Form Poa-1 - Power Of Attorney - New York State Department Of Finance (Page 2 of 2) in pdf

Instructions

POA-1 (6/17) (back)

General information

Section 3 – Mailings

If you want copies of notices and other communications sent to someone

Use Form POA-1, Power of Attorney, when you want to give one or

other than the primary individual representative listed in section 2 of this

more individuals the authority to obligate or bind you, or appear on your

POA, enter the name of that representative on the line provided. This

behalf. You may only appoint individuals (not a firm) to represent you.

representative must be someone who is listed as a representative for the

Note: Authorizing someone to represent you does not relieve you of your

matters covered by this POA on this or another valid POA on file.

tax obligations.

If you do not want copies of notices and other communications sent to

Use this form for all matters (except estate tax) imposed by the Tax

any representative, enter None.

Law or another statute administered by the New York State (NYS)

Department of Taxation and Finance (Tax Department) and the New

Example: On 2/1/2016 you appoint Mr. Smith as your representative

York City (NYC) Department of Finance. If you and your spouse filed a

for all tax matters for 2015. Mr. Smith will receive copies of mailings

joint tax return but have different representatives, you must each file a

for these matters. On 8/15/2016, you appoint Ms. Jones as your

separate Form POA-1.

representative for all tax matters for 2015. Ms. Jones will now receive

copies of mailings for these matters. However, if you want Mr. Smith to

Unless you limit the authority you grant (see section 4), your appointed

continue to receive mailings, you must list Mr. Smith’s name in section 3

representative will be authorized to perform any and all acts you can

of the POA appointing Ms. Jones. Ms. Jones will not receive mailings.

perform, including but not limited to: receiving confidential information

concerning your taxes, agreeing to extend the time to assess tax, and

Section 4 – Authority granted

agreeing to a tax adjustment.

Use this section to specify the matters covered by this POA. By default,

You do not need Form POA-1 to authorize someone to appear with you

this POA will cover all tax types for all tax periods. If you select a tax

or with someone who is already authorized to act for you or to authorize

type, but do not enter a tax period, this POA will cover the tax type

someone to provide information, or prepare a report or return for you.

selected for all tax periods. If you enter a tax period, but do not select a

tax type, this POA will cover the tax period entered for all tax types. For

Only certain types of professionals may act on your behalf before the

tax periods other than calendar years, enter the beginning and ending

NYS Bureau of Conciliation and Mediation Services (BCMS), the NYC

dates for the periods. For taxes based on a specific transaction, enter

Department of Finance Conciliation Bureau or at Tax Appeals. Visit the

the transaction date.

Tax Department’s POA webpage (at ) for more

information.

If your tax type is not listed, or if you are granting authority for a special

assessment or fee administered by an agency, mark an X in the Other

Revocation and withdrawal – New: This POA will remain active until

box and explain. To identify a specific audit case or assessment, mark

you (the taxpayer) revoke it or your representative withdraws from

the Other box and enter a case or assessment ID number.

representing you. Representatives may not revoke a POA.

If you want to limit your representative’s authority, explain the limitation.

For information on ways to revoke a POA, or how a representative

For example, you can limit your representative’s authority to only receive

can withdraw, see the Tax Department’s POA webpage (at

confidential information, but make no binding decisions for you. If you

need more space to explain the limitation, attach a sheet. The attached

Specific instructions

sheet must be signed and dated by each taxpayer named in section 1.

For additional information on how to complete Form POA-1, including

Section 5 – Taxpayer signature

who must sign as the taxpayer, visit the Tax Department’s POA webpage

You or someone who is authorized to act for you must sign and date

(at ).

Form POA-1. The authorized person who signs Form POA-1 may need

Section 1 – Taxpayer information

to provide identification and evidence of authority to sign this POA.

The taxpayer identification number may be a social security number

If a joint tax return was filed and both spouses will be represented by the

(SSN), employer identification number (EIN), individual taxpayer

same representatives, both spouses must sign and date Form POA-1

identification number (ITIN) issued by the Internal Revenue Service, or a

unless one spouse authorizes the other, in writing, to sign for both. In

tax identification number issued by the NYS Tax Department.

that case, attach a copy of the authorization.

Section 2 – Representative information

Where to send Form POA-1

You may use Form POA-1 to appoint one or more representatives. Your

For matters administered by the NYS Tax Department:

Primary individual representative will be mailed copies of notices and

FAX to: (518) 435-8617 (the easiest and fastest method)

other communications unless you direct otherwise in section 3. If you are

Mail to:

appointing more than two representatives, attach a sheet that provides

NYS TAX DEPARTMENT

POA CENTRAL

all of the information requested in section 2. The attached sheet must be

W A HARRIMAN CAMPUS

signed and dated by each taxpayer named in section 1.

ALBANY NY 12227-0864

Caution: This POA cannot be partially revoked or withdrawn. If you

See Publication 55, Designated Private Delivery Services, if not

appoint more than one representative on this POA and later choose

using U.S. Mail.

to revoke one representative or one representative withdraws, the

revocation or withdrawal will apply to all representatives, and none will

For matters administered by NYC Department of Finance, send to the

have ongoing authority to represent you. You must file a new POA to

office in which the matter is pending.

appoint the representatives that you want to continue representing you.

Privacy notification

All representatives are deemed as authorized to act separately unless

New York State Law requires all government agencies that maintain a

you explain that all representatives are required to act jointly on the line

system of records to provide notification of the legal authority for any

in section 4 that allows you to limit the authority granted by this POA.

request for personal information, the principal purpose(s) for which the

For each appointed representative, enter the title or profession or, if

information is to be collected, and where it will be maintained. To view

your representative is not a professional, enter the representative’s

this information, visit our website at , or, if you do not

relationship to you. If the representative is not licensed in NYS, also

have Internet access, call (518) 457-5431 and request Publication 54,

include the state where licensed (for example, Florida attorney). Enter

Privacy Notification.

each representative’s federal preparer tax identification number (PTIN),

The Commissioner of the New York City Department of Finance

SSN, or EIN. If applicable, also enter each representative’s New York tax

is authorized to require disclosure of identifying numbers by

preparer registration identification number (NYTPRIN).

section 11-102.1 of the Administrative Code of the City of New York.

02900206170094

Form Poa-1 - Power Of Attorney - New York State Department Of Finance Page 2

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