Tax Help Archives  
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Form 8821 (Revised April 2004) Tax Information Authorization. Summary: This is an example of Form 8821 (Revised April 2004) that provides permission from the taxpayer to the I.R.S. to discuss tax matters with appointed individuals as explained in the text. The completed line items are:

1. Taxpayer information.”:
Taxpayer name(s) and address (type or print)” field contains
John Oak
8821 Dogwood Lane
Anyplace, North Carolina 28000
Social security number(s)” field contains 000-00-0003
Daytime telephone number” field contains (910) 555-4321
2. Appointee.”:
Name and address (type or print)” field contains
Jane Birch
12 Peartree Lane
Anyplace, North Carolina 28000
Telephone Number” field contains (910) 555-3210
3. Tax Matters.”:
a. Type of tax (Income, Employment, Excise, etcetera)” field contains Income
b. Tax Form Number (1040, 941, 720, etcetera)” field contains 1040
c. Year(s) or Period(s)” field contains 2000, 2001, 2002
5. Disclosure of tax information (you must check the box on line 5a or b unless the box on line 4 is checked):
5a. If you want copies of tax information, notices, and other written communications sent to the appointee on an ongoing basis, check this box” checkbox checked
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 covered.
Signature” field contains John Oak
Date” field contains 2/20/04
Print name” field contains John Oak