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                                                                                                         Arizona Form 
2022 Withholding Tax Information Authorization                                                                     821 
                                                                        
For information or help, call one of these numbers:                    Section   2 - Appointee Information 
Phoenix                                     (602) 255-3381             Enter the name of your appointee.  For an appointee ID, please 
From area codes 520 and 928, toll-free      (800) 352-4090             provide  the  appointee’s Social  Security  Number, CPA  number, 
Tax forms, instructions, and other tax information                     State Bar number, Alternative Preparer Tax Identification Number, 
If you need tax forms, instructions, and other tax information, go to  EIN, or other ID number. 
the department’s website atwww.azdor.gov.                              Section   3 - Authorization 
Withholding Tax Procedures and Rulings                                 The appointee may only be authorized to inspect and/or receive 
These instructions may refer to the department’s withholding tax       Arizona withholding tax information.  Enter the years or periods for 
procedures  and rulings  for  more information.  To  view  or print    which the authorization is granted.   
these, go to our website and click on Reports & Legal Research then    Any  tax  year(s) or period(s) that  have  ended as of the date a 
click on Legal Research and select a Document Type and Category        withholding tax information authorization is signed may be listed.  
from the drop down menus.                                              The number of future tax years or periods that will be accepted is 
Publications                                                           limited to tax years or periods that end no later than four years after 
To view or print the department’s publications, go to our website      the date the withholding tax information authorization is signed. 
and click on Reports & Legal Research. Then click on Publications.     A general reference to “all years” or “all periods” will be accepted 
 
                                                                       as applying only to tax years (periods) ending prior to the date the 
                 General Instructions                                  withholding tax information  authorization is signed.    A general 
                                                                       reference to “all future years” will  be subject  to the four-year 
Purpose    of Form 
                                                                       limitation. 
A  taxpayer  may  use Form  821 to authorize any  individual,           
corporation, firm,  organization,  or  partnership  to  inspect and/or Section 4 - Retention/Revocation of Withholding Tax 
receive confidential Arizona withholding tax information for the                     Information Authorization 
 years or periods listed on the form.                                  A new withholding tax information authorization will revoke a prior 
If  a  taxpayer  wants  an  individual  to  inspect  and/or receive    withholding tax  information authorization if  it is  granted by the 
information for tax types other than withholding, or to perform other  taxpayer to another appointee for the same years or periods covered 
acts on the taxpayer’s behalf, the taxpayer may not use Form 821.       by this document. 
The taxpayer  must use Arizona Form 285,                 General       If there is any existing withholding tax information authorization 
Disclosure/Representation  Authorization    Form,       or other       you do not want to revoke, check the box in this section, and include 
comparable form.   Only an  individual may be  designated as a          a copy of the withholding tax information authorization. 
representative  under a    General Disclosure/Representation           A taxpayer may revoke a withholding tax information authorization 
 Authorization Form.                                                   without authorizing a new appointee  by filing  a  statement  of 
Filing Instructions                                                    revocation with the department.  The statement of revocation must 
If an Arizona Department of Revenue employee requests that you         indicate that  the authority of  the  previous  withholding tax 
submit this form, please submit the completed form to that employee    information  authorization  is revoked  and  must be signed by the 
at the address provided by that employee.                              taxpayer.  Also, the name and address of each appointee  whose 
Otherwise, the department offers three options to submit this form:    authority is revoked must be listed (or a copy of the withholding tax 
                                                                       information authorization  to be revoked  must be  included  and 
•   Email the completed form to:  POA@azdor.gov 
                                                                       marked “revoked”). 
•   Fax the completed form to: (602) 716-6088                           
•   Mail the original or copy of the completed form to:                The filing of a Form 821 will not revoke any Arizona Form 285, 
                 Arizona Department of Revenue                          or other power of attorney that is in effect. 
                 ATTENTION: Power of Attorney                           Section 5 - Signature of or for Taxpayer 
                           PO Box 29086                                 Type of Entity      Who must sign 
                      Phoenix, AZ 85038-9086                            Individuals/Sole    The individual/sole proprietor must sign. 
                                                                        Proprietors 
                 Specific Instructions                                  Corporations        A  principal corporate  officer within the 
Section  1 - Taxpayer Information                                                           meaning ofArizona Revised Statutes § 42-
Individuals/Sole Proprietors - enter your business name, address,                           2003(A)(2)  or a person designated by a 
and your Taxpayer Identification Number (TIN).                                              principal corporate officer must sign. 
Corporations, partnerships,  or associations  -  enter  the  name,      Partnerships    &   A partner  having authority  to act  in the 
business address, and the Employer Identification Number (EIN) of       Ltd Partnerships    name of the partnership must sign. 
                                                                        Trusts              A Trustee must sign. 
the business. 
                                                                        Estates             An Executor/Executrix or  the  personal 
Trusts - enter the name, title, and address of the trustee, as well as 
                                                                                            representative must sign. 
the EIN of the trust.                                                   Limited Liability  A member having authority to act in the 
Estates  - enter  the  name,  title, and address of the decedent’s      Companies           name of the company must sign. 
executor/personal representative as well as the EIN of the estate.      






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