Thank You For Choosing Tax Relief Advocates!
Thank You For Choosing Tax Relief Advocates!
Spouse Last Name Spouse First Name MI Social Sec. # Date of Birth
michaelboggs939@[Link]
Home Phone # Email Address
(470)660-0088
Cell Phone # Work Phone # Spouse Cell Phone # Spouse Work Phone #
Initials:_______________
Section 2. Scope of Services
1. TRA’s assistance of Client will include and is limited to the following services (“Services”):
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
• Services performed for Exploratory Cases are limited to TRA performing the Services outlined in Section 2.1 (a)
and (b) and reporting the results back to Client.
Initials:_______________
Section 3. Client Duties
1. Client agrees to immediately notify and provide TRA copies of any and all notices from the IRS and or State that are
related to their tax situation. Notices include all received prior to becoming a client of TRA as well as any and all notices
received any time after becoming a client of TRA. Client also agrees to immediately notify TRA should they receive any
calls from the IRS or any State taxing authority. Client further understands that they are not to engage in any conversations
with the IRS or State taxing authorities during the term of this Agreement. If Client engages with the IRS and/or State
taxing authorities without TRA’s involvement, any resolution services not completed are non-refundable.
2. Client agrees to make timely payments and file returns as required by any agreements, settlements, and or compromises
that are made with the IRS, State tax authority(s), and or any other taxing authority as agreed to.
3. Client agrees that TRA’s assistance of Client is conditioned upon Client staying current with all future tax liabilities as
they become due. Failure to stay current with any and all tax liabilities will be cause for termination of this Agreement, as it
would greatly affect the ability for TRA to adequately assist Client.
4. Client further understands that the IRS and or State taxing authority(s), as a result of any non-compliance, may reject any
resolution of Client’s tax delinquency matter.
5. Client agrees to respond promptly and fully within 10 days of TRA’s, IRS’s, State taxing authority(s), and or any other
taxing authorities request for information or documents. If Client is unresponsive, TRA is not responsible for uncompleted
services and any paid fees are non refundable.
6. By signing this Agreement, Client agrees and acknowledges that TRA has advised Client of its obligation to fully and
accurately disclose the nature and extent of Client’s assets, liabilities and expenses. The failure to accurately disclose those
assets, liabilities and expenses, whether overstating or understating, may ultimately invalidate any agreement entered into
with any taxing authority.
7. Client agrees to submit all forms accurately prepared by Tax Processing Solutions as provided to Client by TRA without
any changes or alteration, along with any documents indicated by TRA.
8. If Client engages with the IRS and/or State taxing authorities without TRA’s involvement, any resolution services not
completed shall be non-refundable.
9. If Client fails to respond to TRA’s communications, TRA shall not be responsible for uncompleted services and any
previously-paid fees shall be non-refundable.
Initials:_______________
Section 4. Service Fees
In return for the Services described above, Client agrees to pay the following Service Fees for Services rendered by
TRA and or any of TRA affiliates, agents, strategic partners or associates through merchant accounts utilized by TRA
for the Services provided by TRA. The fees apply to those Services described in Section 2 of this Agreement and are
limited for the term of this Agreement. Client, by signing this Agreement agrees to pay TRA the fee, as outlined in
Section 4 of this Agreement, for TRA’s Services.
The term of this Agreement shall be until TRA completes the performance of the Services or until either party terminates this
Agreement as provided in Section 6.
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
Section 6. Cancellation, Termination, Chargebacks, Death of Client and Refund Policies
Cancellation:
1. Client has the right to cancel this Agreement within three (3) business days after the date of entering into this Agreement
by completing and returning the Notice of Cancellation form attached to this Agreement.
2. Upon timely cancellation, Client shall receive any payments made under this Agreement and any negotiable instrument
executed by Client will be returned within 10 days following receipt by TRA of Client’s cancellation notice, and any
security interest arising out of the transaction will be canceled.
Initial(s):_______________
Chargebacks:
7. CLIENT ACKNOWLEDGES THAT IT HAS AUTHORIZED THE CHARGE(S) SET FORTH IN THIS AGREEMENT
AND THAT CLIENT WILL NOT UNDERTAKE ANY ACTION TO CAUSE A CHARGEBACK ON THEIR CREDIT
CARD relating to the Services provided by TRA or challenge any charge to Client’s credit card relating to the Services.
Initial(s):_______________
Death of Client:
8. Upon notification that Client has passed away, TRA will immediately stop any future scheduled payments for services.
Upon receipt of Client’s death certificate, TRA will notify the IRS and/or State tax agency of the death and advise the family
and/or estate of any remaining tax debts. Our tax professionals will review next steps and options with Client’s family
and/or estate at that time. In the event of Client’s passing, TRA will not refund any payments made prior to its receipt of
notification of Client’s death.
Initial(s):_______________
Any controversy, claim or dispute between the parties (“Dispute”) arising out of or relating to this Agreement or the breach,
termination, enforcement, interpretation, unconscionability or validity thereof, including any determination of the scope or
applicability of this Agreement to arbitrate, shall be determined in arbitration conducted in the county where you reside at the
time the Agreement is entered unless we agree otherwise in writing. Issues of arbitrability will be determined in accordance
and solely with the federal substantive and procedural laws relating to arbitration; in all other respects, the arbitrator will be
obligated to apply and follow the substantive law of the state of your residence at the time the Dispute arises.
The arbitration proceeding shall be conducted by the American Arbitration Association (“AAA”) in accordance with the
AAA’s Consumer Arbitration Rules (“AAA Rules”) in effect at the time the action is commenced. The AAA Rules are
available at [Link]/sites/default/files/Consumer%[Link] or by calling the AAA at 1-800-778-7879. AAA shall
appoint a single arbitrator pursuant to the AAA Rules and the arbitrator shall be neutral, independent and shall comply with
the AAA Rules. Any award rendered by the arbitrator shall be final and shall not be subject to vacation or modification
except as provided by law. Judgment on the award made by the arbitrator may be entered in any court having jurisdiction
over the parties. If either party fails to comply with the arbitrator's award, the injured party may petition the circuit court for
enforcement.
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
The parties agree that either party may bring claims against the other only in his, her or its individual capacity and not as a
plaintiff or class member in any purported class or representative proceeding. Further, the parties also agree that the arbitrator
may not consolidate proceedings of more than one person's claims and may not otherwise preside over any form of
representative or class proceeding.
Under current AAA Rules, if you initiate arbitration against TRA, the only arbitration fee you will be required to be pay is
$200. All other costs of the arbitration (but not attorney’s fees, unless determined by the arbitrator as described below) will
be borne by us, including any remaining AAA case management and/or hearing fees and all professional fees for the
arbitrator's services. The prevailing party in the arbitration shall be entitled to recover its reasonable attorney’s fees and any
costs expended. In addition, in the event a party fails to proceed with arbitration, unsuccessfully challenges the arbitrator's
award, or fails to comply with the arbitrator's award, the other party shall be entitled to obtain its costs including its
reasonable attorney's fees for having to compel arbitration or defend or enforce the award. You or we may seek relief in
small claims court or may seek provisional judicial remedies without arbitrating.
You may opt out of this provision within 30 days of entering into this Agreement by sending a signed, written notice to us at
16808 Armstrong Ave, Suite 215, Irvine CA 92692. This section and the arbitration requirement shall survive any
termination of this Agreement.
BINDING ARBITRATION MEANS THAT BOTH PARTIES GIVE UP THE RIGHT TO A TRIAL BY A JURY
AND THE RIGHT TO APPEAL FROM THE ARBITRATOR’S RULING EXCEPT FOR A NARROW RANGE OF
ISSUES IF ALLOWED BY LAW. DISCOVERY IN ARBITRATION MAY BE SEVERELY LIMITED BY THE
ARBITRATOR. IN THIS AGREEMENT, THE PARTIES ALSO GIVE UP THE RIGHT TO BRING A CLASS
ACTION OR OTHER REPRESENTATIVE ACTION AGAINST ONE ANOTHER.
Initials:_______________
Michael Boggs authorizes TRA to disclose Michael Boggs confidential information to its Affiliates and to its officers,
employees, sublicensees, advisors, consultants, subcontractors, and processors as reasonably necessary to complete the
Services listed in Section 2 of this Agreement.
1. Client Communications. Please note that TRA is required to remain in communication with Client to keep him or her
updated relating to the services. As such, Client consents that TRA and its designated staff and service providers may contact
Client directly via mail, internet, email, text/SMS messaging, and through the use of prerecorded and/or autodialed messages
even if your telephone number is currently listed on any state, federal or TRA’s Do Not Call list. Standard phone and data
charges will apply. Client’s consent to the above terms is not required as a condition of purchasing or receiving our
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
services. Client consents to receive all such communications to the addresses and telephone numbers provided by Client
until Client notifies the TRA of updates to such contact information or requests that communication be limited. Client
consents to all telephone calls with TRA and its designated staff and service providers being recorded or monitored, and
stored subject to the TRA’s applicable policy. This section shall survive any termination of this Agreement.
2. Electronic Signature Authorization. Pursuant to the Federal ESIGN Act, you agree to receive contracts for legal services,
authorizations, and disclosures by means of electronic delivery. Transmission of documents in electronic format shall be
considered “in writing.” You agree to execute this Agreement with an electronic signature. However, you understand that
you have the right to receive such documents in paper for by faxing a written request to TRA at 714-804-5249. The request
for paper copies shall include a description of the document(s), your name, address, primary telephone number, and file
number. There is no cost to obtain paper copies of any electronic records.
3. Acknowledgement of Privacy Policy. This confirms your acknowledgement that you have received and agree to the terms
of TRA’s Privacy Policy accompanying this Agreement. You further agree to accept and abide by any changes to the terms
of the Privacy Policy made in the future, as updated on TRA’s website at [Link]
4. Assignability. Due to the nature of this Agreement and Client’s obligations, Client may not assign this Agreement and
any purported assignment by Client shall be void. TRA may assign this Agreement at any time without Client’s consent.
This Agreement shall be binding on Client’s heirs, executors and personal representatives and on TRA’s successors and
assigns.
5. Force Majeure. Neither party shall be held liable or responsible to the other party nor be deemed to have defaulted under
or breached this Agreement for failure or delay in fulfilling or performing any obligation under this Agreement when such
failure or delay is caused by or results from causes beyond the reasonable control of the affected party, including but not
limited to fire, floods, embargoes, war, acts of war, insurrections, riots, strikes, lockouts or other labor disturbances, or acts of
God; provided, however, that the party so affected shall use reasonable commercial efforts to avoid or remove such causes of
nonperformance, and shall continue performance hereunder with reasonable dispatch whenever such causes are removed.
Either party shall provide the other party with prompt written notice of any delay or failure to perform that occurs by reason
of force majeure.
6. Incorporation of Exhibits. This Agreement and all schedules and exhibits attached hereto are incorporated herein by this
reference.
7. Severability. In the event any portion of provision hereof shall be deemed illegal or unenforceable for any reason, there
shall be deemed to be such minor change in the portion or provision as is necessary to make it valid and enforceable as so
modified. Such a finding shall in no way affect, impair or invalidate any other provision of this Agreement which shall
remain in full force and effect.
8. Entire Agreement; Amendments, Modifications and Waivers. This Agreement constitutes the entire agreement between
the Parties and cancels and supersedes all prior agreements, representations, statements, promises and understandings,
whether written or oral, with respect to the subject matter thereof. This Agreement may only be modified, amended or waived
by a writing signed by both of us; provided, however, that we may change any term of this Agreement, or add any additional
term to this Agreement, by providing you with fifteen (15) days’ advance written notice of such change. If you decline to
accept such change, your sole and exclusive remedy will be to terminate this Agreement and withdraw from our services. No
waiver of any provision of this Agreement shall be deemed a waiver of any other provision, nor shall any waiver constitute a
continuing waiver.
Initials:_______________
Section 8. Signatures
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the
date of this transaction. See the attached Notice of Cancellation form for an explanation of this right.
X_____________________________________________Date:_______________
PRINT NAME: Boggs Michael
PAYMENT AUTHORIZATION
Client(s) hereby authorizes the payment of the following fees to TRA on the following terms:
Initials:_______________
Initials:_______________
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
Visa Michael Boggs
Type (Visa/MC/Amex) Card-holder Name
Billing Address
Initials:_______________
If the merchant processor is unable to deduct any payment(s) due to insufficient funds or if the account is closed, or if the
credit card charge is declined, TRA reserves the right to cancel the Agreement or charge a penalty and/or collection fee.
Client accepts responsibility for any overdraft fees charged by the bank. If Client needs to change any payment date(s) or
amount(s), Client must contact TRA or the merchant processor at least three business days prior to the payment date.
X_____________________________________________Date:_______________
PRINT NAME: Boggs Michael
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
Acknowledgements
• I understand that this is a two-phase process. The Tax Investigation and retainer fee is part of
Phase 1. The Resolution and resolution fees are separate and will be part of Phase 2.
Initials:____________
• I understand that IRS income tax debt and State income tax debt are different, and require
separate investigations with separate forms signed and will have separate fees.
Initials:____________
• I understand that the signed IRS form for the Limited Power of Attorney allows the tax
professionals to communicate and negotiate with the IRS on my behalf, and that it does not
protect me from collections.
Initials:____________
• I understand that TRA may not reach out to the IRS directly until I am in full compliance, and
that if I attempt to contact the IRS myself it may jeopardize my case.
Initials:____________
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
Notice of Cancellation
1/29/2025
You may cancel this transaction, without any penalty or obligation, within three business days from the
above date.
If you cancel, any property traded in, any payments made by you under the contract or sale, and any
negotiable instrument executed by you will be returned within 10 days following receipt by the seller of
your cancellation notice, and any security interest arising out of the transaction will be canceled.
If you cancel, you must make available to the seller at your residence, in substantially as good condition as
when received, any goods delivered to you under this contract or sale, or you may, if you wish, comply
with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk.
If you do make the goods available to the seller and the seller does not pick them up within 20 days of the
date of your notice of cancellation, you may retain or dispose of the goods without any further obligation.
If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail
to do so, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any other
written notice, or send a telegram to TRA at 16808 Armstrong Ave, Suite 215, Irvine CA 92606.
not later that midnight of 3rd business day after 1/29/2025.
Date: _________________________
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
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Tax Relief Advocates, 16808 Armstrong Ave, Suite 215, Irvine CA 92692, 1-800-556-5014
Form 2848
(Rev. January 2021)
Power of Attorney
and Declaration of Representative
OMB No. 1545-0150
For IRS Use Only
Received by:
Department of the Treasury
Internal Revenue Service
▶ Go to [Link]/Form2848 for instructions and the latest information. Name
Part I Power of Attorney Telephone
Caution: A separate Form 2848 must be completed for each taxpayer. Form 2848 will not be honored Function
for any purpose other than representation before the IRS. Date / /
1 Taxpayer information. Taxpayer must sign and date this form on page 2, line 7.
Taxpayer name and address Taxpayer identification number(s)
Michael Boggs 255-43-1720
1283 Hancock Ave Daytime telephone number Plan number (if applicable)
Gainsville GA 30501 (470)660-0088
hereby appoints the following representative(s) as attorney(s)-in-fact:
2 Representative(s) must sign and date this form on page 2, Part II.
Name and address CAF No. 0311-27847R
Rosanne Steele PTIN P01780309
16808 Armstrong Ave # 215 Telephone No. (877)553-0603
Irvine CA 92606
Fax No. (714)804-5249
Check if to be sent copies of notices and communications Check if new: Address Telephone No. Fax No.
Name and address CAF No.
PTIN
Telephone No.
Fax No.
Check if to be sent copies of notices and communications Check if new: Address Telephone No. Fax No.
Name and address CAF No.
PTIN
Telephone No.
Fax No.
(Note: IRS sends notices and communications to only two representatives.) Check if new: Address Telephone No. Fax No.
Name and address CAF No.
PTIN
Telephone No.
Fax No.
(Note: IRS sends notices and communications to only two representatives.) Check if new: Address Telephone No. Fax No.
to represent the taxpayer before the Internal Revenue Service and perform the following acts:
3 Acts authorized (you are required to complete line 3). Except for the acts described in line 5b, I authorize my representative(s) to receive and
inspect my confidential tax information and to perform acts I can perform with respect to the tax matters described below. For example, my
representative(s) shall have the authority to sign any agreements, consents, or similar documents (see instructions for line 5a for authorizing a
representative to sign a return).
Description of Matter (Income, Employment, Payroll, Excise, Estate, Gift,
Tax Form Number Year(s) or Period(s) (if applicable)
Whistleblower, Practitioner Discipline, PLR, FOIA, Civil Penalty, Sec.
(1040, 941, 720, etc.) (if applicable) (see instructions)
4980H Shared Responsibility Payment, etc.) (see instructions)
4 Specific use not recorded on the Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on
CAF, check this box. See Line 4. Specific Use Not Recorded on CAF in the instructions . . . . . . . . . . . . . . ▶
5a Additional acts authorized. In addition to the acts listed on line 3 above, I authorize my representative(s) to perform the following acts (see
instructions for line 5a for more information): Access my IRS records via an Intermediate Service Provider;
Authorize disclosure to third parties; Substitute or add representative(s); Sign a return;
For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Cat. No. 11980J Form 2848 (Rev. 1-2021)
Form 2848 (Rev. 1-2021) Page 2
b Specific acts not authorized. My representative(s) is (are) not authorized to endorse or otherwise negotiate any check (including directing or
accepting payment by any means, electronic or otherwise, into an account owned or controlled by the representative(s) or any firm or other
entity with whom the representative(s) is (are) associated) issued by the government in respect of a federal tax liability.
List any other specific deletions to the acts otherwise authorized in this power of attorney (see instructions for line 5b):
6 Retention/revocation of prior power(s) of attorney. The filing of this power of attorney automatically revokes all earlier power(s) of
attorney on file with the Internal Revenue Service for the same matters and years or periods covered by this form. If you do not want to
revoke a prior power of attorney, check here . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶
YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT.
7 Taxpayer declaration and signature. If a tax matter concerns a year in which a joint return was filed, each spouse must file a separate power
of attorney even if they are appointing the same representative(s). If signed by a corporate officer, partner, guardian, tax matters partner,
partnership representative (or designated individual, if applicable), executor, receiver, administrator, trustee, or individual other than the
taxpayer, I certify I have the legal authority to execute this form on behalf of the taxpayer.
▶ IF NOT COMPLETED, SIGNED, AND DATED, THE IRS WILL RETURN THIS POWER OF ATTORNEY TO THE TAXPAYER.
01/29/2025
Signature Date Title (if applicable)
Michael Boggs
Print name Print name of taxpayer from line 1 if other than individual
Part II Declaration of Representative
Under penalties of perjury, by my signature below I declare that:
• I am not currently suspended or disbarred from practice, or ineligible for practice, before the Internal Revenue Service;
• I am subject to regulations in Circular 230 (31 CFR, Subtitle A, Part 10), as amended, governing practice before the Internal Revenue Service;
• I am authorized to represent the taxpayer identified in Part I for the matter(s) specified there; and
• I am one of the following:
a Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below.
b Certified Public Accountant—a holder of an active license to practice as a certified public accountant in the jurisdiction shown below.
c Enrolled Agent—enrolled as an agent by the IRS per the requirements of Circular 230.
d Officer—a bona fide officer of the taxpayer organization.
e Full-Time Employee—a full-time employee of the taxpayer.
f Family Member—a member of the taxpayer’s immediate family (spouse, parent, child, grandparent, grandchild, step-parent, step-child, brother, or sister).
g Enrolled Actuary—enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to practice before
the IRS is limited by section 10.3(d) of Circular 230).
h Unenrolled Return Preparer—Authority to practice before the IRS is limited. An unenrolled return preparer may represent, provided the preparer (1)
prepared and signed the return or claim for refund (or prepared if there is no signature space on the form); (2) was eligible to sign the return or
claim for refund; (3) has a valid PTIN; and (4) possesses the required Annual Filing Season Program Record of Completion(s). See Special Rules
and Requirements for Unenrolled Return Preparers in the instructions for additional information.
k Qualifying Student or Law Graduate—receives permission to represent taxpayers before the IRS by virtue of his/her status as a law, business, or
accounting student, or law graduate working in a LITC or STCP. See instructions for Part II for additional information and requirements.
r Enrolled Retirement Plan Agent—enrolled as a retirement plan agent under the requirements of Circular 230 (the authority to practice before the
Internal Revenue Service is limited by section 10.3(e)).
▶ IF THIS DECLARATION OF REPRESENTATIVE IS NOT COMPLETED, SIGNED, AND DATED, THE IRS WILL RETURN THE
POWER OF ATTORNEY. REPRESENTATIVES MUST SIGN IN THE ORDER LISTED IN PART I, LINE 2.
Note: For designations d–f, enter your title, position, or relationship to the taxpayer in the “Licensing jurisdiction” column.
Licensing jurisdiction Bar, license, certification,
Designation—
(State) or other registration, or enrollment Signature Date
Insert above
licensing authority number (if applicable)
letter (a–r).
(if applicable)
00117987-EA
1 Taxpayer information. Taxpayer must sign and date this form on line 6.
Taxpayer name and address Taxpayer identification number(s)
Michael Boggs 255-43-1720
1283 Hancock Ave Daytime telephone number Plan number (if applicable)
Gainsville GA 30501 (470)660-0088
2 Designee(s). If you wish to name more than two designees, attach a list to this form. Check here if a list of additional
designees is attached ▶
Name and address CAF No. 0313-76514R
Elizabeth Castellanos PTIN P02254049
16808 Armstrong Ave # 215 Telephone No. (800)556-5014
Irvine CA 92606 Fax No.
Check if to be sent copies of notices and communications Check if new: Address Telephone No. Fax No.
Name and address CAF No. 0314-79227R
Jaileen Cruz PTIN P02464105
16808 Armstrong Ave # 215 Telephone No. (949)771-1996
Irvine CA 92606 Fax No. (949)771-1196
Check if to be sent copies of notices and communications Check if new: Address Telephone No. Fax No.
3 Tax information. Each designee is authorized to inspect and/or receive confidential tax information for the type of tax, forms,
periods, and specific matters you list below. See the line 3 instructions.
By checking here, I authorize access to my IRS records via an Intermediate Service Provider.
(a) (b) (c) (d)
Type of Tax Information (Income, Tax Form Number Year(s) or Period(s) Specific Tax Matters
Employment, Payroll, Excise, Estate, Gift, (1040, 941, 720, etc.)
Civil Penalty, Sec. 4980H Payments, etc.)
Income, Separate Assessment 1040, 1040SA, 1099s, W-2s 2001-2026 NA
4 Specific use not recorded on the Centralized Authorization File (CAF). If the tax information authorization is for a
specific use not recorded on CAF, check this box. See the instructions. If you check this box, skip line 5 . . . . . . ▶
5 Retention/revocation of prior tax information authorizations. If the line 4 box is checked, skip this line. If the line 4 box
isn’t checked, the IRS will automatically revoke all prior tax information authorizations on file unless you check the line 5
box and attach a copy of the tax information authorization(s) that you want to retain . . . . . . . . . . . . ▶
To revoke a prior tax information authorization(s) without submitting a new authorization, see the line 5 instructions.
6 Taxpayer signature. If signed by a corporate officer, partner, guardian, partnership representative (or designated
individual, if applicable), executor, receiver, administrator, trustee, or individual other than the taxpayer, I certify that I have
the legal authority to execute this form with respect to the tax matters and tax periods shown on line 3 above.
▶ IF NOT COMPLETED, SIGNED, AND DATED, THIS TAX INFORMATION AUTHORIZATION WILL BE RETURNED.
01/29/2025
Signature Date
Michael Boggs
For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Cat. No. 11596P Form 8821 (Rev. 01-2021)
Tax Information Authorization Form 8821 - Page 2
Additional Designee(s)
Fax No: