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Pennsylvania Free Printable Power of Attorney and Declaration of Representative (REV-677) for 2024 Pennsylvania Power of Attorney and Declaration of Representative

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Power of Attorney and Declaration of Representative
Power of Attorney and Declaration of Representative (REV-677)

REV-677 LE (05-14) POWER OF ATTORNEY AND DECLARATION OF REPRESENTATIVE GENERAL INSTRUCTIONS: This form provides limited authority for department representatives to speak about confidential tax matters with designated third parties. Such authority is limited to the tax period, tax type and the specific issue/purpose identified herein. While tax practitioners are encouraged to maintain appropriate declarations of authority to handle clients' tax matters within their own records, tax practitioners should not submit unsolicited REV-677 forms to the department en masse or as a matter of routine. Such forms will be disregarded. A REV-677 form should only be submitted to an individual within the department upon an agent's request for such authorization. If a department representative has requested a REV-677 form to authorize discussion of confidential tax matters with a third party, please return the form to the department representative as requested. PART I Power of Attorney NOTE: An organization, firm or partnership may not be designated as a taxpayer’s representative. The following taxpayer Identifying Number START Taxpayer Name ➜ Address State City ZIP hereby appoints Appointee Name(s) Telephone Number Address City Preparer Tax Identification Number (PTIN) State ZIP as attorney-in-fact to represent the taxpayer before any office of the PA Department of Revenue for the following tax matter(s). Specify the type(s) of tax, tax year(s) or period(s), tax return/report at issue and the specific purpose for which authorization to discuss confidential tax matters with a third-party is sought. Type(s) of tax Tax Year(s) or Period(s) Tax Return/Form Purpose for Authorization The attorney-in-fact is authorized, subject to revocation, to receive confidential information and perform any and all acts the principal can perform with respect to the above-specified tax matters, excluding the power to receive refund checks and the power to sign the return, unless specifically granted below. Initial here to grant the power to receive – but not to endorse or cash – refund checks for the above-referenced tax matters to the appointee named above. Only if this form is being submitted to the department in response to an audit, provide an address below to which copies may be sent of notices and other written communications addressed to the taxpayer in proceedings involving the above-specified tax matters. Appointee Name(s) Telephone Number Address City State ZIP This power of attorney revokes all earlier powers of attorney and tax information authorizations on file with the PA Department of Revenue for the same matters and years or periods covered by this power of attorney, except the following: Granter Name Date Address City MM/DD/YYYY Refer to attached copies of earlier powers and authorizations State ZIP Signature of or for taxpayer If signed by a corporate officer, partner or fiduciary on behalf of the taxpayer, such party certifies he/she has the authority to execute this power of attorney on behalf of the taxpayer. Signature PLEASE SIGN AFTER PRINTING. Reset Entire Form PRINT FORM Title Date RETURN TO TOP MM/DD/YYYY NEXT PAGE If the power of attorney is granted to a person other than an attorney, certified public accountant or enrolled agent, the taxpayer's signature must be witnessed or notarized below. The person signing as or for the taxpayer (check and complete one): is known to and signed in the presence of the two disinterested witnesses whose signatures appear here: PLEASE SIGN AFTER PRINTING. (Signature of Witness) (Date) MM/DD/YYYY PLEASE SIGN AFTER PRINTING. (Signature of Witness) (Date) MM/DD/YYYY appeared this day before a notary public and acknowledged this power of attorney as a voluntary act and deed. PLEASE SIGN AFTER PRINTING. Witness (Signature of Notary) NOTARIAL SEAL (Date) MM/DD/YYYY PART II Declaration of Representative I declare that I am one of the following: 1 a member in good standing of the bar of the highest court of the jurisdiction indicated below; 2 duly qualified to practice as a certified public accountant in the jurisdiction indicated below; 3 a bona fide officer of the taxpayer organization; 4 a full-time employee of the taxpayer; 5 a member of the taxpayer’s immediate family (spouse, parent, child, brother or sister); 6 a fiduciary for the taxpayer; and/or 7 Other (specify) ; and that I am authorized to represent the taxpayer identified in Part I for the tax matters specified therein. DESIGNATION (INSERT APPROPRIATE NUMBER FROM ABOVE LIST) JURISDICTION (STATE, ETC.) SIGNATURE DATE MM/DD/YYYY PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. PLEASE SIGN AFTER PRINTING. Reset Entire Form PRINT FORM RETURN TO TOP RETURN TO PAGE ONE
Extracted from PDF file 2023-pennsylvania-form-rev-677.pdf, last modified August 2012

More about the Pennsylvania Form REV-677 Other TY 2023

We last updated the Power of Attorney and Declaration of Representative in February 2024, so this is the latest version of Form REV-677, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form REV-677 directly from TaxFormFinder. You can print other Pennsylvania tax forms here.


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Other Pennsylvania Other Forms:

TaxFormFinder has an additional 174 Pennsylvania income tax forms that you may need, plus all federal income tax forms.

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Download all PA tax forms View all 175 Pennsylvania Income Tax Forms


Form Sources:

Pennsylvania usually releases forms for the current tax year between January and April. We last updated Pennsylvania Form REV-677 from the Department of Revenue in February 2024.

Show Sources >

Historical Past-Year Versions of Pennsylvania Form REV-677

We have a total of three past-year versions of Form REV-677 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form REV-677

Power of Attorney and Declaration of Representative (REV-677)

2022 Form REV-677

Power of Attorney and Declaration of Representative (REV-677)

2021 Form REV-677

Power of Attorney and Declaration of Representative (REV-677)


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