Instructions For Form 8802 - 2016 Page 14
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16THEN the Form
8802 penalties of
IF the applicant
perjury statement
STATING: “This certification is given under penalties of perjury and to the best of
is...
must include...
my knowledge and belief, the statements are true, correct, and complete.”
a foreign
an additional
[Insert name of partnership and EIN] is not required to file Form 1065 under Regulations
partnership
statement from a
section 1.6031(a)-1(b) and the entity classification has not changed since the filing of the
under
general partner
partners' returns.
Regulations
section
1.6031(a)-1(b)
a disregarded
a statement from
This certifies that [insert name and TIN of the owner of the DRE corporation, partnership, or
entity (DRE)
the owner of the
individual] trading as [insert name of limited liability company] is a single-owner limited
DRE
liability company that is treated as a disregarded entity for U.S. income tax purposes, that
[insert name of corporation, partnership, or individual] is the single owner of [insert name of
limited liability company], and, as such, [insert name of corporation, partnership, or
individual] is required to take into account all the income, gain, loss, deductions, and
credits of [insert name of limited liability company] on its/his/her U.S. federal income tax or
information return.
a nominee
a statement from
[Insert name and TIN of individual(s)/entity(ies) on whose behalf the nominee is acting] is a
each individual or
U.S. resident and will continue to be throughout the current tax year.
entity for whom the
nominee is acting
Signature and Date
attach documentation (for example,
not identified in the instructions, enter a
Form 2848) of the authorization. See
statement in line 10 and attach any
Form 8802 will not be considered
Table 3 to determine who has authority
appropriate documentation to indicate
complete and valid if the application is
to sign Form 8802.
such individual's authority to sign Form
not signed and dated by an individual
8802. If you are granting authority to a
who has the authority to sign Form
To avoid processing delays and
third party, you must sign and date the
8802. A third-party representative with
possible rejection of Form 8802, if Form
documentation.
authorization to sign Form 8802 must
8802 is signed by an individual who is
-14-
Instructions for Form 8802 (Rev. 10-2017)
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