INSTRUCTIONS: ARIZONA WITHHOLDING TAX PAYROLL SERVICE COMPANY AUTHORIZATION (Form 821-PSC) To authorize a payroll service company to receive and inspect confidential documentation regarding Arizona withholding tax, you must file a form 821-PSC. This document can be obtained from the website maintained by the Arizona Department of Revenue. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 1: Section 1 requires information about the taxpayer. On the first line, enter your name and daytime telephone number. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 2: On the second line, enter your street address or PO box number. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 3: On the third line, enter your city, state and zip code. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 4: In the box on the right, enter your Employer Identification Number (EIN). Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 5: Section 2 requires information about the payroll service company being authorized. On the first line, enter their name and identification number. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 6: On the second line, enter their street address or P.O. box number and their telephone number. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 7: On the third line, enter their city, state, zip code and fax number. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 8: Section 3 states that you are authorizing the payroll service company in question to discuss confidential documentation with the Arizona Department of Revenue, as well as making deposits to that department and filing and signing tax returns. Enter the year from which going forward the payroll service company is authorized to take these steps. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 9: Section 4 states that this authorization automatically revokes all previous authorizations filed for this period. If this is not the case, check the box where indicated and attach copies of all authorizations you wish to remain in effect. Arizona Withholding Tax Payroll Service Company Authorization 821-PSC Step 10: Section 5 only needs to be read, not completed. In section 6, at least one taxpayer and up to two must print their name on the first line, provide their signature on the second line, and enter the date on the third line.