Form R-7 - Application For Enrollment As A Virginia Authorized Agent


Application for Enrollment as a
Form R-7
Virginia Authorized Agent
Complete this form to register as an authorized agent representing taxpayers before the Virginia Department of Taxation
or to change information if you are already registered as an authorized agent. A Virginia Authorized Agent is not required
to be an enrolled agent. The Virginia Authorized Agent designation simply means that the individual has registered with the
Virginia Department of Taxation as a representative for taxpayers.
When this form is processed, a letter will be sent from the Virginia Department of Taxation confirming your registration as
an authorized agent and will include your Virginia Authorized Agent Number. This number must be included on the Form
PAR 101.
Form PAR 101 must be completed by the taxpayer to declare a representative and establish a power of attorney.
Return this form to:
Virginia Department of Taxation
(804) 367-2603
P.O. 1114
For Individual Assistance Call:
(804) 367-8031
Richmond, Virginia 23218-1114
For Business Assistance Call:
(804) 367-8037
Representative Information
Change of information - Check here to indicate this form is being
Virginia Authorized Agent Number
submitted for changes to name, address, phone number, fax and e-mail
(complete for changes only)
address. Include the Authorized Agent number for change of
A -
information only.
Last Name
First Name
Business Name (If applicable)
Business Address or P.O. Box (Mailing address if not a business)
Note: Additional businesses may be
included by attaching a separate list.
City, State and Zip Code
Be sure to include complete business
name, address and FEIN.
SSN (or last 4 digits)
Federal CAF # (if applicable)
Sign Here
Best Daytime Phone Number
FAX Number
E-mail Address
Note: No personalized taxpayer correspondence or tax data
will be sent via e-mail. The e-mail address will be used only for
general information and registration purposes.
VA Dept. of Taxation 1501245 Rev. 05/12


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