authorizations relating to certain issues are not recorded.

authorization, write "REVOKE" across the top of the

Check the box on line 4 if Form 8821 is being submitted

particular authorization that you want to revoke. Provide a

for any of the following reasons.

current taxpayer signature and date under the original

1. Requests to disclose information to loan companies

signature that was provided on line 7.

or educational institutions.

If you do not have a copy of the tax information

2. Requests to disclose information to federal or state

authorization you want to revoke, send a notification to the

agency investigators for background checks.

IRS. In the notification:

3. Requests for information regarding the following

1. State that the authority of the appointee is revoked,

forms:

2. List the name and address of each appointee

a. Form SS-4, Application for Employer Identification

whose authority is being revoked,

Number,

3. List the tax matters and tax periods, and

b. Form W-2 Series,

4. Sign and date the notification.

c. Form W-4, Employee’s Withholding Allowance

Certificate,

If you are completely revoking the authority of the

appointee, state “revoke all years/periods” instead of

d. Form W-7, Application for IRS Individual Taxpayer

listing the specific tax matters, years, or periods.

Identification Number,

-3-

Instructions for Form 8821 (Rev. 3-2015)

Instructions For Form 8821 - Tax Information Authorization - 2016 Page 4

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