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Form 8821 Minnesota Hennepin: What You Should Know

Health Facilities System of the Minnesota Department of Human Services. Form 8821 has been designated as a Tax Information Authorization in accordance with Internal Revenue Code (I.R.C.) §6044. All persons, corporations, firm, or organizations that obtain tax information from a Health Facilities System of the Minnesota Department of Human Services must provide this Tax Information Authorization through the Department of Human Services. This form is designed for non-profit organizations. Your consent for the following is required before a request for any and all tax information will be made by the Department of Human Services, Bureau of Medical Services and the Minnesota Department of Human Services Bureau of Vital Statistics and Public Health. I.R.C. §6044(a)(1)(A). Please read this form carefully before signing. (1) For the purpose of preparing your tax return (2) For the purpose of any ongoing investigation or assessment with respect to any tax return or tax return information (3) To change or correct any return, information, or assessment. This information authorization is voluntary and a signed copy of it does not constitute an admission of liability or responsibility by the taxpayer. The Commissioner of Revenue and/or the Minnesota Department of Human Services reserve the right to use the information authorization only for tax administration purposes. This is an agreement between a taxpayer and the Commissioner of Revenue and/or the Minnesota Department of Human Services, Bureau of Medical Services and the Minnesota Department of Human Services Bureau of Vital Statistics and Public Health. The Commissioner of Revenue & the Minnesota Department of Human Services reserve the right to revoke their use as needed for tax administration purposes when there is specific law enforcement or other public safety or welfare purposes in relation to the specific individual and the Commissioner of Revenue or Minnesota Department of Human Services, Bureau of Medical Services and Bureau of Vital Statistics and Public Health determine that the use of the tax information authorization was used without the taxpayer's specific consent. Please also read our terms of use page.

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