IRS Disclosure Authorization for Victims of Identity Theft

Tax Information Authorization

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1165 can be found here:

Documents and Forms

Document Name Document Type
Form 8821-A IRS Disclosure Authorization for Victims of Identity Theft Form and Instruction
8821-A IRS Disclosure Authorization for Victims of Identity The Form_8821-A_APR2012.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	IRS Disclosure Authorization for Victims of Identity Theft	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 26 CFR 301.6103(c)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	8821-A	IRS Disclosure Authorization for Victims of Identity Theft	Form_8821-A_APR2012.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title: IRS 24.030--Customer Account Data Engine Individual Master File, formerly Individual Master File, and IRS 34.037--IRS Audit Trail and Security Records System	FR Citation: 83 FR 42980

Number of Respondents: 182	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	182	-49,818	50,000
Annual IC Time Burden (Hours)	27	-7,473	7,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.