2022 Withholding Tax Payroll Service Company Authorization
Arizona Form 821-PSC
For information or help, call one of these numbers:
Phoenix: (602) 255-3381
From area codes 520 and 928, toll-free: (800) 352-4090
Tax forms, instructions, and other tax information
If you need tax forms, instructions, and other tax information, go to the department’s website at www.azdor.gov.
Withholding Tax Procedures and Rulings
These instructions may refer to the department’s withholding tax procedures and rulings for more information. To view or print these, go to our website and click on Reports & Legal Research then click on Legal Research and select a Document Type and Category from the drop down menus.
Publications
To view or print the department’s publications, go to our website and click on Reports and Legal Research. Then click on Publications.
General Instructions
Purpose of Form
A taxpayer may use Form 821-PSC to authorize any individual, corporation, firm, organization, or partnership to sign returns, file returns, make payments, inspect and receive confidential Arizona withholding tax information beginning with the withholding tax period listed on the form until either four years after the authorization is received by the department, or the authorization is revoked, whichever occurs first.
If a taxpayer wants an individual to inspect or receive information for tax types other than withholding, or to perform other acts on the taxpayer’s behalf, the taxpayer may not use Form 821-PSC. The taxpayer must use Arizona Form 285, General Disclosure/Representation Authorization Form, or other comparable form. Only an individual may be designated as a representative under a General Disclosure/Representation Authorization Form.
Filing Instructions
If an Arizona Department of Revenue employee requests that you submit this form, please submit the completed form to that employee at the address provided by that employee.
Otherwise, the department offers three options to submit this form:
• Email the completed form to: POA@azdor.gov
• Fax the completed form to: (602) 716-6088
• Mail the original or copy of the completed form to: Arizona Department of Revenue
ATTENTION: Power of Attorney PO Box 29086 Phoenix, AZ 85038-9086
Specific Instructions
Section 1 - Taxpayer Information
Individuals/Sole Proprietors - enter your business name, address, and your Taxpayer Identification Number (TIN).
Corporations, partnerships, or associations - enter the name, business address, and the Employer Identification Number (EIN) of the business.
Trusts - enter the name, title, and address of the trustee, as well as the EIN of the trust.
Estates - enter the name, title, and address of the decedent’s executor/personal representative as well asthe EIN of the estate.
Section 2 - Appointee Information
Enter your appointee information. For an appointee ID, please provide the appointee’s Social Security Number, CPA number, State Bar number, Preparer Tax Identification Number, EIN, or other ID number.
Section 3 - State Authorization
The appointee is authorized to sign returns, file returns, make payments, inspect and receive confidential Arizona withholding tax information beginning with the withholding tax period listed on the form for either four years after the authorization is received by the department, or the authorization is revoked, whichever occurs first. Enter the period for which the authorization begins. If you do not want to authorize all of these acts, use another form, such as Arizona Form 821.
Section 4 - Retention/Revocation of Authorization
A new authorization will revoke a prior authorization if it is granted by the taxpayer to another appointee for the same periods covered by this document.
If there is any existing authorization you do not want to revoke, check the box on this line, and include a copy of the authorization.
A taxpayer may revoke an authorization without authorizing a new appointee by filing a statement of revocation with the department. The statement of revocation must indicate that the authority of the previous authorization is revoked and must be signed by the taxpayer. Also, the name and address of each appointee whose authority is revoked must be listed (or a copy of the authorization to be revoked must be included and marked “revoked”).
The filing of a Form 821-PSC will not revoke any Arizona Form 285, or other power of attorney that is in effect.
Section 6 - Signature of or for Taxpayer
NOTE FOR CORPORATIONS:
An Officer holding a corporate title other than one of those listed, should check the box above the signature line in Section 6 to certify that they are a principal officer of the corporation. For example; a Vice President of Finance or an Assistant Treasurer is not listed and therefore would be required to certify that the officer is a principal officer by checking the box in Section 6.
For more information, see the department’s General Tax Procedure, GTP 18-1, Procedure for Submitting an Authorization for Disclosure of Confidential Information and Powers of Attorney