Form 8821 - Tax Information Authorization
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1ACD - 31102
Rev 10-2015
State of New Mexico - Taxation and Revenue Department
TAX INFORMATION AUTHORIZATION
oTaxpayer Name
o Business Name
o NM ID
o SSN
o FEIN
o EIN
Telephone Number
oTaxpayer Address o Business Address
City
State
Zip Code
Hereby authorizes ___________________________________________________________________________________________________
Address:
____________________________________________________
Telephone Number: ______________________________
____________________________________________________
____________________________________________________
____________________________________________________
to represent me and/or my business pertaining to taxes administered by the New Mexico Taxation and Revenue
Department.*
IF IRS INFORMATION IS INVOLVED, BE SURE TO OBTAIN FORM 2848 OR FORM 8821, AS APPLICABLE.
CHECK ALL ITEMS THAT APPLY
q
q
all state taxes
FOR
any year
q
CRS taxes
OR
q
q
income taxes
specify specific year(s) ____________________
q
specify others _____________________________
_________________________________________
I certify that I have the authority to execute this tax information authorization.**
_________________________________________________
____________________________________
_________________
Print Name
Title
Date
_______________________________________________
____________________________________
_________________
Signature
Title
Date
*
The taxpayer may limit the scope of this authorization by specifying the particular information or tax types to be handled
by the authorized person.
** For joint returns, both taxpayers must sign. If not signed by the taxpayer, signature must be that of a corporate officer,
partner, or fiduciary on behalf of the taxpayer.
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Parent category: Financial