 | Pennsylvania Tax Power of Attorney Form |
The Pennsylvania tax power of attorney form is a document that is completed and provided by a taxpayer, to authorize powers for an individual or tax business entity, for the purpose of completing tax forms or, if needed, represent a taxpayer before the Department of Revenue.
The document must be signed by all parties after completion of the document and after the document has been printed. Unless otherwise stated, completion and signature to this document will revoke all other tax documents. This document may be revoked at the discretion of the taxpayer.
How to Write
Step 1 – Taxpayer’s Information – Enter the following:
- Taxpayer name
- Identification number (SSN, EIN etc)
- Address
- City
- State
- Zip Code
- AND
- Appointed Agent’s name
- Telephone number
- Tax preparer identification number (PTIN)
- Address
- City
- State
- Zip Code
Step 2 – Type of Tax Information and Authorization – Submit the following information:
- Types of tax
- Tax Year(s) or Period(s)
- Tax return/Form
- Purpose for authorization
- The Agent must read and agree to the statement
- Initial the box to grant powers to receive confinential, financial information but not to endorse or cash checks
Step 3 – In the Event of Audit – Agent must provide:
- Agent(s) name(s)
- Telephone number(s)
- Address
- City
- State
- Zip Code
- Signature of Agent or taxpayer
- AND
- Granter’s name
- Date of execution of document mm/dd/yyyy format
- Check box to refer to attacked documents
- Address
- City
- State
- Zip Code
- Signature for taxpayer
Step 4 – Signature –
- Provide the signature of the Agent signing on behalf of the taxpayer
- Title
- Date of signature in mm/dd/yyyy format
Step 5 – Signature(s) of Witnesses OR Notary – Should the Agent be an individual who is not a CPA, attorney or enrolled Agent, the document must be witnessed by a notary:
- Enter the witnesses signatures
- Date the signatures in mm/dd/yyyy format
- OR
- The notary shall witness the signatures of the taxpayer and Agent’s
- The notary will complete the section by entering all required information in acknowledgement
Step 6 – Declaration of Representative – The Agent(s) must read the declaration and provide the following:
- Designation (by selecting the applicable number 1 through 7 )
- Jurisdiction (State)
- Signatures to be printed after printing
- Dates of signatures in mm/dd/yyyy format
