Form 921-A - Consent Fixing Period Of Limitation On Assessment Of Income And Profits Tax Page 2
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1
2Instructions
If this consent is executed with respect to a year for which a JOINT RETURN OF A
HUSBAND AND WIFE was filed, it must be signed by both unless one, acting under a
power of attorney, signs as agent for the other.
If the taxpayer is a corporation, this consent must be signed with the corporate name
followed by the signature and title of the officer(s) duly authorized to sign. It is not
necessary that the corporate seal be affixed. The space provided for the seal is for the
convenience of corporations required by charter or by the laws of the jurisdictions in
which they are incorporated to affix their corporate seals in the execution of instruments.
This consent may be executed by the taxpayer's attorney or agent, provided this is
specifically authorized by a power of attorney which, if not previously filed, must
accompany this form.
Instructions for Internal Revenue Service Employees
Complete the Division Executive's name and title depending upon your division.
If you are in the Small Business /Self-Employed Division, enter the name and title
for the appropriate division executive for your business unit (e.g., Area Director for
your area; Director, Compliance Policy; Director, Compliance Services).
If you are in the Wage and Investment Division, enter the name and title for the
appropriate division executive for your business unit (e.g., Area Director for your
area; Director, Field Compliance Services).
If you are in the Large and Mid-Size Business Division, enter the name and title of
the Director, Field Operations for your industry.
If you are in the Tax Exempt and Government Entities Division, enter the name and
title for the appropriate division executive for your business unit (e.g., Director,
Exempt Organizations; Director, Employee Plans; Director, Federal, State and
Local Governments; Director, Indian Tribal Governments; Director, Tax Exempt
Bonds).
If you are in Appeals, enter the name and title of the appropriate Director, Appeals
Operating Unit.
The signature and title line will be signed and dated by the appropriate authorized
official within your division.
921-A
Catalog Number 16976Z
Form
(Rev. 1-2001)
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