 | Indiana Tax Power of Attorney Form |
The Indiana tax power of attorney form is a legal document that provides notarized permission for an attorney, CPA or individual of the Principal’s selection, to complete tax information and/or represent the Principal before tax agencies. This document will require that all fields be completed. This document may be revoked at the discretion of the Principal.
How to Write
Step 1 – Taxpayer(s) Information – Complete the following:
- Taxpayer(s) Name(s)
- Doing Business As (DBA) Name(s) (if applicable)
- Address ( is this a new address?)
- City
- State
- Zip Code
- Telephone Number
Step 2 – Identification Numbers – Enter:
- Enter the Indiana Taxpayer ID Number (10 digits long)into the boxes
- Social Security Number
- OR
- Employer Identification Number
- Spouses Social Security Number
Step 3 – Appointment of Agent – Provide the following:
- Individual Representative Name
- Address
- City
- State
- Zip Code
- Telephone Number
- Email Address
- AND
- Additional Individual Representative’s Name
- Address
- City
- State
- Zip Code
- Telephone Number
- Email Address
The Principal may name up to three Agents to serve consecutively if needed
Step 4 – Firm/Vendor Information – Enter:
- Firm/Vendor Name (if applicable)
- Address
- City
- State
- Zip Code
- Telephone Number
- Email Address
If the representative(s) are with a firm, provide the following:
- Representative(s) Names
- Telephone Number(s) (respective)
- Email Addresses (respective)
Step 5 – General Authorization –
- Read the paragraph
- If the Principal agrees, check the box preceding the statement
Step 6 – Tax Type(s)
This is not applicable if the box is checked in question 5)
- Enter the type of tax into the lines provided
- Enter the years or periods (check the appropriate box)
- The Principal must read and agree to the acknowledgement statements
Step 7 – Authorizing Signature –
- Principal’s Signature
- Printed Name
- Telephone Number
- Date of signature
- Title
- Email Address
Look over the completed form to ensure all fields are completed. Failure to complete all of the fields will result in the form being returned to the sender
