Date. DAY MONTH YEAR ✍
Date. Xxxxxxxxx Xxxxxxxxx United Nations Development Programme São Tomé, São Tomé and Principe Dear Sir/Madam:
Date. 3. Name from to Awaiting decision Visa label number DAY MONTH YEAR DAY MONTH YEAR If granted a visa without a label, provide the 13-digit visa grant number (as shown on the
Date. 6. Name from DAY MONTH YEAR DAY MONTH YEAR to
Date. Full name (print in English) POSTCODE Number of additional applicants :
Date. Data no formato dd/MM/yyyy 00:00 - Exemplo: 11/12/2018 00:00 Data no formato dd/MM/yyyy hh:mm . Exemplo: 11/12/2018 16:42
Date. Title (if applicable) Print Name PIN Number
Date. Title (if applicable) Under penalties of perjury, I declare that: ● I am not currently under suspension or disbarment from practice before the Internal Revenue Service; ● I am aware of regulations contained in Circular 230 (31 CFR, Part 10), as amended, concerning the practice of attorneys, certified public accountants, enrolled agents, enrolled actuaries, and others; ● I am authorized to represent the taxpayer(s) identified in Part I for the tax matter(s) specified there; and ● I am one of the following: h Unenrolled Return Preparer—the authority to practice before the Internal Revenue Service is limited by Circular 230, section 10.7(c)(1)(viii). You must have prepared the return in question and the return must be under examination by the IRS. See Unenrolled Return Preparer on page 1 of the instructions. } IF THIS DECLARATION OF REPRESENTATIVE IS NOT SIGNED AND DATED, THE POWER OF ATTORNEY WILL Designation—Insert above letter (a–r) Jurisdiction (state) or identification Signature Date Form 2848 (Rev. 6-2008) Form 8821(Rev. August 2008)Department of the Treasury Internal Revenue Service Tax Information Authorization } Do not sign this form unless all applicable lines have been completed. } Do not use this form to request a copy or transcript of your tax return. Instead, use Form 4506 or Form 4506-T. OMB No. 1545-1165 For IRS Use Only Received by: Name Telephone ( ) Function Date / / Taxpayer name(s) and address (type or print) Social security number(s) Employer identification number Daytime telephone number ( ) Plan number (if applicable) Name and address CAF No. Telephone No. 000 000 0000 Fax No. 000 000 0000 Check if new: Address ✔ Telephone No. Fax No.
Date. Title (if applicable)
Date. Title (if applicable) PIN number for electronic signature PIN number for electronic signature Cat. No. 11596P Form 8821 (Rev. 8-2008) Form 8822 (Rev. December 2008) Department of the Treasury Internal Revenue Service