TAX REFUND/ REMBOLSO DE IMPOSTOS
US/ EUA
TAX REFUND/ REMBOLSO DE IMPOSTOS
INSTRUÇÕES
Para solicitar seu reembolso, você deve:
Assinar os formulários do IRS (Receita americana) 2848, 8821 e 8822
Enviá-los por e-mail, juntamente com seus demonstrativos de renda, documentos de identificação e nosso contrato.
Após imprimir os 3 formulários e o contrato, proceder da seguinte maneira:
Formulário 2848 – 2 páginas:
Página 1: Coloque suas iniciais (1ª letra de seu primeiro e último nome) em azul ou preto, onde houver a figura de uma “canetinha”.
Página 2: Assinar e datar em azul ou preto, próximo à canetinha impressa.
Formulários 8821 e 8822 – Apenas assine e date em azul ou preto.
Acordo com o cliente / Customer Agreement - Assine e date em azul ou preto, apenas onde estiver marcado com a canetinha.
Identificação – Envie-nos uma cópia de seu Social Security Card e do visto no passaporte.
Demonstrativos de pagamento – último payslip (contracheque) ou W2 de cada empregador nos EUA. Informações de contato – se tiver um novo número de celular ou e-mail, favor atualizar tais dados. É necessário para o envio do reembolso.
A forma mais rápida de obter uma restituição é:
Enviando sua documentação scaneada para: xxxxxxxxxxx@xxxxxxx.xxx.
Digitalizar imagens:
1. Configure no padrão americano cada documento digitalizado:
• Altura: 11 polegadas (279mm);
• Largura: 8.5 polegadas (216mm).
2. Em preto e branco;
3. Resolução “300 dpi”;
4. Arquivos PDF ou JPEG;
5. O tamanho máximo permitido para cada arquivo é 2MB.
Havendo qualquer dificuldade para digitalizar os documentos, fale conosco em xxx.xxxxxxx.xxx/xxxx
ou contate uma de nossas agências. Veja qual a mais próxima acessando xxx.xxxxxxx.xxx/xxxxxxxxx.xxx
xxxxxxx.xxx
Endereço no Brasil: Xx. Xxxxxxxx, 0000 Xxxxx X - Xx. 000 Xxx Xxxxx - XX
CEP: 01311-300
T: 55 11 3266 8878
F: 55 11 3284 9756
E: xxxxxx@xxxxxxx.xxx W: xxx.xxxxxxx.xxx.xx
Endereçonos EUA: 333N,MichiganAve Xxxxx0000
Xxxxxxx,XX00000 XXX
T:0018882038900
F:0013128734202
EndereçonaEuropa: IDABusiness& TechnologyPark
RingRoad,Kilkenny Ireland
P:0035318871999
F:0035316706963
Visite xxx.xxxxxxx.xxx para mais informações sobre nossos serviços
Quanto mais dados você puder nos fornecer, mais rápido será providenciada a restituição. xxxxxxxxxxx@xxxxxxx.xxx
US/ EUA
TAX REFUND/ REMBOLSO DE IMPOSTOS
Preencha e assine estes formulários. Anexe seus W2s, últimos Holerites, cópia do visto e cópia do Social Security Card. Xxxxxxxx e envie tudo para XXxxxxxxxxx@xxxxxxx.xxx
APPLICATION FORM / FORMULáRIO DE REqUERIMENTO
1 2
Assine os formulários
Envie-os com seus dados tributários
Receba seu reembolso
xxxxxxx.xxx
3
Endereço no Brasil: Av. Paulista, 2073 Horsa I - Cj. 413
1
CONTACT INFORMATION / INFORMAÇÕES PARA CONTATO:
P LEASE PRINT IN BLOCK CAPITALS in ENGLISH / FAvOR PREENChER COm LETRA dE formA mAIúScULA
São Paulo - SP CEP: 01311-300
T: 55 11 3266 8878
F: 55 11 3284 9756
Mr/Sr:
Mrs/Sra:
Ms/Srta:
First Name / Nome:
E: xxxxxx@xxxxxxx.xxx W: xxx.xxxxxxx.xxx.xx
Surname / Sobrenome: Middle Initial / Inicial de nome do meio:
Date of Birth / Data de nasc: DAY MONTH YEAR Tel:
Email: Mobile / Cel:
Home Country / País de origem:
How did you hear of our service / Como soube da Taxback?
Postal address / Endereço postal:
2 VISA INFORMATION / DADOS DO VISTO:
Please X the correct option / Assinale com um “X” na opção correta: Visa Type / Tipo de visto:
Program type / Tipo de programa:
Work & Travel Intern/Estágio Other/ Outros X0 X0 X0X X0X Q L E P O Other / Outro:
Endereçonos EUA:
333N,MichiganAve
Suite2415,Chicago,IL60601 USA
T:0018882038900
F:0013128734202
EndereçonaEuropa:
IDABusiness&TechnologyPark RingRoad,Kilkenny
Ireland
P:0035318871999
F:0035316706963
Date of arrival in the USA / Data de chegada aos EUA: DAY MONTH YEAR Date of departure from the USA / Data de partida dos EUA: DAY MONTH YEAR
Have you applied for this refund before/ Já solicitou este reembolso antes? Yes No
What was the cost of your programme to the US / Qual o custo de seu programa para os EUA? $ What was the cost of your flight to the US / Quanto custou seu vôo aos EUA? $
Portadores de visto que possuem despesas no país de origem durante programa nos EUA poderão obter valores maiores em restituição legal.
Please tick which living expenses you paid for in your home country, while you were on your US program / Favor assinalar os custos a seu encargo no país de origem no período do programa nos EUA:
Insurance (medical, home, vehicle, etc) / Mobile phone costs / Club membership (gym, sports, social, etc) / Seguros (médico, residencial, de veículos, etc): Desapesas com telefone celular: Clubes (academias, esportes, sociais, etc):
Housing costs (rent, mortgage, board, etc) / Transportation (car, motorbike, bicycle, etc) / Other / Despesas com habitação (aluguel, hipoteca, mantimentos, etc.): Transporte (carro, moto, bicicleta, etc.): Outros:
Uma restituição maior pode lhe ser concedida se esteve empregado em seu país antes e após o programa nos EUA, e/ou provendo o sustento de alguém em seu país durante o programa.
1. Did you have a job in your home country? / Tinha emprego em seu país? Yes No
2. Do you intend to return to that job when you leave the US? / Pretende retornar a esse emprego ao deixar os EUA? Yes No
3. Do you have a permanent address in your home country? / Possui xxxxxxxx fixo em seu país? Yes No
4. Do you intend to return to this address when you leave the US? / Pretende retornar a esse endereço quando deixar os EUA? Yes No
5. Did you pay money towards a household in your home country while in the US?/
Contribuiu com dinheiro para o sustento de um lar em seu país enquanto esteve nos EUA? Yes No
6. Are you entitled to vote in your home country? / Você é eleitor em seu país? Yes No
7. Do you have a bank account in your home country? / Possui conta bancária em seu país? Yes No
8. Did you receive mail to your home address while in the US?/
Recebia correspondência em seu endereço residencial nos EUA? Yes No
3 EMPLOYMENT INFORMATION / INFORMAÇÕES DE EMPREgOS
1st Company Name / Nome da 1ª empresa: Final work date / Data de término do trabalho: DAY MONTH YEAR
City / Cidade: State / Estado: Tel:
Do you have your W2 Form? / Possui seu(s) W2? Yes | No | If no, would you like us to get a replacement for you?*/ Se não, gostaria que o(s) conseguíssemos para você? Yes No |
2nd Company Name / Nome da 2ª empresa: | Final work date / Data de término do trabalho: DAY MONTH YEA | |
City / Cidade: State / Estado: | Tel: | |
Do you have your W2 Form? / Possui seu(s) W2? Yes | No | If no, would you like us to get a replacement for you?*/ Se não, |
gostaria que o(s) conseguíssemos para você? Yes No
*Document retrieval fee applies / *É cobrado taxa para obtenção de documentos
If you had more than two employers please include information on a separate page. /
Se você teve mais de dois empregadores, favor incluir as informações em uma folha separada.
Quanto mais dados você puder nos fornecer, mais rápido será providenciada a restituição. xxxxxxxxxxx@xxxxxxx.xxx
US/ EUA
TAX REFUND/ REMBOLSO DE IMPOSTOS
CUSTOMER AgREEMENT / CONTRATO
I confirm that / Confirmo que 1. I understand that xxxxxxx.xxx is a trading name for the services of Taxback Inc., Chicago, USA, and hereby contract with Taxback Inc. to carry out the services described herewith. / Compreendo por xxxxxxx.xxx nome fantasia para serviços da Taxback Inc., Chicago, USA, conforme descritos neste instrumento, através do qual ora é firmado contrato. 2. I understand that Taxback Inc will utilise its parent company Taxback Ltd and its subsidiary and affiliate companies to gather information regarding the services where necessary and that the contract remains with Taxback Inc for the duration of the service. / Taxback Inc recorrerá àTaxback Ltd (controladora), bem assim subsidiárias e afiliadas, caso seja necessário reunir informações pertinentes aos serviços – durante prestação do qual o contrato permanece em poder da Taxback Inc. 3. I have signed the necessary power of attorneys to authorize Taxback. Inc, and / or its subsidiary undertakings trading as xxxxxxx.xxx and referred to hereafter as the Agent, to prepare this tax return and represent me before the US Tax Authorities (IRS and State Tax Authorities). / Assinei as procurações que autorizam àTaxback. Inc e/ou seus empreendimentos subsidiários atuando sob nome xxxxxxx.xxx, doravante aqui tratados como o Agente, lavrar minha declaração de impostos e representar-me perante o fisco norte-americano (IRS e autoridades estaduais). | taxback.com Endereço no Brasil: Xx. Xxxxxxxx, 0000 Xxxxx X - Xx. 000 Xxx Xxxxx - XX CEP: 01311-300 T: 55 11 3266 8878 F: 55 11 3284 9756 |
Endereçonos EUA: 333N,MichiganAve Xxxxx0000 Xxxxxxx,XX00000 XXX T:0018882038900 F:0013128734202 | |
4. I authorize the Agent to receive all correspondence from the US Tax Authorities on my behalf. / Autorizo o EndereçonaEuropa: Agente a receber todas as correspondências enviadas pelas Autoridades Fiscais dos EUA em meu nome. IDABusiness& TechnologyPark 5. I want to avail of the offer to “pay no fee up-front” when I sign up for the service. In order to avail of this option, I understand RingRoad,Kilkenny that the fee will need to be paid by me when the refund has been issued by the US Tax Authorities. / Desejo contratar este Ireland serviço valendo-me da política “Tarifa Adiantada Zero”. Para tanto, aceito efetuar o devido pagamento à xxxxxxx.xxx tão P:0035318871999 logo minha restituição de impostos seja deferida pelas Autoridades Fiscais dos EUA. F:0035316706963 6. I authorize the Agent to receive my refund cheque(s) from the Tax Authorities. / Autorizo o Agente a receber meu(s) cheque(s) de restituição enviado pelas Autoridades Fiscais. 7. I further authorize the Agent to endorse the cheques, deduct the necessary fee and to send me the remaining amount. / Além disso, autorizo o Agente a endossar o(s) cheque(s), deduzir tarifas necessárias e me enviar a quantia restante. 8. I understand that once my refund is processed, I will be contacted by the Agent with regard to payment options for receiving my refund and will be able to provide my bank details. / Estou ciente de que uma vez processada a restituição, o Agente me fará contato para definirmos a forma de recebimento do reembolso; quando então poderei fornecer os detalhes de minha conta bancária. 9. Should the Agent choose for any reason not to endorse the cheque, I understand and agree that I will pay the fee due and will cash the tax office refund cheque myself. / Caso o Agente por qualquer motivo decida não endossar meu(s) cheque(s) de reembolso, pagarei a tarifa pelo serviço concluído e pessoalmente os descontarei. 10. Should I receive the refund directly from any other source other than the Agent, I understand and agree that I will pay the fee due to the Agent for the work completed. / Se a restituição chegar através de qualquer outra fonte que não seja o Agente, pagarei a tarifa devida a este pelo trabalho realizado. 11. Should I owe income tax for other tax years, and the US Tax Authorities deduct this owed money from the refund due for other tax year (s), I understand and agree that I need to pay the Agent processing fee for each tax year for which a tax return was processed. / Caso eu tenha pendências referentes a outros anos fiscais, e a Receita dos EUA deduzir tal valor da restituição deferida por outro(s) períodos(s) trabalhado(s), concordo em pagar a taxa de processamento do Agente para cada ano fiscal cuja declaração do imposto de renda foi emitida. 12. I understand that the US Tax Authorities will make the final decision on the value of any refund due. I understand that the Agent will provide the best estimation possible based on current tax law and information given, however this is estimation only, not a guarantee. / Compreendo caber às Autoridades Fiscais nos EUA a decisão final sobre o valor do reembolso. Embora a estimativa do Agente (elaborada com base nas leis fiscais vigentes e em dados fornecidos) seja a melhor possível, o valor nela contido não constitui uma garantia. 13. I agree to and accept the terms and conditions of service as written online at xxx.xxxxxxx.xxx and to any changes in the terms and conditions which Taxback Inc may affect from time to time, and to the fees of the agent which represents the services I have requested and which are provided by Taxback Inc and/or its affiliate companies. / Estou de pleno acordo com os termos contratuais, segundo descritos online em xxx.xxxxxxx.xxx, bem como possíveis alterações efetuadas nos mesmos pela Xxxxxxx.Xxx. Isto também se aplica aos honorários do Agente por conta dos serviços que solicitei, prestados por Xxxxxxx.Xxx e /ou por empresas associadas. 14. I understand that information collected in writing and/or verbally for US tax return filing services can and may be used for internal auditing purposes by xxxxxxx.xxx and provided to the US Tax Authorities (IRS and State Tax Authorities) for external auditing purposes, subject to relevant data protection legislation. / Dados fornecidos por escrito e/ou verbalmente para emissão das declarações de impostos podem ser examinados em auditorias internas conduzidas pela xxxxxxx.xxx, e/ou submetidos ao fisco norte-americano (IRS e autoridades estaduais) na realização de auditorias externas, conforme as disposições legais regulatórias do sigilo de informação. 15. I confirm that I have given the Agent all information needed and available to me. / Forneci ao Agente todas as informações das quais dispunha. 16. I commit to updating the Agent of any change in my contact details. / Manterei o Agente atualizado sobre qualquer alteração em minhas informações de contato. Name in print / Nome em letra de forma: Date / Data: Signature /Assinatura: Social Security Number: | |
Visite xxx.xxxxxxx.xxx para mais informações sobre nossos serviços xxxxxxxxxxx@xxxxxxx.xxx
Form 2848
(Rev. June 2008) Department of the Treasury Internal Revenue Service
Power of Attorney
and Declaration of Representative
} Type or print. } See the separate instructions.
Part I Power of Attorney
Caution: Form 2848 will not be honored for any purpose other than representation before the IRS.
OMB No. 1545-0150
For IRS Use Only
Received by:
Name Telephone Function
1 Taxpayer information. Taxpayer(s) must sign and date this form on page 2, line 9. Date / /
Taxpayer name(s) and address Social security number(s) Employer identification number
c/o TB Refunds Ltd., IDA Business & Technology Park,
Ring Road, Kilkenny, Ireland
Plan number (if applicable)
Daytime telephone number
( )
hereby appoint(s) 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 AK Tax Services Inc., 0000 X. Xxxxxxxxx, Xxxxxxx, XX 00000 | CAF No. Telephone No. 000 000 000 Fax No. Check if new: Address Telephone No. Fax No. |
Name and address Taxback Inc., 000 Xxxxx Xxxxxxxx Xxx., Xxxxx 0000 Xxxxxxx, XX 00000 | CAF No. Telephone No. 000 000 0000 Fax No. 000 000 0000 Check if new: Address Telephone No. Fax No. |
Name and address | CAF No. Telephone No. Fax No. Check if new: Address Telephone No. Fax No. |
to represent the taxpayer(s) before the Internal Revenue Service for the following tax matters:
3 Tax matters
Type of Tax (Income, Employment, Excise, etc.) or Civil Penalty (see the instructions for line 3) | Tax Form Number (1040, 941, 720, etc.) | Year(s) or Period(s) (see the instructions for line 3) |
Individual Income Tax | 1040, 1040NR | 2010, 2009, 2008, 2007 |
FICA Tax | 843, 8316 | 2010, 2009, 2008, 2007 |
4 Specific use not recorded on Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on CAF, check this box. See the instructions for Line 4. Specific Uses Not Recorded on CAF }
5 Acts authorized. The representatives are authorized to receive and inspect confidential tax information and to perform any and all acts that I (we) can perform with respect to the tax matters described on Iine 3, for example, the authority to sign any agreements, consents, or other documents. The authority does not include the power to receive refund checks (see line 6 below), the power to substitute another representative or add additional representatives, the power to sign certain returns, or the power to execute a request for disclosure of tax returns or return information to a third party. See the line 5 instructions for more information.
Exceptions. An unenrolled return preparer cannot sign any document for a taxpayer and may only represent taxpayers in limited situations. See Unenrolled Return Preparer on page 1 of the instructions. An enrolled actuary may only represent taxpayers to the extent provided in section 10.3(d) of Treasury Department Circular No. 230 (Circular 230). An enrolled retirement plan administrator may only represent taxpayers to the extent provided in section 10.3(e) of Circular 230. See the line 5 instructions for restrictions on tax matters partners. In most cases, the student practitioner’s (levels k and l) authority is limited (for example, they may only practice under the supervision of another practitioner).
List any specific additions or deletions to the acts otherwise authorized in this power of attorney: This Power of Attorney is being filed pursuant to Regulations 1.6012-1(a)(5), which requires a Power of Attorney to be attached to the return if a return is signed by an agent, by reason of continuous absence from the United States.
6 Receipt of refund checks. If you want to authorize a representative named on Iine 2 to receive, BUT NOT TO ENDORSE OR CASH, refund checks, initial here and list the name of that representative below.
Name of representative to receive refund check(s) }
For Privacy Act and Paperwork Reduction Act Notice, see page 4 of the instructions.
Cat. No. 11980J Form 2848 (Rev. 6-2008)
Form 2848 (Rev. 6-2008)
7 Notices and communications. Original notices and other written communications will be sent to you and a copy to the first representative listed on line 2.
Page 2
a If you also want the second representative listed to receive a copy of notices and communications, check this box }
b If you do not want any notices or communications sent to your representative(s), check this box }
8 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 tax matters and years or periods covered by this document. 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.
9 Signature of taxpayer(s). If a tax matter concerns a joint return, both husband and wife must sign if joint representation is requested, otherwise, see the instructions. If signed by a corporate officer, partner, guardian, tax matters partner, executor, receiver, administrator, or trustee on behalf of the taxpayer, I certify that I have the authority to execute this form on behalf of the taxpayer.
} IF NOT SIGNED AND DATED, THIS POWER OF ATTORNEY WILL BE RETURNED.
Signature
Date
Title (if applicable)
Print Name
PIN Number
Print name of taxpayer from line 1 if other than individual
Part II
Signature
Print Name
Declaration of Representative
PIN Number
Date
Title (if applicable)
Caution: Students with a special order to represent taxpayers in qualified Low Income Taxpayer Clinics or the Student Tax Clinic Program (levels k and l), see the instructions for Part II.
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:
a Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below.
b Certified Public Accountant—duly qualified to practice as a certified public accountant in the jurisdiction shown below.
c Enrolled Agent—enrolled as an agent under the requirements of Circular 230.
d Officer—a bona fide officer of the taxpayer’s organization.
e Full-Time Employee—a full-time employee of the taxpayer.
f Family Member—a member of the taxpayer’s immediate family (for example, spouse, parent, 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 Internal Revenue Service is limited by section 10.3(d) of Circular 230).
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.
k Student Attorney—student who receives permission to practice before the IRS by virtue of their status as a law student under section 10.7(d) of Circular 230.
l Student CPA—student who receives permission to practice before the IRS by virtue of their status as a CPA student under section 10.7(d) of Circular 230.
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 SIGNED AND DATED, THE POWER OF ATTORNEY WILL
BE RETURNED. See the Part II instructions.
Designation—Insert above letter (a–r) | Jurisdiction (state) or identification | Signature | Date |
B | ILLINOIS | ||
H | |||
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 / / |
1 Taxpayer information. Taxpayer(s) must sign and date this form on line 7.
Taxpayer name(s) and address (type or print) | Social security number(s) | Employer identification number | |||
Daytime telephone number ( ) | Plan number (if applicable) | ||||
2 Appointee. If you wish to name more than one appointee, attach a list to this form.
Name and address
CAF No.
Telephone No. 000 000 0000
Taxback Inc., 000 Xxxxx Xxxxxxxx Xxx., Xxxxx 0000
Fax No.
000 000 0000
Xxxxxxx, XX 00000
Check if new: Address ✔
Telephone No.
Fax No.
3 Tax matters. The appointee is authorized to inspect and/or receive confidential tax information in any office of the IRS for the tax matters listed on this line. Do not use Form 8821 to request copies of tax returns.
(a) Type of Tax (Income, Employment, Excise, etc.) or Civil Penalty | (b) Tax Form Number (1040, 941, 720, etc.) | (c) Year(s) or Period(s) (see the instructions for line 3) | (d) Specific Tax Matters (see instr.) |
Individual Income Tax | 1040, 1040NR | 2010, 2009, 2008, 2007 | |
4 Specific use not recorded on Centralized Authorization File (CAF). If the tax information authorization is for a specific use not recorded on CAF, check this box. See the instructions on page 4. If you check this box, skip lines 5 and 6 }
5 Disclosure of tax information (you must check a box on line 5a or 5b unless the box on line 4 is checked):
✔
a If you want copies of tax information, notices, and other written communications sent to the appointee on an ongoing basis, check this box }
b If you do not want any copies of notices or communications sent to your appointee, check this box }
6 Retention/revocation of tax information authorizations. This tax information authorization automatically revokes all prior authorizations for the same tax matters you listed on line 3 above unless you checked the box on line 4. If you do not want to revoke a prior tax information authorization, you must attach a copy of any authorizations you want to remain in effect and check this box }
To revoke this tax information authorization, see the instructions on page 4.
7 Signature of taxpayer(s). If a tax matter applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner, guardian, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to execute this form with respect to the tax matters/periods on line 3 above.
} IF NOT SIGNED AND DATED, THIS TAX INFORMATION AUTHORIZATION WILL BE RETURNED.
} DO NOT SIGN THIS FORM IF IT IS BLANK OR INCOMPLETE.
Signature
Print Name
Date
Title (if applicable)
Signature
Print Name
Date
Title (if applicable)
PIN number for electronic signature PIN number for electronic signature
For Privacy Act and Paperwork Reduction Act Notice, see page 4.
Cat. No. 11596P
Form 8821 (Rev. 8-2008)
Form 8822
(Rev. December 2008)
Department of the Treasury Internal Revenue Service
Change of Address
} Please type or print.
} See instructions on back. } Do not attach this form to your return.
OMB No. 1545-1163
Part I Complete This Part To Change Your Home Mailing Address
Check all boxes this change affects:
✔
1 Individual income tax returns (Forms 1040, 1040A, 1040EZ, 1040NR, etc.)
} If your last return was a joint return and you are now establishing a residence separate from the spouse with whom you filed that return, check here }
2 Gift, estate, or generation-skipping transfer tax returns (Forms 706, 709, etc.)
} For Forms 706 and 706-NA, enter the decedent’s name and social security number below.
} Decedent’s name } Social security number | |||
3a Your name (first name, initial, and last name) | 3b Your social security number | ||
4a Spouse’s name (first name, initial, and last name) | 4b Spouse’s social security number | ||
5 Prior name(s). See instructions.
0x Xxx xxxxxxx (xx., xxxxxx, xxxx xx xxxx, state, and ZIP code). If a P.O. box or foreign address, see instructions. | Apt. no. |
6b Spouse’s old address, if different from line 0x (xx., xxxxxx, xxxx xx xxxx, state, and ZIP code). If a P.O. box or foreign address, see instructions. | Apt. no. |
7 New address (no., street, city or town, state, and ZIP code). If a P.O. box or foreign address, see instructions. TB Refunds Ltd., IDA Business & Technology Park, Ring Road, Kilkenny, Ireland | Apt. no. |
Part II Complete This Part To Change Your Business Mailing Address or Business Location
Check all boxes this change affects:
8 Employment, excise, income, and other business returns (Forms 720, 940, 940-EZ, 941, 990, 1041, 1065, 1120, etc.)
9 Employee plan returns (Forms 5500, 5500-EZ, etc.)
10 Business location
11a Business name | 11b Employer identification number | ||
12 Xxx xxxxxxx xxxxxxx (xx., xxxxxx, xxxx xx xxxx, state, and ZIP code). If a P.O. box or foreign address, see instructions. | Xxxx xx xxxxx xx. | ||
00 Xxx xxxxxxx xxxxxxx (xx., xxxxxx, xxxx xx xxxx, state, and ZIP code). If a P.O. box or foreign address, see instructions. | Xxxx xx xxxxx xx. | ||
00 Xxx xxxxxxxx xxxxxxxx (xx., xxxxxx, xxxx xx xxxx, state, and ZIP code). If a foreign address, see instructions. | Room or suite no. | ||
Part III Signature
Daytime telephone number of person to contact (optional) } ( )
Sign Here
}
}
Your signature
Date
}
}
If Part II completed, signature of owner, officer, or representative Date
If joint return, spouse’s signature
Date
Title
For Privacy Act and Paperwork Reduction Act Notice, see back of form.
Cat. No. 12081V
Form 8822 (Rev. 12-2008)
US/ EUA
TAX REFUND/ REMBOLSO DE IMPOSTOS
POWER OF ATTORNEY
I, FULL NAME / NOME COMPLETO , Date of Birth: MONTH DAY YEAR
SSN (last 4 digits)
xxxxxx appoint the following representative as attorney-in-fact:
Taxback Inc.
000 X. Xxxxxxxx Xxxxxx Xxxxx 0000
Xxxxxxx XX 00000
to act as my legal representative before my employer(s), to perform any and all acts I can perform with regards to the following matters:
xxxxxxx.xxx
Endereço no Brasil: Xx. Xxxxxxxx, 0000 Xxxxx X - Xx. 000 Xxx Xxxxx - XX
CEP: 01311-300
T: 55 11 3266 8878
F: 55 11 3284 9756
E: xxxxxx@xxxxxxx.xxx W: xxx.xxxxxxx.xxx.xx
Endereçonos EUA: 333N,MichiganAve Xxxxx0000
Xxxxxxx,XX00000 XXX
T:0018882038900
F:0013128734202
EndereçonaEuropa: IDABusiness& TechnologyPark
RingRoad,Kilkenny Ireland
P:0035318871999
F:0035316706963
(a) to review, receive and collect original and copied W-2 forms, tax information statements, earnings statements an any other payroll, tax and income related forms and information.
(b) to deal with my Social Security and MediCare (FICA) tax rebate and to receive tax information and refund checks issued in my name at the address stated above.
This Power of Attorney shall become effective immediately on the date signed and shall terminate on the date these matters are completed.
This Power of Attorney revokes all prior Power of Attorney(s) filed.
I am fully informed as to all the contents of this form and understand the full import of granting these powers to my representative.
Signed: Date: MONTH DAY YEAR
Visite xxx.xxxxxxx.xxx para mais informações sobre nossos serviços
Quanto mais dados você puder nos fornecer, mais rápido será providenciada a restituição. xxxxxxxxxxx@xxxxxxx.xxx