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Form 2848 Power Of Attorney And Declaration Of Representative 2848 - Official Federal Forms
| Form 2848 Power Of Attorney And Declaration Of Representative Form. This is a national form and can be used in Department Of Treasury . |
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Form (Rev. March 2012) Department of the Treasury Internal Revenue Service 2848 Power of Attorney and Declaration of Representative Type or print. See the separate instructions. OMB No. 1545-0150 For IRS Use Only Received by: Name Telephone Function Date Part I Power of Attorney Caution: A separate Form 2848 should be completed for each taxpayer. Form 2848 will not be honored for any purpose other than representation before the IRS. / / 1 Taxpayer information. Taxpayer must sign and date this form on page 2, line 7. Taxpayer name and address Taxpayer identification number(s) Daytime telephone number hereby appoints the following representative(s) as attorney(s)-in-fact: 2 Representative(s) must sign and date this form on page 2, Part II. CAF No. PTIN Telephone No. Fax No. Check if new: Address CAF No. PTIN Telephone No. Fax No. Check if new: Address CAF No. PTIN Telephone No. Fax No. Check if new: Address to represent the taxpayer before the Internal Revenue Service for the following matters: 3 Matters Description of Matter (Income, Employment, Payroll, Excise, Estate, Gift, Whistleblower, Practitioner Discipline, PLR, FOIA, Civil Penalty, etc.) (see instructions for line 3) Tax Form Number (1040, 941, 720, etc.) (if applicable) Year(s) or Period(s) (if applicable) (see instructions for line 3) Telephone No. Fax No. Plan number (if applicable) Name and address Check if to be sent notices and communications Name and address Telephone No. Fax No. Check if to be sent notices and communications Name and address Telephone No. Fax No. 4 5 Specific use not recorded on Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on CAF, check this box. See the instructions for Line 4. Specific Uses Not Recorded on CAF .............. Acts authorized. Unless otherwise provided below, the representatives generally are authorized to receive and inspect confidential tax information and to perform any and all acts that I can perform with respect to the tax matters described on line 3, for example, the authority to sign any agreements, consents, or other documents. The representative(s), however, is (are) not authorized to receive or negotiate any amounts paid to the client in connection with this representation (including refunds by either electronic means or paper checks). Additionally, unless the appropriate box(es) below are checked, the representative(s) is (are) not authorized to execute a request for disclosure of tax returns or return information to a third party, substitute another representative or add additional representatives, or sign certain tax returns. Disclosure to third parties; Other acts authorized: (see instructions for more information) Exceptions. An unenrolled return preparer cannot sign any document for a taxpayer and may only represent taxpayers in limited situations. An enrolled actuary may only represent taxpayers to the extent provided in section 10.3(d) of Treasury Department Circular No. 230 (Circular 230). An enrolled retirement plan agent may only represent taxpayers to the extent provided in section 10.3(e) of Circular 230. A registered tax return preparer may only represent taxpayers to the extent provided in section 10.3(f) of Circular 230. See the line 5 instructions for restrictions on tax matters partners. In most cases, the student practitioner's (level k) authority is limited (for example, they may only practice under the supervision of another practitioner). List any specific deletions to the acts otherwise authorized in this power of attorney: Substitute or add representative(s); Signing a return; For Privacy Act and Paperwork Reduction Act Notice, see the instructions. Cat. No. 11980J American LegalNet, Inc. www.FormsWorkFlow.com Form 2848 (Rev. 3-2012) Form 2848 (Rev. 3-2012) Page 2 6 Retention/revocation of prior power(s) of attorney. The filing of this power of attorney automatically revokes all earlier power(s) of attorney on file with the Internal Revenue Service for the same matters and years or periods covered by this document. If you do not want to revoke a prior power of attorney, check here . . . . . . . . . . . . . . . . . . . . . . . . . . YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT. 7 Signature of taxpayer. If a tax matter concerns a year in which a joint return was filed, the husband and wife must each file a separate power of attorney even if the same representative(s) is (are) being appointed. If signed by a corporate officer, partner, guardian, tax matters partner, executor, receiver, administrator, or trustee on behalf of the taxpayer, I certify that I have the authority to execute this form on behalf of the taxpayer. IF NOT SIGNED AND DATED, THIS POWER OF ATTORNEY WILL BE RETURNED TO THE TAXPAYER. Signature Date Title (if applicable) Print Name PIN Number Print name of taxpayer from line 1 if other than individual Part II Declaration of Representative Under penalties of perjury, I declare that: · I am not currently under suspension or disbarment from practice before the Internal Revenue Service; · I am aware of regulations contained in Circular 230 (31 CFR, Part 10), as amended, concerning practice before the Internal Revenue Service; · I am authorized to represent the taxpayer identified in Part I for the matter(s) specified there; and · I am one of the following: a Attorney--a member in good standing of the bar of the highest court of the jurisdiction shown below. b Certified Public Accountant--duly qualified to practice as a certified public accountant in the jurisdiction shown below. c Enrolled Agent--enrolled as an agent under the requirements of Circular 230. d Officer--a bona fide officer of the taxpayer's organization. e Full-Time Employee--a full-time employee of the taxpayer. f Family Member--a member of the taxpayer's immediate family (for example, spouse, parent, child, grandparent, grandchild, step-parent, stepchild, brother, or sister). g Enrolled Actuary--enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to practice before the Internal Revenue Service is limited by section 10.3(d) of Circular 230). h Unenrolled Return Preparer--Your authority to practice before the Internal Revenue Service is limited. You must have been eligible to sign the return under examination and have signed the return. See Notice 2011-6 and Special rules for registered tax return preparers and unenrolled return pr
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