Fillable Form Rev184 - Power Of Attorney (Page 2 of 2) in pdf

Form REV184 Instructions

What is a Power of Attorney

Appointee

• Your situation is not specific to a tax type,

year, or period, such as an administrative

(POA)?

The appointee is the person that you are select-

appeal, audit, or collection matter. De-

ing to represent you before the department. The

A power of attorney (POA) is a legal document

scribe the situation(s) on the line below.

person you appoint must be eligible to practice

authorizing someone to act as your represen-

before the Department of Revenue. (See Min-

Optional Elections

tative or appointee. It grants your appointee

nesota Rules 8052.0300.) The following people

power to act on your behalf. It also allows your

Send all department correspondence to the

cannot act as your POA:

appointee to discuss your private tax and nontax

primary appointee

• A person barred or suspended from practice

debt matters with the Minnesota Department of

You can choose to have the department send all

before the department

Revenue.

refunds, legal notices, correspondence, and tax

• A person barred or suspended from practice

information directly to the primary appointee.

When do I use this form?

This election is effective only for the authority

as an attorney or CPA in Minnesota

To give, change, or take away authority of an

you have granted to your primary appointee.

• A person barred or suspended from practice

attorney, accountant, agent, tax return preparer

To make this election, check the box for “Autho-

before the Internal Revenue Service

or other person to represent you before the

rize primary appointee to receive all correspon-

department.

• An employee of the department

dence, including refunds, from the department.”

• A former Revenue employee within 1 year

How do I complete this

Note: If you make this election, you will no

of leaving the department

form?

longer receive anything from the department

Note: You are responsible to keep your ap-

and your primary appointee will receive it all

1) Fill out the taxpayer information.

pointee informed of your tax and nontax debt

on your behalf, including any refunds.

matters. The department does not routinely send

2) Check the box for Add, Change, or Remove.

all documents to the designated appointee. For

See the “Add, Change, or Remove” section

Communicate by email

exceptions, see the Optional Elections section.

below.

If you would like the department to communi-

cate by email with your appointee:

3) Fill out the appointee information. See the

Adding Multiple Appointees

“Appointee” section for details. If you are

• Check the optional election box for “Autho-

To appoint multiple POAs, attach a separate

removing a POA, skip to step 7.

rize appointee to communicate by email”

piece of paper with the following:

4) Choose the authority you want the appointee

• Have your appointee sign and date the elec-

• Appointee information requested in the

to have.

tion

Power of Attorney section of the form

5) Check any of the optional elections you want

Signature

• If you want to authorize the appointee to

the appointee to have. See Optional Elec-

communicate by email, write “I authorize

This power of attorney is not valid until it

tions on this page for details.

this appointee to communicate with the de-

is signed and dated by the taxpayer. If you

6) Enter an expiration date for the POA and

partment by email” and have that appointee

are granting authority for a joint return, both

optional elections. If you do not enter an

sign the piece of paper.

spouses must sign.

expiration date, your POA and optional

Note: The additional appointees must have the

Expiration Date

elections remain in effect until changed or

same authority as the primary appointee. Only

removed.

If you want the POA and elections to end on a

the primary appointee can receive all correspon-

specific date, fill in your chosen month, day and

dence.

7) Sign and date the form.

year in this section.

8) Send the form to the department:

What kind of authority can I

If you don’t provide a date, the POA and elec-

• Attach in a secure email to

grant?

tions will remain in effect until changed or

MNDOR.POA@state.mn.us; or

removed.

You can grant your appointee full authority or

• Fax to 651-556-5210; or

limited authority to work with the department.

Use of Information

• Mail to: Minnesota Revenue, Mail

Full Authority allows your appointee to perform

The information collected on this form may

Station 4123, St. Paul, MN 55146-4123

any and all acts that you can perform in respect

be private or nonpublic data. If so, we cannot

to your private tax and nontax debt that have

Add, Change, or Remove

disclose this data to the public or other agencies.

been referred to the department.

It will only be used for tax administration or col-

Add—Check this box to appoint a new POA.

lection of nontax debts. If you do not provide all

Limited Authority allows your appointee to act

Change—Check this box to change an existing

the requested information, we may not process

on specific tax or nontax debt.

POA that is on file with the department.

your Form REV184.

• Check the box for the tax type or nontax debt

Remove—Check this box to end an existing

for which you want to give you appointee the

Who do I contact with

POA that is on file with the department.

authority.

questions?

Note: If you are starting a new power of at-

• If you want to limit the years or filing periods

torney AND ending another, complete a separate

Website:

list them in the field next to the tax type.

Form REV184 for each task. If you do not end

Email:

MNDOR.POA@state.mn.us

the previous POA, they will both be considered

• Other. Check this box if:

Phone:

651-296-3781 or 1-800-652-9094

your representatives.

• You are granting authority for a tax type

not listed on the form. Enter the tax

type(s) on the line below.

Form Rev184 - Power Of Attorney Page 2

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