Form 8821-Vt - Authorization To Release Tax Information (Page 2 of 2) in pdf

Form 8821-VT INSTRUCTIONS

This form allows the authorized recipient designated in Section 2 to receive, inspect or discuss with the Vermont Department

of Taxes your confidential tax information for the tax type and tax periods listed in Section 3.

This form does not allow the authorized recipient to act on your behalf, to execute waivers, consents, or closing agreements,

to bind you to a payment plan, or otherwise to represent you before the Vermont Department of Taxes.

Form 8821-VT signed by all parties must be received by the Vermont Department of Taxes within 60 days of the date the

taxpayer signed the form.

Revocation of Authorization To revoke the authorization to disclose information to the recipient named in Section 2, simply

provide a written statement to the Department indicating the tax type(s), tax matter(s) and tax period(s) for which you wish

to revoke authorization. If you wish to revoke all authorization, indicate the name of the person who is no longer authorized

and state “remove all taxes, years and periods.”

Section 1 Taxpayer

Individuals – Enter your name, Social Security or Taxpayer Identification Number, the address where you live, and contact

information in the space provided. If authorizing the release of confidential tax information for a jointly filed return, also

enter your spouse/civil union partner information.

Corporations, Partnerships and other Business Entities – Enter the business name, Employer Identification Number, business

address and contact information in the space provided.

Trusts – Enter the name, title, and address of the trustee; and the name of the trust and the trust’s Federal Identification

Number, and contact information in the space provided.

Estates – Enter the name, title and address of the decedent’s executor/personal representative, the name and identification

numbers of the estate, and contact information in the space provided. Estate identification numbers are the Federal Identification

Number and the decedent’s Social Security or Taxpayer Identification number.

Section 2 Authorized Recipient

Enter the name, address and contact information of your authorized recipient in the space provided. Please reference the

authorized representative’s name as entered here in any communication or submissions with the Vermont Department of Taxes.

Section 3 Scope of Authorization

Enter the tax type, tax form, and tax period you wish to disclose to your authorized recipient, and any specific tax issue you

want the Vermont Department of Taxes to address beyond the tax return information. Examples of specific tax issues are

tax lien, balance due on the return, tax liability, assessment of tax.

The tax periods must be identified. For example, to authorize disclosure of your 2008 Vermont personal income tax, enter

Income as the tax type, IN-111 as the tax form, and 2008 as the tax year. For multiple years, indicate each tax year (2008,

2009, 2010) or 2008 – 2010 or 2008 through 2010. Taxpayers filing monthly or quarterly returns should enter the specific

filing period or for the year. For example, enter Sales & Use as tax type, SU-451 as tax form, and either limited periods (1

quarter or August 2010) or the full year (2010 filings). If you are a fiscal year filer, use the ending year and month in the

YYMMDD format for the tax period.

The authorization to disclose tax information cannot be honored if the tax type or tax periods are general designation such

as “all years,” “all periods,” or “all taxes.”

Section 4 Signatures

Individuals – Sign and date the authorization. If authorizing disclosure on a joint return, either spouse/civil union partner

may sign the form.

Corporations – This form may be signed by an officer having legal authority to bind the corporation, a person designated

by the board of directors or other governing body.

Partnerships – This form may be signed by partner who was a partner during any part of the tax period designated in Section 2.

Trusts and Estates – This form may be signed by the appointed guardian, executor, or administrator.

Form 8821-Vt - Authorization To Release Tax Information Page 2