Fillable Form 8821 - South Dakota Housing Development Authority printable pdf download

8821

OMB No. 1545-1165

Tax Information Authorization

For IRS Use Only

Form

Received by:

Do not sign this form unless all applicable lines have been completed.

Name

▶

(Rev. October 2011)

Telephone

Do not use this form to request a copy or transcript of your tax return.

▶

Department of the Treasury

Function

Instead, use Form 4506 or Form 4506-T.

Internal Revenue Service

Date

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

Taxpayer name(s) and address (type or print)

Taxpayer identification number

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 in any office of the IRS for the

tax matters listed on this line. Do not use Form 8821 to request copies of tax returns.

(a)

(b)

(c)

(d)

Type of Tax

Tax Form Number

Year(s) or Period(s)

Specific Tax Matters (see instr.)

(Income, Employment, Excise, etc.)

(1040, 941, 720, etc.)

(see the instructions for line 3)

or Civil Penalty

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 on page 4. 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 on page 4.

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 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

Signature

Date

Print Name

Title (if applicable)

Print Name

Title (if applicable)

PIN number for electronic signature

8821

For Privacy Act and Paperwork Reduction Act Notice, see page 4.

Form

(Rev. 10-2011)

Cat. No. 11596P

Form 8821 - South Dakota Housing Development Authority

Related Articles

Related forms

Related Categories