Form M-5008-R - Appointment Of Taxpayer Representative
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1
2M-5008-R
State of New Jersey Division of Taxation
Page 1 of 2
(11-16)
APPOINTMENT OF TAXPAYER REPRESENTATIVE
(Type or Print)
1. Taxpayer Information
If the matter(s) for which you are preparing this appointment involves a joint gross income tax return and the representa-
tive(s) is/are being appointed to represent both spouses, you must enter the information for both.
If the taxpayer is a trust or estate, you must enter its name, employer identification number (EIN), and the name and ad-
dress of the trustee, executor, or administrator, as applicable.
Taxpayer is:
Individual
Corporation
Partnership
Sole Proprietorship
Estate
Limited Liability Company
Trust (other than a business trust)
Other: ______________________________________________________
Taxpayer’s Name
Social Security Number
Spouse’s/CU Partner’s Name
Social Security Number
Mailing Address
NJ Taxpayer ID number (if other than SS#)
City
Name and Address of Trustee or Executor
State
Zip
2. Representative Information
In order to accept this appointment, the named representative(s) must sign and date where indicated in Section 8 on page
2. If the representative being appointed is a tax practitioner, the representative must enter his/her preparer tax identifica-
tion number (PTIN) as the Representative ID. Representatives who do not have a PTIN must enter their social security
number.
The taxpayer(s) named in Section 1 above appoints the person(s) named below as his/her/their taxpayer representative to
represent them in connection with the tax matter(s) listed in Section 3.
Name and Address
Telephone Number:
Fax Number:
Representative ID:
Name and Address
Telephone Number:
Fax Number:
Representative ID:
3. Tax Matters
I/We appoint the representative(s) named in Section 2 above for represent me/us for:
All tax matters
The specific tax matters listed below:
Type of Tax (NJ Gross Income, Sales and Use, Corporate Business, Employment, etc.)
Years(s) & Period(s)
4. Acts Authorized. The representative(s) is/are authorized to receive and inspect confidential tax records and is/are
granted full power to act with respect to the tax matters described in Section 3 above, and to do and perform all such acts
as I/we could do or perform. The authority granted by this appointment does not include the power to endorse a refund
check.
If you want the representative(s) to have limited power, provide an explanation on the lines below and mark an X in
this box. You may attach additional information as well.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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