Montana Power of Attorney

Power of Attorney
Form POA
CLEAR FORM

Power of Attorney
Authorization to Disclose Information

MONTANA
POA
Rev 10 19

File online at https://tap.dor.mt.gov.

PART I
Caution! Taxpayers who would like to designate someone else to represent them before the Department of
Revenue must complete and submit this form. Spouses filing a joint return must each complete a separate form.
This form will not be honored for any purpose other than representation before the Department of Revenue. This form cannot be used
for any purpose other than designating representation before the Department of Revenue.
Notice: The department will accept a completed federal form 2848 as a power of attorney for representation before the Department
of Revenue if Part I, Section 3, Matters, includes the tax type, the tax form number and year(s) or period(s) that the representative is
authorized to discuss with the department. If you use the federal form, you must provide a copy to the Department of Revenue.
1.

Taxpayer Information. Taxpayers must sign and date this power of attorney form on page 2, section 6.
Taxpayer Name and Address

Taxpayer Identification Number(s)

Telephone Number
hereby appoints the following representative(s) as attorney(s)-in-fact:
2.

Representative(s)
Name and Address

PTIN
Telephone Number
FAX Number
Email Address

Name and Address

PTIN
Telephone Number
FAX Number
Email Address

to represent the taxpayer before the Montana Department of Revenue for the following matters:
3.

Tax Matters and Tax Years Covered by This Form
Your representative is authorized to inspect, receive and discuss confidential information for the tax types and tax years you
authorize by checking the appropriate boxes below and inserting the specific tax years. If tax matters and tax periods are not
specified, you are authorizing the representative access to all tax matters and years until you revoke such authorization.
Provide specific tax years	

Provide specific tax years

q Individual Income Tax

____________________ 	

q

Rental Vehicle Tax

____________________

q Corporation Income Tax	

____________________

q

Withholding Tax

____________________

q S Corporation

____________________

q

Lodging Facilities Tax

____________________

q Partnership

____________________

q

Combined Oil and Gas Tax	 ____________________

q

Other, please specify below	 ____________________
___________________________________________

4.	 Acts Authorized by This Form
	
Check the box that best describes what authorization you are delegating to your representative.
q	 Representation. Department employees can provide confidential information to the representative and discuss the information.
q	 Information sharing. Department employees can provide confidential information to the representative, but cannot discuss
the information.
q	 Decision-making authority. Department employees can provide confidential information to a representative, can discuss
the information and the representative can act on the taxpayer’s behalf for all purposes, including settlement and waiver of
appeal rights.
5.	 Revocation of Prior Power(s) of Attorney
	

q	 Check this box if you want all prior POAs revoked.
If you are a representative and want to withdraw an existing POA, write WITHDRAW across the top of the existing form. See
instructions on page 3.

6.	 Signature of taxpayer. If a tax matter concerns a year in which a joint return was filed, the spouses each file a separate power of
attorney even if the same representative(s) is(are) appointed. If signed by a corporate officer, partner, guardian, tax matters partner,
executor, receiver, administrator, fiduciary 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 not be in effect and the taxpayer will be notified.
_______________________________________ 	
	
Signature	

_____________________ 	
Date	

_______________________________________ 	
	
Print Name	
	

___________________________________ 	
Title (if applicable)
___________________________________
Print Taxpayer Name from Line 1 (if other
than individual)

PART II. Declaration of Representative
I declare that:

	 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 - licensed to practice law in 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 or Licensed Public Accountant, etc.
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, step-parent,
step-child, brother or sister).
g.	Other

Representative Signature. See instructions on page 4.
Designation Insert Letter from
Above (a-g)

Relationship to Taxpayer
(see instructions for Part II)

Signature

Filing this Form
► File Online on TransAction Portal at https://tap.dor.mt.gov.
► Fax to: (406) 444-7723.
Or, if you are already working with a department employee, fax your completed form to the number
provided by that person.
► Mail the completed form to:
Montana Department of Revenue
340 N. Last Chance Gulch
PO Box 5805
Helena, MT 59604-5805
2

Date

Instructions for Power of Attorney
Authorization to Disclose Tax Information

Part I

decedent’s death instead of a tax year.

Section 1. Taxpayer Information

If the tax matter and tax periods aren’t specified, you are
authorizing the representative access to all tax matters and
years until you revoke their authorization.

Individual. Enter your name, personal address, social
security number (SSN), telephone number, individual
taxpayer identification number (ITIN) and/or federal
employee identification number (FEIN) if applicable.
Do not use your representative’s address or post office
box for your own. If you file a tax return that includes
a sole proprietorship business (federal Schedule C)
and the matters for which you are authorizing the listed
representative(s) to represent you include your individual
and business tax matters, including employment tax
liabilities, enter both your SSN (or ITIN) and your business
FEIN as your taxpayer identification numbers. If the tax
matter concerns a joint return, a separate power of attorney
form is required for each spouse.

Section 4. Acts Authorized by This Form
If you are providing authorization to another individual,
check one of the three boxes depending on what
authorization you are providing to your representative.
A disclosure authorized by this form may take place by
telephone, letter, facsimile, email or a personal visit.
Note: If you check the “yes” box on the individual tax return
next to the question “Do you want to allow another person
(third party designee) to discuss this return with us?” you
authorize Department of Revenue employees to discuss
the tax return with the third party designee. They cannot
discuss any other issues, such as outstanding tax liabilities,
without a completed power of attorney form.

C Corporation, S corporations, partnership, limited
liability company or association. Enter the name,
business address, federal employer identification number
(FEIN), and telephone number. If this form is being
prepared for C corporations filing a combined tax return, a
list of subsidiaries is not required. This power of attorney
applies to all members of the combined tax return.

Section 5. Revocation of Prior Power(s) of Attorney
Taxpayer Revocation. Check the box if you want all prior
POAs revoked.
Revocation Withdraw by Representative. If you are a
representative and want to revoke an existing POA, write
REVOKE across the top of the form and submit the form as
indicated on page 4.

Trust. Enter the name, title, address of the trustee, the
name and FEIN of the trust and telephone number.
Estate. Enter the name of the decedent as well as the
name, title and address of the decedent’s personal
representative. Enter the estate’s FEIN for the taxpayer
identification number or, if the estate does not have an
FEIN, the decedent’s SSN (or ITIN).

Section 6. Signature
Individual. You must sign and date the form. If you file
a joint return, your spouse must execute his or her own
Montana power of attorney to designate a representative.
Corporation or association. An officer having authority to
bind the corporation must sign.

Section 2. Authorization of Representative
Enter your representative’s full legal name. Use the
identical full name on all submissions and correspondence.
Enter the representative’s telephone number, address or
post office box and e-mail address, if applicable.

Partnership. All partners must sign unless one partner is
authorized to act in the name of the partnership. A partner
is authorized to act in the name of the partnership if,
under Montana law, the partner has authority to bind the
partnership. If there is any doubt whether a partner has the
authority to bind the partnership, it is best that all partners
sign the form.

If a trust, estate, guardianship or conservatorship wants an
individual other than the personal representative, trustee or
other fiduciary to handle tax matters before the Department
of Revenue, the personal representative, trustee or other
fiduciary must complete this form and designate the
other individual with the power of attorney. Otherwise,
the personal representative, trustee or other fiduciary has
the requisite authority to handle tax matters before the
Department of Revenue and need not complete this form.

Limited Liability Company (LLC). If the LLC is membermanaged, all members must sign, unless one member
is authorized to act in the name of the LLC. If the LLC is
manager-managed, the manager must sign.
Estate, trust or other fiduciary. As discussed in Section 2,
if a trust, estate, guardianship or conservatorship wants an
individual other than the personal representative, trustee or
other fiduciary to handle tax matters before the Department
of Revenue, the personal representative, trustee or other
fiduciary must complete this form and designate the other
individual with the power of attorney. Thus, the personal
representative of an estate must sign. The trustee of a trust
must sign. If a guardian or conservator has been appointed

Section 3. Tax Matters and Tax Years Covered by the Form
Indicate, by checking the appropriate boxes, what tax types
you are authorizing your representative to inspect, receive
and discuss with the Department of Revenue.
You may list any tax years or periods that have already
ended as of the date you sign the form.
If the matter relates to estate tax, enter the date of the
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for a taxpayer, the guardian or conservator must sign. In
all cases, the fiduciary must include the representative
capacity in which the fiduciary is signing, such as “John
Doe, guardian of Jane Roe.”

f.	 Family Member – Enter the relationship to the taxpayer
(for example, spouse, parent, child, brother, sister,
etc.).
g.	 Other – Identify the type of representative and enter a
brief description of the representative’s relationship to
the taxpayer.

Part II. Declaration of Representative
The representative(s) you name may sign and date
the Declaration of Representative. Enter the applicable
designation (items a-g) under which the representative
is authorized to handle matters before the Department of
Revenue. In addition, provide a brief description of the
representative’s relationship to the taxpayer:

Filing this Form
File Online on TransAction Portal at
https://tap.dor.mt.gov.
Fax the completed form to (406) 444-7723. Or, if you are
already working with a department employee, fax your
completed form to the number provided by that person.

a.	 Attorney – Enter the two-letter abbreviation for the state
in which the attorney is admitted to practice.

Mail the completed form to:
Montana Department of Revenue
340 N. Last Chance Gulch
PO Box 5805
Helena, MT 59604-5805

b.	 Certified Public Accountant – Enter the two-letter
abbreviation for the state in which the CPA is licensed
to practice.
c.	 Enrolled Agent, Licensed Public Accountant, etc.
d.	 Officer – Enter the title of the officer (for example,
President, Vice President, Secretary, etc.).

Questions? Please call us at (406) 444-6900.

e.	 Full-Time Employee – Enter title or position (for
example, Comptroller, Accountant, etc.)

File online at https://tap.dor.mt.gov.

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